Greenfields

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence, and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Based on our inspection of key areas safe and well-led, we found:

Right Support:

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff were able to respond to people’s individual needs and preferences. Staff understood how to protect people from abuse. The service worked with other agencies and healthcare professionals to ensure the care provided met people's needs.

Right Culture:

People received good quality care and support because trained staff could meet their needs and wishes. We observed staff knew and understood people well and were responsive. On the day of inspection it was evident staff knew people well. A relative we spoke with at the service when we asked if people were safe told us, “Definitely, they are outstanding, wonderful people, so friendly and helpful. Nothing is too much for them.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was Good (published 20 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection completed in August 2015, the service was rated Good.

This unannounced inspection took place on 13 and 22 September 2017, where we found the service continued to be good in all domains.

Why the service was rated as good.

People looked calm and relaxed in the environment. Staff understood people’s needs and complex ways of communicating. There was a warm and friendly atmosphere and staff interacted with people throughout the day. People were supported to enagage in activities which they enjoyed and were meaningful to them.

Staff were well trained and supported to do their job effectively. The management team valued staffs’ experience and ideas and encouraged on-going learning through national diplomas in care as well as updates on key areas of health and safety. Medicines were stored, adminsterered and recorded safely.

People benefitted from an environment which was clean, homely and had the right equipment to keep them safe and well.

The staff provided care and support which was responsive to people’s individual needs. This included ensuring their emotional and social needs were being met. People indicated they enjoyed a variety of activities and outings which helped them access the local community.

People’s family knew how to make any concerns known and were confident their views would be listened to and actioned. Visitors and family were made welcome and believed their views and suggestions were valued. One relative said “I feel you can talk to all the staff about any concerns you have.”

The service was well led by a registered manager and provider who shared the same values and encouraged a culture of openness and transparency. Staff felt they worked well as a team and all worked within an ethos of encouraging people to be as independent as possible within a homey and loving environment.

We spoke with six staff and with one relative of a person who was staying at the service for respite care. We looked at the care files and daily records for three people and talked to the new manager of the home and service manager about what systems were in place to support staff in their learning.

We saw staff were highly skilled at understanding the needs of people with complex physical and learning disabilities. Staff had built up their expertise by working with individuals, their carers and support services to understand the different ways people may communicate their needs. This is crucial to ensuring people's rights, wishes and needs were met.

People who were able to give their view of receiving care at Greenfields were complimentary. One person told us ''It's like a five star hotel here, I feel very safe and well looked after.'' Another person said ''the staff know me and what I am like, they know what I mean when I talk to them.''

Care and support was well planned and delivered by a staff team who were trained and supported to do their job effectively.

Systems were in place to review the quality of care provided taking into account the views of people and staff.

We saw care and support was delivered in a kind and respectful way. People used a variety of ways to express their needs through hand gestures, facial expressions and vocal sounds. Their care workers knew them very well. For example, we saw each person smile when their care workers talked with them. One person told us they 'like it' at Greenfields. A relative told us their relation was 'very settled and seems to enjoy going there'.

We looked at some key documents including care plans, risk assessments and quality assurance records. This helped us to make a judgement about how well the home was being run.

Care was being planned and people were involved in making decisions about their care. This included any treatment they needed and activities of daily living, such as personal care. We saw people enjoyed things they liked to do by the expressions they made, based on the information we read about them. We were told the manager regularly put additional care workers on duty to take people out and about in the local community and organised activities within the home.

Overall, we found Greenfields was compliant with all of the standards we looked at.