The Green

This unannounced inspection took place on 15 January 2019. At this inspection we found the service was Good overall.

Why the service is rated Good overall:

There is a registered manager running the service. 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’s safety was upheld by staff who had been trained in safeguarding vulnerable adults and health and safety policies and procedures. Staff clearly understood how to protect people and who to alert if they had any concerns. General building and operational risks and risks to individuals were identified, assessed and appropriate action was taken to eradicate or reduce them.

There were enough staff on duty at all times to meet people’s diverse, individual needs safely and effectively. Whilst there had been some turnover of staff the service had a consistent staff team. The provider had robust recruitment procedures. People were given their medicines safely, at the right times and in the right amounts by trained and competent staff.

The service remained effective. Staff were well-trained and able to meet people’s health and well-being needs. They were able to respond effectively to people’s current and changing needs. The service sought advice from and worked with health and other professionals to ensure they met people’s needs.

People were encouraged to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practise.

The service continued to be caring and responsive. The committed, attentive and knowledgeable staff team provided care with kindness and respect. Individualised care planning ensured people’s equality and diversity was fully respected. People were provided with a range of activities, according to their needs, abilities, health and preferences. Care plans were reviewed and updated and management maintained an oversight. Care plans contained up to date information and records demonstrated that risk assessments were usually reviewed within stated timescales.

The registered manager was well regarded and respected. The quality of care the service provided continued to be reviewed and improved, as necessary.

At the time of the inspection there was 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.

The provider completed recruitment checks on potential members of staff. Maintenance of the property was carried out promptly according to risk. Checks on fire alarms and emergency lighting had been completed in accordance with the provider’s policy and manufacturer’s instructions.

There was a system to ensure people received their medicines safely and appropriately. The quality of the service was monitored by the registered manager through gaining regular feedback from people and their representatives and the auditing of the service. The provider had plans in place to deal with emergencies that may arise.

People who use the service were able to give their views about the service. Relatives and commissioners told us they were happy with the service they received from The Green and felt that people were safe using the service. The service had systems in place to manage risks to both people and staff. Staff had good awareness of how to keep people safe by reporting concerns promptly through procedures they understood well. Information and guidance was available for them to use if they had any concerns.

People were treated with kindness, dignity and respect. They were involved in decisions about their care as far as they were able and relatives/representatives told us they had been asked for their views on the service. People’s care and support needs were reviewed regularly. The registered manager ensured that up to date information was communicated promptly to staff through regular meetings.

Staff felt very well supported by the registered manager and said they were listened to if they raised concerns and action was taken without delay wherever possible and necessary. We found an open culture in the service and staff were comfortable to approach the registered manager for advice and guidance.

Staff understood their responsibilities in relation to gaining consent before providing support and care. People’s right to make decisions was protected. New staff received an induction and training in core topics.

We observed the staff with people and saw they were kind and caring and used language that people could understand. We saw them guide people so that were independent with daily tasks and used caring language to help people identify risks so that they could keep them safe. The staff told us people they cared for were "brilliant" and that they enjoyed working there, they told us they liked the manager and that they made good decisions.

We saw the care plans for people which gave guidance for staff so they could care for people safely and show consideration for their wishes, we saw assessments that promoted the safety and independence of people with regard to; personal care, road safety, stranger danger and financial awareness. We saw that these assessments were reviewed regularly and that people were involved with planning their care and were enabled to make their own decisions.

Another person using the service told us "I get on very well with the staff here, they're very good to me and I feel like I make all the decisions."

The RM explained the historical connection with people from the Jewish faith and talked about the expectation being that everyone would abide by "Observance, but there is provision for exception."

Care plans for people using the service each contained a person centred plan and objectives for the coming year together with risk assessments and action to be taken where concern had been identified.

One member of staff told us about a recent incident which demonstrated that the service took the requirements of the safeguarding policy very seriously.

We were told that "All staff recruitment includes a service user. It's their home, after all." We were shown staff rotas for the calendar year 2012 which demonstrated that the staffing available changed dependant upon the number of people in residence and their needs.

We were shown an analysis of incidents during 2012 and changes which had been made as a consequence. We also saw how the views of people using the service, their relatives and staff were sought, through meetings and questionnaires and how these were acted upon.