Greenbanks

Updated 17 August 2021

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 Care Act 2014.

This inspection was prompted by our data insight that assesses potential risks at services, concerns in relation to aspects of care provision and previous ratings. As a result, we undertook a focused inspection to review the key questions of safe, and well-led only. This enabled us to review the previous ratings.

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 team consisted of two inspectors (one inspector visited the service and one inspector looked at records remotely).

Service and service type

Greenbanks 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. However, some people who lived at the service did not receive personal care.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection-

We spoke with six people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager, the deputy manager, three support workers, the maintenance person and activities person. We also spoke to a relative.

We reviewed a range of records. This included multiple medication records, accident and incident records, staff and residents meeting minutes and complaints. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed documentation remotely. We looked at training data and quality assurance records, health and safety checks and audits. We reviewed five people’s care plans, risk assessments. We spoke with the nominated individual who is responsible for supervising the management of the service on behalf of the provider. We spoke on the phone with two relatives and three professionals who have regular contact with the service.

Updated 17 August 2021

Greenbanks is a residential care home for 20 older people and younger adults who need support due to having learning disabilities, autism and special mental health needs. It can also accommodate people who have physical and/or sensory adaptive needs. The service can support up to 20 people in one adapted building. At the time of this inspection there were 20 people living at the service

The service is run by a limited company. The shareholders and directors of the company are family members or guardians of the people who live there.

Not everyone who used the service received personal care along with their accommodation. CQC only inspects where people receive personal care with accommodation under one package of care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

People told us that they were very happy living at Greenbanks. One person said, “I have lived here a long, long time. I don’t want to be anywhere else.” Another person said, “This is a hundred times better than where I lived before.”

The service was in the process of transferring all their records onto an electronic system. This process had not yet been completed and some records required reviewing and updating. Some records were not accurate. The registered manager took action to address these shortfalls after the inspection.

Risks to people had been identified and mitigated. However, guidance for some risks had not yet been fully recorded on the new system. Staff knew people well and people were kept as safe as possible. Staff were consistent in their approach in managing risks.

Some care plans were written in a way that could be misinterpreted by staff, so people might not receive the care and support that suited them best. These records were being reviewed and updated. We observe and we were told by people, relatives, staff or visiting professionals that people were always listened to and treated with respect. The registered manager identified that additional training and support was required for certain staff members in recording information in peoples care plans.

At the last inspection people had not always been supported to take their medicine as safely as possible. At this inspection improvements had been made. Since the last inspection there was increased monitoring and auditing of medicines to make sure errors were reduced and if any mistakes were made, they were identified quickly.

People told us they felt safe at Greenbank’s. Incidents that had occurred had been reported to the local safeguarding team. The registered manager had taken action to make sure people were safe.

People were supported to have day to day choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Staff helped to maintain people's independence by encouraging them to do as much as possible for themselves.

There were enough staff available to make sure people received the personal care and support that they needed. People's needs had been assessed and assessments had been used to plan staffing levels. Staff had been recruited safely to make sure they were suitable to work with people at Greenbanks.

When accidents or incidents occurred, learning was identified to reduce the risk of them happening again. When people were unwell or needed extra support, they were referred to health care professionals and other external agencies.

Infection was prevented and controlled including risks associated with COVID -19. No people living at the service had contracted COVID-19 during the pandemic.

The registered manager had oversight and scrutiny of the service. People, staff, external professionals and relatives were satisfied and complimentary about the leadership within the service. People and staff also told us that the registered manager was approachable and had an 'open door' to hear their concerns or suggestions. Quality checks had been completed and people had been consulted about the development of the service. The service worked in partnership with other professionals, and the local community.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

We did not review all aspects of Right support, right care, right culture as the inspection only looked at Safe, and Well-Led. In the areas we covered in the inspection we found the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people's choice, control and Independence. People had access to professional advice and equipment to maximise their independence.

Right care:

• Care is person-centred and promotes people's dignity, privacy and human rights. Staff demonstrated how individualised support was offered to people.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. People’s consent and views were valued by staff and management, improvements had been made to the environment with people’s input.

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 10 September 2019) and there had been one breach of the regulations.

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

The inspection was prompted in part due to concerns received about medicines, staffing levels and bullying by senior staff towards care staff. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions 'Safe' and 'Well-led'.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

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

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenbanks on our website at www.cqc.org.uk.

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.