The Green Care Home with Nursing, Hasland

The Green Care Home with Nursing, Hasland is a residential care home providing the regulated activities personal and nursing care to up to 40 people. The service provides support to older people. At the time of our inspection there were 27 people using the service.

People’s experience of the service and what we found:

People and their relatives told us they felt the service was safe. Staff were recruited safely and there were sufficient numbers of staff to meet people's needs. Medicines were managed safely and risks that affected people's daily lives were regularly monitored and assessed. Infection, control and prevention measures were in place and followed by staff.

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.

The provider and manager had a quality assurance system in place which ensured all aspects of the service were regularly audited. There was a positive person-centred approach to the delivery of people's care. People and their relatives had regular opportunities to suggest improvements to the service in person to the manager or through meetings. Staff were clear about their role and responsibilities and had received training to ensure they knew how to provide care and support to the required standard.

Rating at last inspection

The last rating for this service was Good published 5 September 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Green Care Home with Nursing, Hasland on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ The provider had ensured the required personal protective equipment (PPE) was in place. Staff had received training in how to use it appropriately. This meant that staff were able to use PPE in accordance with the guidance to reduce the risk of cross infection.

¿ There was an agreed approach to relatives being able to visit. In addition to video calls, emails and telephone contacts.

¿ Cleaning of the home had increased, through the use of more domestic staff and agreed schedules of cleaning.

¿ Staff were supported by the provider and registered manager, by receiving supervisions, meetings and any new guidance or information.

¿The provider continued to have oversight, with regular audits and video links. to share good practice and any new or developing guidance and changes.

¿ Health care professionals had continued to develop the relationship with the staff and provider through shared tasks, using video calls and mutual understanding when supporting individuals.

¿ The registered manager was proud of their staff team and the way they had adapted and worked together to ensure everyone’s safety.

Further information is in the detailed findings below.

At our last inspection we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good. 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 in October 2015. There were 35 people accommodated, including nine people who received nursing care.

People continued to receive safe care and support from staff who were safely recruited and deployed to provide their care. People were protected from the risk of harm or abuse by staff who understood and followed relevant guidance to ensure this.

Known potential risks to people’s safety associated with their health conditions, were assessed before people received care, monitored and regularly reviewed. People’s medicines were safely managed.

The environment and any equipment used for people’s care was kept clean, hygienic and well maintained. Emergency contingency planning and related safety procedures, helped to ensure people’s safety at the service.

People continued to receive effective care from staff who were trained and supported to ensure this. People were supported to maintain or improve their health and nutrition and received food and drink to suit their dietary needs and preferences.

Staff understood and followed the Mental Capacity Act 2005 (MCA), to obtain people’s consent or appropriate authorisation for their care. People received least restrictive care that was lawful and in their best interests when required.

The environment was adapted to meet people’s safety, independence and orientation needs. This included pleasant award winning external gardens and also people’s own rooms, which were personalised to suit their wishes.

Staff were kind, caring and compassionate. People were treated with respect by staff, who ensured their dignity, comfort, choice and rights when they provided people’s care.

People and relatives were appropriately informed and involved to agree people’s care. Staff followed what was important to people for their care and knew how to communicate with them in the way they preferred.

People continued to receive timely, personalised care that was responsive to their needs and wishes. People were supported to participate in daily living activities and engage in home and community life, in way that was inclusive, enjoyable and meaningful to them.

People and relatives were informed and confident to raise any concerns or make a complaint if they needed to. Feedback was regularly sought from people living at the service and those with any interest there. This information was used to inform and improve people’s care when needed.

People received locally awarded end of life care, which was consistent, co-ordinated and personalised. This helped to ensure people experienced a comfortable and dignified death.

The service continued to be well led. The provider operated effective systems to ensure the quality and safety of people’s care, ongoing service improvement and partnership working to inform and people’s care experience.

Staff understood their roles and responsibilities for people’s care. People’s care was effectively informed, lawful and well led. The provider met their legal obligations, to share relevant information with us about people’s care, and to inform others with an interest about our judgements.

Further information is in the detailed findings below.

A single inspector carried out this inspection. We spoke with four people who lived at the home and with the relatives of two others. We also spoke with four members of the staff.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Each person’s records contained detailed information about their individual care needs and risk assessments were in place detailing the risks associated with each person’s care.

People were protected from the risk of unsafe care as the provider had taken appropriate steps to assess, plan, monitor and review all aspects of their care and support. The provider had appropriate arrangements in place to protect people from the risk of abuse.

People were protected from the risk of infection because appropriate guidance had been followed.

Emergency and business continuity plans contained information for staff about how they should handle emergency situations and staff understood what to do in case of emergency.

Is the service effective?

Care plans included information about all aspects of daily living including people’s medications, information about their dietary requirements, people’s hobbies and how they preferred to spend their time. People’s care needs were fully assessed and written care plans were devised from these. They provided staff with the information they needed to effectively care for people.

People were treated with respect and their dignity was maintained.

Is the service caring?

People had been involved in agreeing their care and preferred daily living routines. For example what time people preferred to get up and how they liked to spend their day and

people and their relatives were positive about the standard of the care people received.

Staff demonstrated good rapport with the people they were caring for and people were relaxed and seemed comfortable in their surroundings.

Is the service responsive?

People we spoke with knew how to make a complaint if they were unhappy, but said they had not needed to complain. People and their relatives were given opportunities to comment on the way care and support was being delivered and the provider had responded to reflect people’s views.

The provider was responsive to people’s changing care needs and care was designed and delivered to meet people’s individual needs.

Is the service well-led?

There was a registered manager in place, who coordinated and regularly checked the arrangements for people’s care and support to make sure it was safe and met their needs.

The provider regularly checked the quality and safety of people’s care and services provided at The Green. Records showed that regular checks were undertaken to identify any risks to the safety of people who used the service. Where issues had been found action plans had been put in place to deal with them.

The provider kept records of all accidents and incidents in the home. These had been investigated and the cause of the issues identified. Actions plans had been put in place to reduce re-occurrence.

There were suitable arrangements in place to ensure that people were consulted and involved in making decisions about their care. Where people could not make decisions there were systems in place to ensure decisions were being made in people’s best interests.

People were protected from the risk of malnutrition and dehydration. People told us the foods served were of “good quality” and confirmed to us they were offered a choice of meal.

Medicines were suitably stored and handled. Staff were suitably trained and there systems in place to administer regular and ‘as required’ medications when they were needed.

There robust recruitment procedures followed which ensured staff were suitable to work with vulnerable adults.

There were suitable systems in place to handle complaints. People and relatives told us they would speak to staff if they had any concerns but had not felt the need to. People were offered opportunities to discuss any worries at regular residents meetings and participate in surveys.