Archived: Green Gables Care Home

Updated 12 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 and 16 June 2015 and was unannounced. The inspection team consisted of one inspector, a specialist professional advisor, whose specialism was in the care of older people and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at notifications we had received from the registered provider and registered manager. Notifications are information we receive from the service when significant events happen, like a death or a serious injury.

During our inspection we spoke with the provider, the registered manager, six staff, two local authority case managers and one person’s relative. We visited people’s bedrooms, with their permission; we looked at care records and associated risk assessments for four people. We looked at management records including three staff recruitment, training and support records, health and safety checks for the building, and staff meeting minutes. We observed the support provided to people.

Updated 12 August 2015

This inspection was carried out on 15 and 16 July 2015 and was unannounced.

We last inspected Green Gables Care Home in August 2014. At that time we found that the registered provider was not compliant with all the regulations and took enforcement action in relation to people’s care and welfare. At this inspection we looked to see what action the provider had taken to become compliant. We that the provider had completed the actions we required them to take.

Green Gables Care Home provides accommodation for up to 18 older people and people living with dementia. The service is a converted domestic property. Accommodation is arranged over three floors. Stair lifts are available to assist people to get to the upper floors. The service has 16 single and one double bedroom, which people can choose to share. There were 17 people living at the service at the time of our inspection.

A registered manager was working at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager was not clear about their responsibilities under Deprivation of Liberty Safeguards (DoLS). Arrangements were not in place to check if people were at risk of being deprived of their liberty and apply for DoLS authorisations. Systems were in operation to obtain consent from people, however, processes to assess people’s capacity to make decisions and to make decisions in people’s best interests were not in place. Staff assumed people had capacity and supported them to make decisions and choices.

The registered manager provided strong leadership to the staff and had oversight, with the provider, of all areas of the service. Staff were motivated and felt supported by the registered manager and provider. The staff team had a clear vision of the aims of the service and made sure these were delivered. Staff told us the provider and registered manager were approachable and they were confident to raise any concerns they had with them. Processes were in place to learn from incidents and accidents and continually improve the service.

There were enough staff, who knew people well, to meet peoples’ needs at all times. The needs of people had been considered when deciding how many staff were required on each shift. Staff had the time and skills to provide the care and support people needed. Staff were clear about their roles and responsibilities and were accountable for their actions.

Staff recruitment systems were in place and information about staff had been obtained to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff were supported to provide good quality care and support. The registered manager had a training plan in place to keep staff skills and knowledge up to date. Most staff held recognised qualifications in care. Staff met regularly with the registered manager to discuss their role and practice and any concerns they had.

Staff knew the possible signs of abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team. Plans were in place and staff knew how to keep people safe in an emergency.

People’s needs had been assessed to identify the care they required. Care and support was planned and reviewed to keep people safe and support them to be as independent as possible. People and their relatives were involved in planning their care.

People were supported to participate in hobbies and activities they enjoyed, at the service and in their local community, such as bingo. Possible risks to people had been identified and were managed to keep people as safe as possible.

People got the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care and treatment they needed to keep them as safe and well as possible.

People were involved in choosing their own food and drinks and were supported to have a balanced diet. Choices were offered to people in ways they understood. Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained.

People and their relatives were confident to raise concerns and complaints about the service. These were logged and investigated and people had received a satisfactory response.

The registered manager completed regular checks of the quality of the service provided. When shortfalls were found action was taken quickly to address these and prevent them from occurring again. People, their relatives and staff were asked about their experiences of the care. These were used to improve and develop the service.

The environment was safe, clean and homely. Maintenance and refurbishment plans were in place and areas of the home had recently been redecorated and refurbished.

Accurate records were kept about the care and support people received and about the day to day running of the service and provided staff with the information they needed to provide safe and consistent care and support to people.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.