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Archived: Greenhills Good


Inspection carried out on 25 March 2016

During a routine inspection

The inspection took place on 25 March 2016 and was unannounced. Greenhill’s provides care and accommodation for up to nine people with learning disabilities. On the day we visited, seven people were living in the service. Emcompass (Dorset) owns this service and has other services in the Dorset area.

The service had a registered manager. 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. We met and spoke to all seven people during our visit. People were not able to fully verbalise their views and used other methods of communication, for example pictures and sign language. We therefore spent time observing people.

People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff had completed appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals, such as speech and language therapists.

People’s records were personalised to meet people’s individual needs. Staff understood people’s needs and responded when needed. People were not able to be fully involved with their care plans, therefore others including family members supported staff to complete and review the care plans. People’s preferences were sought and respected.

People’s risks were recorded, monitored and managed well to ensure they stayed safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. People had support preparing some meals and drinks.

Staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by the staff. They knew how to make sure people, who did not have the mental capacity to make decisions for themselves, had their legal rights protected and worked with others in their best interest. People’s safety and liberty were promoted.

Staff had completed safeguarding training and had a good understanding of what constituted abuse and how to report any concerns. Staff described what action they would take to protect people against harm and were confident any incidents or allegations would be acted upon.

Staff described the registered manager as being very approachable and supportive. Staff spoke positively about their jobs and their roles.

People who required it had additional staffing. Staff confirmed there were sufficient staff to meet these requirements. Staff had completed training and had the right skills and knowledge to meet people’s needs. New staff received a comprehensive induction programme when they started working for Encompass. People were protected by safe recruitment procedures.

All significant events and incidents were documented and analysed. Evaluation of incidents was used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback to assess the quality of the service provided was sought from people living in the home, professionals and staff.

Inspection carried out on 22 August 2013

During an inspection in response to concerns

The people who lived at Greenhills had complex needs and were not able to tell us about their experiences. We used a number of different methods in order to understand how they were experiencing their care, which included observations and discussions with staff. We saw that people were relaxed in the company of the staff who supported them, and that the staff were respectful and warm in their interactions.

People�s care plans and risk assessments were regularly reviewed and updated. People were supported to live an active and fulfilling life at Greenhills and also in their community.

Staff understood how to respond to safeguarding concerns and were aware of the types of abuse that can occur in a residential setting.

People were cared for by staff who were supported and trained to deliver care safely and to a suitable standard.

The records kept by the home were current and accurate.

Inspection carried out on 4 March 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people who used the service, because they had complex needs which meant they were not able to tell us their experiences. We relied on our observations and discussions with staff to understand the experience of care for the people living in Greenhills.

People who used the service were supported to live an active and fulfilling life at Greenhills and also in the community.

People�s care plans and risk assessments were not being regularly reviewed or updated and therefore did not reflect their current care needs and the support they required to minimise risks to their health and safety and welfare.

People were cared for by staff who were not effectively supported to deliver care safely and to a suitable standard. Staff did not receive appropriate supervision and were not supported to improve the quality of care and the support people received.

There was an effective system in place to monitor and check the quality of care and service that people who lived at Greenhills were receiving.

Inspection carried out on 27 June 2012

During a routine inspection

People who lived at Greenhills had profound learning or physical disabilities and therefore were not able to tell us about their experiences. To help us understand people�s experiences we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allowed us to spend time watching what was going on in the service and helped us to record how people spent their time, the type of support they received and whether they had positive experiences.

We saw staff interacted well with people living at the home and saw no negative interactions. We saw staff treated people with respect. People appeared calm, relaxed and happy in the company of staff. Staff were attentive and noticed for example if they looked uncomfortable, wanted to go out or wanted something to eat or drink.

Observation and records showed that people who lived at the home were able to make choices about the care and treatment available to them.

The home had been adapted for people with physical disabilities. Corridors and communal areas were spacious to accommodate people who used wheelchairs or mobility aids. Assisted baths and wet rooms were available. Ceiling mounted hoists were available for moving people from their beds to their chair. The home had a sensory room with sound and lighting equipment. There was also a comfortable chair where people were able to relax and watch a DVD.

People had access to a variety of activities to suit their needs. Three people who lived at the home were taken to a social education centre where they had access to a range of activities, work experience and leisure activities. Examples included pottery, computer courses, and music sessions.

People who lived at the home were supported to access to NHS health services. Examples included physiotherapist, speech and language therapist and GPs. Specialist health care professionals were also contacted. Examples included gynaecologist, epilepsy specialist nurse, community nurses, and neurologist.

All the people we saw appeared relaxed around the staff. Mutual affection was shared and there was humour between people and the staff. Some people liked to hug staff which staff supported with appropriate responses. Staff were kind and respectful and gave people time when communicating and mobilising.

Staff were structured and clear when people demonstrated inappropriate behaviours. These actions and behaviours were clearly shown in care records.

During our period of observation it was clear that people were able to express if they were unhappy about anything or wanted staff attention. We saw that staff understood the signs and communication that people used and were receptive to people�s needs.