We carried out this announced inspection on 27 and 28 November 2018. At our last inspection, in June 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.Greenbank Care provides care and support to adults of all ages, in their own homes. The service provides help with people's personal care needs in and around the Liskeard area of Cornwall. This includes people with physical disabilities and dementia care needs. The service mainly provides personal care for people in short visits at key times of the day to help them get up in the morning, go to bed at night and support with meals. Longer visits to provide respite care for families and companionship and emotional support for people are also provided. At the time of our inspection the service was providing personal care for 32 people. These services were mostly purchased direct by people, either through their own funds or through the direct payments scheme.
Without exception everyone we spoke with were extremely satisfied with the quality of the service they received and consistently praised staff for their caring attitude. People told us they felt safe using the service and they trusted the staff who supported them. People told us they received a reliable service and had regular staff who visited them. They had agreed the times of their visits and were always kept informed of any changes. Comments included, "If I have any worries I know I can just pick up the phone and talk to someone", “I am very happy with the service”, "I am more than happy with the care, it’s just fantastic", “I'd ring the office if I had a complaint" and “The office tell me that if I am worried about anything just ring and they will sort it out.”
The registered manager and staff were able to tell us about how they went 'the extra mile' for people and the difference this had made for them. Staff were highly motivated and had gone out of their way to support people and find ways to help them in manner that was individual to the person. Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. People said they were treated respectfully and staff asked how they wanted their care and support to be provided.
Staff had achieved exceptional outcomes for people, especially for people who had dementia or mental health needs. The service offered befriending visits to provide companionship and emotional support. These visits had enabled staff to find out about the person’s life and what was important to them. This had helped develop more personalised and holistic care plans and enabled staff to understand how to provide care for people who may become anxious or have memory difficulties.
Care plans provided staff with direction and guidance about how to meet people’s individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff. People were aware of their care plans and had a copy in their homes. People who needed help taking their medicines were appropriately supported by staff.
Risk assessments clearly identified any risks and gave staff guidance on how to minimise the risk. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.
Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.
Staff were aware of the reporting process for any accidents or incidents that occurred and there was a system in place to record incidents. Records showed that appropriate action had been taken and where necessary changes had been made to reduce the risk of a re-occurrence of the incident.
The service acted within the legal framework of the Mental Capacity Act 2005(MCA). Management and staff understood how to ensure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.
The service had robust recruitment practices, which meant staff were suitable to work with vulnerable people. Training records showed staff had been provided with all the necessary training, which had been refreshed regularly. Staff told us they found the training to be beneficial to their role and said they were encouraged to attend training to develop their skills, and their career.
Staff told us they enjoyed their work and received regular supervision, appraisals and team meetings. Staff were complimentary about the management team and how they were supported to carry out their work. The management team provided strong leadership and led by example. They had clear visions and values about how they wished the service to be provided and these values were shared with the whole staff team. There was a very positive staff culture and value system which placed people at the heart of the service. Management valued their staff, developed them and had identified ways to retain them to ensure continuity of care for people.
There were effective quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received. People had details of how to raise a complaint and told us they would be happy to make a complaint if they needed to.