Green Gables - Care Home Physical Disabilities

Updated 20 May 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 two inspectors and an Expert by Experience supported the inspection by making telephone calls to relatives following our site visit.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Green Gables Care Home Physical Disabilities 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. Green Gables Care Home Physical Disabilities is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 and professionals who work with the service. 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 this information to plan our inspection.

During the inspection

We spoke with five people who used the service and 13 members of staff including the regional operations manager, the registered manager, the deputy manager, team leader, support workers and the chef. Our expert by experience spoke with seven relatives about their experience of the service and care provided.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training, maintenance and quality assurance information and further policies and procedures.

Updated 20 May 2022

About the service

Green Gables Care Home Physical Disabilities is a residential care home providing personal care to up to 28 people. The service provides support to adults of all ages and people who have a physical disability. We also found the service was supporting people with a learning disability. The provider told us they would update CQC with this information. At the time of our inspection there were 23 people using the service.

Green Gables Care Home Physical Disabilities accommodates people in one adapted building across two floors. The service has communal lounges and an outside space with raised flower beds and seating.

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

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.

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.

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

There was a positive person-centred approach to the planning and delivery of the care. People were supported to be independent and their dignity and human rights were promoted. Staff knew people well and empowered them to make decisions about their care. The leadership of the service were keen to drive improvements, we found them to be responsive to feedback they received.

We found that medicines had not always been safely managed, we found that topical creams had not been risk assessed for storage in people’s bedrooms and protocols to instruct staff on the administration of ‘as required’ (PRN) medicines lacked the required detail to inform staff when a person may require the medicine. The registered manager took immediate action to address these issues.

We found not all actions from an external Infection, prevention and control (IPC) audit had been completed in a timely manner. The Registered manager sent us an action plan of how they would address this.

Effective auditing systems were not in place for medicines and infection, prevention and control as they had not identified the issues we found during this inspection. The provider shared with us their plans to improve these systems.

People had detailed personalised care plans in place which were reviewed regularly and reflected people's changing needs. People told us they had been involved in this process.

Staff spoke with knowledge about the people in the service and it was apparent they knew people well.

Information had been adapted into an easy read format for people to follow. This included the minutes of resident’s meetings, information on how people could complain and information on keeping safe during the pandemic.

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

Rating at last inspection

The last rating for the service under the previous provider was good, published on 22 November 2017.

Why we inspected

This was the first inspection of the service since the new provider took over and registered the service with the CQC on 06 August 2019.

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.

Follow up

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