Archived: Greenbank

The last inspection of this service was carried out on 26 April 2014. The service met the regulations we inspected against at that time.

Greenbank is a large detached family house set in a residential area near local shops and transport. The service is registered for five places and there were five people living there when we visited. The home does not provide nursing care.

There was a registered manager for 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 told us they “liked” their home. They felt comfortable with the staff who supported them. Staff were clear about how to recognise and report any suspicions of abuse. They told us they were confident that any concerns would be listened to and investigated to make sure people were protected.

There were enough staff to assist people in the house in a safe way and to support people to go out to activities in the community. The recruitment of staff included the right checks and clearances so only suitable staff were employed.

Potential risks to people’s safety were assessed and managed. People’s medicines were managed in a safe way, although it would be better if checks were kept of the temperature of the room where medicines were stored.

Staff had training in the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. Staff asked for permission before carrying out care tasks. People told us they made their own choices about their daytime routines.

People told us they “liked” staff. We saw people actively sought out staff members to spend time with and chat about their day and plans for the next day. Staff spoke about people in a valuing and positive way, and supported them to play an active part in their local community. For example, people used local shops and pubs. One staff member commented, “I love going with them to the local [social] club. They have such a great time.”

People were supported to access healthcare services, such as GPs and physiotherapists when they needed these. People were fully involved in planning their menus and preparing meals. Each person’s nutritional well-being was assessed. They were encouraged to enjoy a healthy diet, but staff understood people could make their own choices about this.

People’s care was planned to make sure they got the right support to meet their individual needs. People enjoyed a range of vocational activities outside of the home. Two people did voluntary work and staff also helped people to find activities in the local community that they might be interested in.

People had information about how to make a complaint or comment. During this inspection a complaint about the service was raised. This was shared with the provider who carried out a comprehensive investigation and reported the findings back to the complainant.

People and staff had opportunities to comment on the service at any time as well as at regular meetings. Staff felt the organisation was run in the best interests of the people who lived there. The provider had a quality assurance system to check the quality and safety of the service provided.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Where staff had identified a potential risk, either during the initial assessment or after admission, we found that a risk assessment had been completed to ensure people were safe. We saw that the risk assessment clearly identified the potential hazards and the control measures in place to manage the risk. The provider had developed policies and procedures in relation to safeguarding adults. We viewed these policies and saw that they contained information for staff to refer to about safeguarding, such as what constituted abuse, key responsibilities and how to report concerns. The provider had a system for logging and investigating safeguarding concerns.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that DoLS had been submitted appropriately and relevant staff had been trained to understand when an application should be made.

Is the service effective?

Each person had individual support plans which set out their specific care needs and people had been involved in the assessment and planning of their care. Relatives we spoke with told us they were also involved in the planning of care. We saw that support plans and risk assessments were up to date and reflected people's individual needs and we observed staff supporting people in a caring and sensitive way.

There was an advocacy service available if people needed it, this meant that when required people could access additional support. We found that care records had been written using a person-centred approach. This meant that they described the person's abilities and how they preferred their care needs to be met. Staff we spoke with told us the managers were approachable and accessible at all times. The provider had systems in place to ensure that staff training was kept up to date.

Is the service caring?

People were supported by calm, kind and attentive staff. We saw that care workers showed patience and gave encouragement when assisting people. We saw people were supported to enjoy their meals at their own pace. Staff spent time chatting with people about their interests in a warm and engaging manner. We saw staff were skilled at understanding people's individual communication methods. They guided people in a way that supported them to retain their dignity. Staff told us they knew what interested people by reading what was written in the persons care plan and also spending time with them. Staff gave us examples of preferences of people watching DVD films and one person enjoyed knitting. Our observations of the care provided and discussions with people showed us that individual wishes for care and support were taken into account.

Is the service responsive?

People were given the chance to make decisions for themselves. Records showed that people's preferences, interests and needs had been taken into account and care and support had been provided in accordance with people's wishes.

We saw that where necessary people had been referred to other professionals. For example, we saw one person had been referred to the Speech and Language Therapy Team. Family members we spoke with were aware of how to make a complaint but they did not raise any complaints or concerns with us about their relative's care.

Is the service well led?

The provider had a system to assure the quality of the service they provided. The way the service was operated had been regularly reviewed. A range of checks were carried out including care records, medication and the environment for people who lived there. The area manager carried out at least monthly visits to audit the systems and procedures at the home.

The manager held regular team meetings with staff. Regular checks of the premises took place to ensure it was safe and suitable for the people who lived there. Staff were properly supported by the manager and received training relevant to their role.

We saw staff assisting the people with their usual daily activities, including helping with some domestic tasks such as returning their crockery to the kitchen and watching television. They responded to their needs in a professional and pleasant way, and were clear about how the individual was supported. These activities maximised people's independence while maintaining their safety and wellbeing. The atmosphere in the service was quiet and calm.

During our visit, the people using the service looked to the staff for reassurance when we spoke to them, and the staff provided this support without it being intrusive or inappropriate.

The provider has taken steps to make sure Greenbank was an environment that is suitably designed and adequately maintained and an on-going programme of maintenance and re-furbishment was in place. It was clean, well decorated and furnished to suit the building and choices of people living there.

There were sufficient numbers of staff employed and on duty to ensure that people were supported to live active and fulfilled lives.