We carried out a review of the data available to us about Greenwood on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Greenwood, you can give feedback on this service.
Greenwood is a residential home providing short stay respite care for 15 young people and adults. People using the service had a learning disability and may also have a physical disability, sensory impairment or mental health issues. 140 people had used the service in the past year for short stays and respite care. The length of time people stayed was dependent on the needs of the individual and their relatives/carers.
Greenwood is a large detached, purpose built property set in a residential area. The service has two floors and is surrounded by an accessible garden. The service has large communal areas and 13 bedrooms are en suite the remaining two being left for people with acute sensory issues.
The service has been developed and designed in line with the principles and values that underpin Registering the Right support and other best practice guidance. This ensures that people that use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
People’s experience of using the service and what we found
Care and support provided was person-centred. People were supported by relatives/carers every time care plans and risk documents were reviewed and updated. Most people attended a local day centre but those who did not, used the Greendays service provided at the service. Greendays offered a comprehensive range of activities and outings, selected by people. Strong links had been established within the local community. A robust complaints policy was in place and accessible in a variety of formats for people to use. Complaints were few but were all addressed in a timely way with evidence seen of learning being carried forward.
The registered manager had worked at the service for 20 years and had taken up the managerial role in 2017. People, relatives/carers and professionals all spoke highly of the manager. Staff at the service were assigned lead roles and took responsibility for certain work, for example manual handling. Monthly reports were provided to the registered manager who would then audit all aspects of the service. The service placed value on feedback and every opportunity was taken to ask people, relatives, professionals and visitors to the service, their views. Feedback fed directly into the service improvement plan. The registered manager told us, “There is no service like this,” and “Respite is wonderful.”
People we spoke with told us they felt safe. This view was supported by relatives/carers and professionals. Staff took time to read and update care plans and risk assessments and they knew people well and responded to their care and support needs. Staff were able to describe to us what they felt would amount to a safeguarding issue and were able to tell us the correct course of action to take and who to report incidents to. Detailed risk assessments, tailored specifically to people’s needs were in place and people, staff, relatives and professionals were involved in regular reviews. Staff were recruited safely and a staff to people matrix ensured that there were always enough staff on duty to meet people’s needs. The induction process was robust and had evolved over time to include feedback from staff. People brought their medication with them and it was safely stored and dispensed.
People were supported by staff during their time at Greenwood. They were supported to have control and choice about the things that they did throughout the day. Staff training was in place and was relevant to meet the needs of the people using the service. Training included safeguarding, mental capacity and epilepsy. Staff could request training if they felt it would help meet the needs of people. People’s hydration and nutritional needs were met and support was provided where needed. People were supported with health and social care needs appointments if required although these were few due to the nature of the service.
People and relatives told us that staff were kind, caring and attentive to people’s needs. Peoples’ privacy, dignity and independence were respected and promoted. Staff described respite care as a time when people were on holiday from their usual routines and they were supported safely to do things that they wanted to. The principles of the Equalities Act 2000 were upheld and people’s differences were respected and celebrated.
For more details, see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good. (Published 12 January 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service was last inspected on 29 August 2013. At that time we found the service was meeting the requirements of the regulations we inspected at that time.
This inspection took place on 1 November 2016. There were 10 people using the service at the time of this inspection.
There was an experienced and qualified manager at the service who was registered with CQC. 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 service had made a difference to the lives of people who used it and their family. One person said, “I know that when I come here, people at home are cared for too and people of my own age are here as well.” We received positive feedback from family members who said their relatives were well supported, safe and treated with dignity and respect when they stayed at the service. A relative commented, “We know we are lucky to have access to this service and the care is safe as well and respectful.” Another said, “The staff are supportive and helpful, they understand the impact of transitions and how people need to be with peers to develop and feel comfortable.” A health professional told us, “We work closely with parents who feedback to us how valuable the service is…”
The registered manager and staff explained they referred to people using the service as “guests” and they intended to provide a ‘hotel’ style service, which was safe, flexible and fun to use.
Staff communicated skilfully with people using their preferred methods and displayed a warm and caring attitude. People appeared comfortable in their surroundings and quickly made themselves at home when they arrived at the service or returned from day time activities.
The service had been completely refurbished to a very high standard since the last inspection. All bedrooms were single occupancy rooms and they were spacious and had en-suite facilities. There were various aids and adaptations to support people with their mobility needs such as overhead hoist tracking, specialist bathing facilities, dining space for wheelchairs and beds specific to people’s needs. All areas were tastefully decorated and furnished to a high standard.
There were systems in place to protect people from the risk of abuse and harm. The registered manager and staff were knowledgeable about safeguarding people and were aware of the procedures to follow should an allegation of abuse be suspected. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people's safety.
There was a sufficient number of staff deployed to meet people's needs and preferences. Thorough recruitment procedures were in place to ensure staff were suitable to work in a care environment.
Medicines were stored, administered, and disposed of safely and staff were trained in the safe management of medicines. We recommended that the service follow the guidance issued by the National Institute for Health and Care Excellence (NICE) in relation to record keeping. The registered manager took immediate action during the inspection to improve the recording of medicines received by the service.
The service was meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding and knowledge of the Act, and people who used the service had been assessed to determine if a DoLS application was required.
Staff had the skills, knowledge and experience required to support people with their care and support needs. Staff received essential training, additional training relevant to people's individual needs, and effective support from the registered manager with regular one to one supervision sessions.
During their stays people were involved in menu planning and they said they enjoyed the food provided and meal times. Staff knew about people's dietary preferences and needs and promoted healthy dietary choices. People’s health was monitored during their stay and they were supported to access health care services when needed.
People’s care and support was planned with them and their family members (where appropriate). The care delivered was personalised and ensured people’s health, welfare, social and leisure needs were met during their stay. People had access to a variety of activities which provided regular in-house stimulation, as well as trips out into the community.
The registered manager used effective systems to continually monitor the quality of the service and had ongoing plans for improving the service people received. They gathered information about
the quality of the service from a variety of sources including people who used the service and their family.
To help us understand why this was happening and to assess that people using the service were safe, we met nine of the people staying on respite at the service. In addition, we met with, nine staff of varying roles and responsibilities. We listened to what people had to say and we also reviewed some documentation in respect of the people staying there and staff. We reviewed information collated about incidents.
We were satisfied that people using the service received a good standard of care and were safe. We found the service was well led. We found there were enough skilled and trained staff to support people. Staff were proactive in identifying and escalating incidents and these were managed well to minimise disruption to others. People and staff were happy with the service but indicated that resource issues regarding transport and activities could be improved, and we passed this to the manager to look into.
When we visited, we spoke with four people who were using the service for respite. Three people said that they had visited the home previously and liked to come there. They said they liked to carry on with their usual day time activities when they visited.
One person said this was their first visit. They said that they did not think that it was the right place for them. However, they understood this was an interim placement whilst other arrangements were made for their accommodation. They said that they had as much freedom as they wanted but found the need to be back by a certain time a nuisance.