Greenfields Close

Updated 17 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector, a specialist advisor 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. An inspection manager was also present to carry out a routine assessment of the inspection process.

Service and service type

Greenfields Close is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Greenfields Close is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with 14 people who used the service and observed how care and support was given generally. We also made observations of people and how they expressed themselves through their facial expressions and body language. Not everyone living at the service was able to talk with us, and used different ways of communicating, including body language and signs. We got feedback from 2 relatives about their experience of the care provided to their family members.

We spoke with 8 members of staff including the registered manager and deputy manager. We reviewed a range of records. This included 5 people’s care records and people’s medication records. We looked at staff training and the provider's quality auditing system. During the inspection visit we asked the provider to give us additional evidence about how the service was managed, which they sent to us. We also received feedback from 2 health and social care professionals.

Updated 17 December 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Greenfields Close is registered to provide accommodation and personal care for up to 30 people. The service is split across four residential buildings on one site: Greenfields, The Stables, Klosters and Aspen. There is also a building for activities, training and administration (The Lodge). There were 18 people living at the service at the time of our inspection. Greenfields Close is designed to meet the needs of people diagnosed with a learning disability and/or autistic people. Some people living at the service also receive care in relation to their physical disability.

People’s experience of using this service and what we found

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture

Right Support

The service supported people to have the maximum possible choice, independence and control over their own lives. People were supported by staff to pursue their interests, take part in activities and be active in their local area. Relatives were happy with the care people received and felt they were safe and looked after well. Staff communicated with people in ways that met their needs and supported them to make decisions about how they wanted to live their lives.

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.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity and promoted equality and diversity in their support for people. They understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people's needs and keep them safe.

Right culture

People received good quality care and support because staff could meet their needs and wishes. Staff knew and understood people well and were responsive, supporting their aspirations to live the lives they wanted. Staff placed people’s wishes and needs first. People and relatives were involved in planning their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 November 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 15 September 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the premises were clean and properly maintained, and systems in place to assess, monitor and improve the quality and safety of the service were effective.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. The inspection was also prompted in part due to concerns received about the quality of care for people. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained Requires improvement. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, caring and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenfields Close 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.