Archived: Greengates

Greengates provides accommodation with personal care for up to seven people with learning disabilities. Some people may also have physical or sensory disabilities.

The service had a registered manager in post. 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.

People lived in a clean and homely environment, although in many areas the decorations were old and showing signs of wear. There were plans in place to redecorate many areas in the near future. Equipment had been regularly maintained to ensure people and staff were protected from risks to their health and safety.

Staff described how they supported people to participate in a range of activities of their choice, both at home and in the local community. However, there were very few daily records completed by staff to provide evidence of the things people did each day, or the support people received from staff to meet their planned care needs. Staff also described how they supported people to keep in contact with families and friends.

There were sufficient staff employed to meet people’s needs safely. Staff rotas had been drawn up to ensure each person received support at the right times to meet their individual needs. Safe recruitment procedures were followed to minimise the risk of harm or abuse to people who use the service.

Medicines were stored and administered safely by competent staff. Each person held their own medicines in locked cupboards in their rooms and received individual support from the staff team to manage their medicines safely.

The provider ensured each person’s savings, income, cash and belongings were safe and people were protected from the risk of financial abuse.

Staff were trained, supervised and supported and had the skills and competence to meet each person’s needs effectively. Staff received training and regular updates on all mandatory health and safety related topics, as well as topics relevant to the needs of each person living in the home. Staff were given opportunity to gain relevant qualifications in health and social care.

People were involved in all aspects of meal planning and preparation. Staff were aware of each person’s individual dietary needs and provided people with a choice of varied and healthy meals.

People were supported to maintain good health and wellbeing by the staff team and a range of local NHS and social care professionals. Specialist medical advice and support was obtained when necessary. Care and support files contained detailed information on all aspects of each person’s health needs and contained evidence of medical appointments and treatment by a range of health and social care professionals. Care records had been regularly reviewed and included risk assessments and guidelines for staff on how to support people to remain safe and healthy.

People were supported by a team of staff who were kind, cheerful and patient. During our inspection we saw staff supporting and encouraging people to gain as much independence as possible. Staff understood how much satisfaction each person gained from doing things for themselves rather than the staff carrying out tasks for the person. A person who lived in the home told us with pride “I support myself. I do my own personal care – the lot!”

The service was well managed. The provider and manager had systems in place to regularly check all daily routines to ensure people received a safe service that met their needs.

We saw that people were invited to return to their rooms to have their medication privately; their decision was respected if they declined and the manager explained that people were given their medication in the lounge if they preferred.

We looked at the recruitment records for three staff members. Two of these showed that appropriate checks had been completed to ensure they were suitable to work with vulnerable people; however one file did not contain evidence of a CRB check or references. The manager assured us that the Somerset County Council HR department would not employ someone without the necessary checks being done.

We saw evidence that the network manager conducted unannounced visits to monitor the quality of service provision. During these visits, the network manager conducted observations and discussions and monitored complaints and incident reports.

People's needs were assessed and plans drawn up to meet their needs. We found that the provider had carried out thorough risk assessments of how people would be supported in the event of needing to go into hospital.

We found that all staff had been trained in safeguarding and the staff we spoke were able to tell us what they would do if abuse was suspected, witnessed or alleged. One staff member told us "if I thought someone was being mistreated I would do something about it".

The provider ensured there was sufficient staffing to meet people's needs and made additional staff available for activities when needed. We found that staff were appropriately skilled and experienced and were supervised. One staff member told us "my supervision is good, I can talk about how to do my job better".

We found the provider had systems in place to seek the views of people using the service and their family members. We saw one family member had commented that the catch up morning held in July 2012 had been productive. The provider learnt from investigations carried out and made changes as a result.