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Inspection carried out on 8 April 2019

During a routine inspection

About the service:

Heartly Green provides a 30 bedded residential unit on the ground floor for older people who require support with personal care. The registered provider (Community Integrated Care) has a service level agreement to also supply care staff on the second floor, which is an intermediate care (IMC) unit ran by Salford Royal NHS Foundation Trust. The IMC unit is managed by the NHS, who also supply the nursing and therapy staff. Community Integrated Care hold the responsibility to manage the care staff on both floors. There were 26 people living in the residential unit at the time of the inspection.

People’s experience of using this service:

We saw the service had received many compliments from people who used the service and their relatives. One compliment said, “The staff are constantly around, walking, talking, and caring for the residents. They laugh and joke with them, even with the ones who cannot always understand or respond, but who get such a thrill from being included and not ignored.”

People’s outcomes were consistently good, and people’s feedback confirmed this. One person told us, “I love it here.”

Staff worked with other agencies to provide consistent, effective and timely care. We saw that the staff and management worked with community organisations.

We observed positive interactions between staff and people. Staff had good relationships with people and were seen to be caring and respectful towards people and their wishes.

People were supported to express their views. People we spoke with told us they had choices and were involved in making day to day decisions.

The provider and registered manager followed governance systems which provided effective oversight and monitoring of the service.

The premises were homely and well maintained. We observed a relaxed atmosphere throughout the home. We have made a recommendation about the gardens being more accessible for people.

The service continued to meet the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection:

At the last inspection the service was rated Good (report published 21 November 2016). The overall rating has remained the same.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner. We will follow up on our recommendations at the next scheduled inspection.

Inspection carried out on 25 October 2016

During a routine inspection

The inspection visit took place on the 25 October 2016 and was unannounced which meant the staff and provider did not know we were visiting.

Heartly Green is situated in Irlam and provides an intermediate care unit on the first floor which is registered to Salford Royal hospital and a 30 bedded residential unit on the ground floor of the home. The registered provider supply care staff for both units but the first floor intermediate care unit is managed and nurses and therapists are provided by the NHS.

The service was registered by the Care Quality Commission to the new provider in February 2015 and it has not been inspected since that time.

There was a registered manager in post who joined the inspection visit on the day for feedback as they were on annual leave. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The inspection was facilitated by the experienced deputy manager who had worked at the service for 11 years.

There were policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know when an application should be made and how to submit one. The registered manager also ensured that capacity assessments were completed and ‘best interest’ decisions were made in line with the MCA code of practice. This meant people were safeguarded.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

All people told us they felt safe at the service. Staff were aware of procedures to follow if they observed any concerns. The staff team were supportive of the registered manager and each other and feedback from visiting professionals on the day were very positive about the service at Heartly Green.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. Medicines were stored in a safe manner. We witnessed staff administering medication in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace.

There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. The food had recently been changed to offer a ready prepared meals called “Apetito” which had been implemented in August 2016. Feedback about this change was mixed but we saw the kitchen staff immediately responded and acted on any complaints or issues. We spoke with kitchen staff who had a good awareness of people’s dietary needs and staff also knew people’s food preferences well.

The service told us it was changing its care plan approach to become more person centred and based on the views of the person. We saw people’s new care plans were personalised and had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved, when they were able, the person. We saw people being given choices and encouraged to take part in all aspects of day to day life at the service.

We observed that all staff and the deputy manager were very caring in their interactions with people at the service. People clearly felt very comfortable with all staff members and there was a lovely warm and caring atmosphere in the service and people were very relaxed. We saw people being treated with dignity and respect and relatives and people told us that staff were kind and professional.

The service did obtain feedback