Background to this inspection
Updated
19 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one adult social care inspector.
Service and service type:
The service is a 'care home'. People in care homes receive accommodation and personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at on this inspection. The care service had been developed and designed in line with the values that underpinned Registering the Right Support and other best practice guidance. These values included choice, promotion of independence and inclusion. People with learning disabilities and autism using the service could live as ordinary a life as any citizen.
The service had a new manager who was in the process of registering with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This was a planned inspection and was unannounced.
What we did:
Before the inspection, we reviewed the latest Provider Information Return (PIR) from the service. This is a form that asks the provider to give some key information about the service, what the service does and improvements they plan to make. We reviewed this information and in addition looked at notifications which the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive.
We spoke with seven people, the regional manager, the manager and deputy manager and two staff. We spoke with two health and social care professionals on the telephone. We inspected the premises, observed staff care practices and people's interactions with staff and each other. This helped us understand people's experiences. We reviewed a range of records including three care plans, staffing rotas, training records and other information about the management of the service. This included accidents and incidents information, three Medicine Administration Records (MAR), compliments and complaints, equipment checks and quality assurance audits.
Updated
19 June 2019
About the service:
3, The Green is an eight bedded care home for people with learning disabilities. There were eight people living at the home when we inspected. These people were living with mild to moderate learning disabilities and autism.
People’s experience of using this service:
People’s experiences of using this service has deteriorated since their last inspection in 2016 which was rated as ‘Good’. The overall rating for this service now is ‘Requires improvement’.
This was because we found breaches with practices to do with the safe administration of medicines and good governance systems. This meant that some aspects of the service were not safe and governance systems were not always effective.
The provider had not consistently reviewed and assessed risks to people’s care to ensure they were doing everything possible to reduce and to manage those risks.
The premises needed some refurbishment and redecoration in the communal areas of the home.
People said they felt safe with the support they received.
The provider had robust recruitment procedures to ensure only suitable staff were employed. There were enough staff to support people safely.
The premises were clean and free from infection.
Staff received effective training, support for staff with supervision needed to be improved.
People were supported to live healthier lives and to access healthcare services appropriately.
People were able to provide consent for their care and where necessary best interest meetings were held. They were able to express their views and be actively involved in their care.
People told us they were cared for by kind and compassionate staff. Their privacy and dignity was respected by staff.
People enjoyed a wide range of activities inside the home and outside in the community.
People knew how to complain and had confidence the management team would respond appropriately to any issues they raised.
The provider’s auditing or governance systems had not identified some of the concerns we found or had not acted promptly to resolve concerns they had found.
We found the service met the characteristics of a "requires improvement" rating overall.
Rating at last inspection: At our last inspection we rated the service as Good (23 November 2016).
Why we inspected: This inspection was a scheduled inspection based on the previous rating.
Enforcement:
At this inspection we identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 regarding the safe management of medicines and effective governance systems.
Follow up: The provider has a legal responsibility to send us a written report of the action they are going to take meet the breach of regulations we identified in this report, which we will follow up with them.
In the interim, we will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in keeping with our inspection methodology for services rated Requires Improvement overall.