Background to this inspection
Updated
16 January 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 14 November 2018 and was conducted by one inspector. It was a comprehensive, unannounced inspection.
We reviewed information received about the service, for example the statutory notifications the provider had sent us. A statutory notification is information about important events, which the provider is required to send to us by law. We also contacted the local authority commissioners to find out their views of the service provided. These are people who contract care and support services paid for by the local authority. They did not share any information of concern about the service.
Before the inspection visit, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to This enabled us to ensure we were addressing potential areas of concern at our inspection. The PIR was very detailed and we were able to review the information in the PIR during our inspection visit. We found the information in the PIR was an accurate assessment of how the service operated.
During the inspection visit we interacted and spoke with four people who lived at the home and observed how care and support were delivered in the communal areas. We spoke with the registered manager and four care staff.
We reviewed two people's care plans and daily records to see how their care and treatment was planned and delivered. We looked at other records related to people's care and how the service operated, including two medicine records and the provider's quality assurance audits.
Updated
16 January 2019
We last carried out a comprehensive inspection of Greenways in June 2016 where we found the registered provider was rated ‘Good’ in each of the five key questions that we ask.
This inspection took place on 14 November 2018 and was unannounced.
Greenways is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
Greenways is registered to provide accommodation and personal care for up to five adults who have a learning disability. At the time of our inspection four people live here. The service is delivered from a two-story house in a residential area.
It is a requirement of the provider's registration that they have a registered manager in post. 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. The registered manager was present during this inspection.
Greenways continues to provide a good level of care and support to people.
The registered manager and staff team at Greenways ensured people were safe. Risk s to people’s health and safety were well managed without restricting people’s choice to take part in ‘risky’ activities such as horse riding. Staff understood their responsibilities about protecting people from abuse, and knew who they must contact if they suspected it was taking place. Where accidents took place, these were reviewed to prevent a re-occurrence.
Staffing levels were based on the needs of the people who live here. The provider’s recruitment process ensured staff were safe to work with the people living at Greenways.
People lived in a clean home, and the risk of the spreading of infections was well managed through use of protective equipment such as gloves and aprons.
People received their medicines when they needed them. The storage and disposal of medicines was carried out in accordance with national best practice guidance.
Procedures were in place to ensure that before someone new came to stay at the home, the staff and home would be able to meet their needs. The registered manager said that people from the lesbian, gay, bisexual or transgender communities would be made to feel safe and welcome if they came to live here. Staff received effective training and supervision to ensure they had the skills necessary to meet people’s needs.
People were supported to have enough to eat and drink. Dietary preferences and support needs were accommodated. People had a good level of access to health care professionals for routine appointments, or if they felt unwell. Staff worked well as a team to ensure that information was passed from one shift to the next so that people had care and support that met their changing needs.
The house where people live had a homely feel, and some adaptations had been made to meet people’s needs, for example smooth flooring to reduce the risk of trips and falls. Some areas of the homes decoration looked tired, such as the bathroom and carpets. The registered manger was in the process of applying for improvements to the environment so that people’s future needs (for example if their mobility decreased) could be accommodated.
Peoples rights under the mental capacity act where understood by staff. The requirements of the act were followed to ensure people’s consent was sought before decisions about care and support were made.
People were supported by kind and caring staff who knew each person as an individual. The care staff team had worked at the home for many years, so positive friendships had been developed between themselves, and the people who live here. Staff respected people’s privacy, and treated them with dignity and respect.
People were involved in day to day decisions about their care, and information was given to them in formats they could understand.
People support plans had been developed with them. These were based on goals and aspirations that people had. These were reviewed on a regular basis to ensure people’s needs had been met. People had access to a range of activities in the local community, as well as within the home environment. This helped people follow their hobbies and interests and to keep in contact with friends and meet new people.
There was a robust complaints process in place, however this had not been needed as everyone we spoke with was happy with the service. People would be supported at the end of their lives by staff that understood their preferences and would respect their wishes. The registered manager was considering specific end of life care training for the staff that had recently been developed by the hospice services in Surrey.
The home and staff team continued to be well led. The registered manager had been in post for about seven months. They had taken over from the previous registered manager and continued to provide a good level of care for people and support for staff. Quality assurance processes were used to make sure that people received a good level of support. People were involved in giving feedback about the level of care via regular house meetings and questionnaires. Results of this feedback were actioned where a need was identified. All the feedback we saw on the day of the inspection was positive about the home and staff that worked here.