25 April 2022
During an inspection looking at part of the service
About the service
Greenways is a residential care home registered to provide personal care for up to four people with a learning disability and/or autism. At the time of the inspection four people were living at the service
People’s experience of using this service and what we found
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
People had a choice about their living environment and were able to personalise their rooms.
Staff supported people to take part in activities and pursue their interests in their local area.
Right Care
The service had not always effectively assessed risks to people to keep them safe from harm. This was a breach of the safe care and treatment of people using the service.
People’s care, treatment and support plans had not always been updated and did not show how people had been involved. The service had identified care plans were not up to date and were in the process of updating them as they transferred them to a new electronic system.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. One staff member said, “The four people I work with are amazing, kind and it is a blessing to be their support worker.”
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.
Right Culture
The quality of the care people received had not always been monitored and reviewed to ensure people’s needs were met. This was a breach of the good governance on the service. The registered manager put plans in place to improve this before the inspection ended.
People did not always have the right tools in place to support their communication. This meant their views had not always been sought. The service had already identified this, had organised communication aids and were waiting for staff to receive training.
Staff placed people’s wishes, needs and rights at the heart of everything they did. One relative said, “Staff are kind, compassionate and caring.”
People and those important to them, including advocates, 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
The last rating for this service was Good (published 12 July 2018).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support right care right culture.
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 received concerns in relation to the management of the service, risk management, poor nutrition, staffing and record keeping. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led relevant sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe care and treatment and the good governance of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.