We carried out a review of the data available to us about Green Gables on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Green Gables, you can give feedback on this service.
Green Gables is a residential care home providing accommodation and personal care to 17 people aged 65 and over at the time of the inspection. The service can support up to 18 people. The premises were built over two floors, with all the communal areas located on the ground floor.
People’s experience of using this service and what we found
People were supported receive their medicines. However, where people were prescribed medicated creams, staff did not always record they had given these on the medicine administration record and we have made a recommendation about this.
Procedures were in place to help protect people from the risk of abuse and staff understood their responsibility with regard to safeguarding people. Risk assessments were in place which provided guidance about how to support people in a safe way. There were enough staff working at the service to meet people’s needs and robust staff recruitment practices were in place. The service sought to learn lessons when accidents and incidents occurred. Steps had been taken to protect people from the risk of infection.
People’s needs were assessed before they commenced using the service to ensure those needs could be met. Staff received training and supervision to support them in carrying out their role effectively. The design and layout of the building was suitable for the people using it. People had a choice of what they ate and drank. The service worked with other agencies and professionals to support people’s health care 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.
People told us staff were kind and caring and treated them respectfully. Staff had a good understanding of how to promote people’s privacy, dignity and independence. The provider sought to meet people’s needs in relation to equality and diversity.
Care plans were in place which set out how to meet people’s needs. People and their relatives were involved in developing these plans. People had access to a range of social and leisure activities and we saw people enjoying these on the day of our inspection. Complaints procedures were in place. Steps had been taken to make communication with people accessible to them. The service worked with people to meet their end of life care needs.
Quality assurance and monitoring systems were in place to help drive improvements at the service. Some of these included seeking the views of people who used the service and others. The service had links with other agencies to help develop best practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 3 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Green Gables is a large detached house in a quiet residential area. It provides care and support for up to 18 older people, some of whom are living with dementia. There were 18 people living at the service when we visited.
There is a registered manager working at the service, they are currently at the service two days a week due to their leave arrangements. The service is being overseen by a deputy manager with the support of the provider and 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. This was the first inspection since a change of provider in November 2016.
People told us they felt safe at the service. Staff recognised different types of abuse and knew who they would report any concerns to, they were confident that the registered manager or deputy manager would address any issues. Risks to people were identified, assessed and plans were put in place which gave staff the guidance needed to manage and minimise the risks. People’s medicines were managed safely and in the way they preferred.
The management team had completed audits to identify environmental risks. Fire drills were completed and people had a personal emergency evacuation plan (PEEP) in case of a fire. Additional audits had been completed to monitor the quality of care given to people and checks were carried out on the records completed by staff to make sure they were accurate and up to date.
There were enough staff to meet people’s needs and they were recruited safely. Staff told us they were well supported, they had regular one to one meetings with their line manager and had the training required to meet people’s needs. People, staff and relatives told us that the provider, registered manager and deputy manager were approachable and accessible. Everyone working at the service shared the same visions and values, which were to give people excellent care and support them to have the best lives possible.
People were involved in developing and updating their care plans. People’s care plans were person centred and showed what people could do for themselves and how they preferred to be supported. Staff knew people well, interactions between people and staff were affectionate and relaxed. Staff offered people reassurance and encouragement. People could have visitors whenever they liked and were supported to maintain relationships with family and friends.
There was a board in the dining room letting people know what activities were happening each day, some people said these could be more varied. The deputy manager agreed this was an area for development.
People had a choice of food and drinks each day. People were encouraged to eat a balanced diet to stay healthy. When people were at risk of losing weight they were referred to a nutritionist and any guidance put in place was followed by staff. People had access to healthcare professionals when required and any concerns about people’s health were responded to quickly.
The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm.
The registered manager asked people for feedback about the service and their care on a regular basis and took action to address any issues raised. People had meetings where they could put forward their opinions about the food they were offered and activities they wanted to take part in. Complaints were recorded and responded to appropriately.
The registered manager attended local forums for managers and shared their learning with staff through team meetings. Staff treated people with dignity and respect; they understood confidentiality and people’s records were stored securely. Both the registered manager and the deputy manager had clear oversight of the service, using regular audits and addressed any issues as they arose.