CQC report explained · a residential care home
What the CQC found at Green Gables
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with the storage and administration of medicines, including incomplete instructions for as-needed medicines and an open, poorly monitored medicine trolley. Infection control audit actions had also not all been completed promptly, although other safeguarding, staffing and risk-management arrangements were found to be in place.
- Effective?
- Good
- Care plans reflected people's needs and choices, staff had relevant training, and people were supported with food, drink and healthcare. Inspectors also found that mental capacity and best-interest processes were being followed.
- Caring?
- Good
- People were treated with dignity and respect. Staff knew people well, offered choices and supported people to maintain their independence and personal relationships.
- Responsive?
- Good
- Care was personalised and communication support was tailored to each person. People had access to activities, visits and calls, and complaints were investigated with lessons shared with staff.
- Well-led?
- Requires improvement
- The home had a positive person-centred approach, but its audits had not identified the medicine and infection control problems. Relatives also said they were not always involved in care planning or asked for feedback.
What inspectors found, May 2022
Overall rating Requires Improvement; inspectors found kind, personalised care, but medicines and quality checks were not always safe or effective.
This was an unannounced inspection on 12 April 2022. Inspectors spoke with five people, 13 staff members and seven relatives. They reviewed care records, training, maintenance, medicines and quality checks.
The home supported 23 people, with space for up to 28. Inspectors found people were treated with kindness, involved in their care and supported to be independent. Care plans were detailed and regularly updated. Ratings were Good for Effective, Caring and Responsive.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. Some medicines were not stored safely, instructions for some medicines were not detailed enough, and quality checks had not found these problems. The manager took immediate action on some medicine issues and provided plans to address other concerns.
Personalised care
Care plans reflected people's changing needs, choices and preferences. People said they were involved in planning their care.
“People had detailed personalised care plans in place which were reviewed regularly and reflected people's changing needs.” from the report
Kind and respectful staff
Inspectors observed positive interactions. Staff knew people well and supported their dignity, choices and independence.
“There was a positive person-centred approach to the planning and delivery of the care.” from the report
Communication support
The home adapted information into easy-read formats and recorded how staff should support individual communication needs.
“Information had been adapted into an easy read format for people to follow.” from the report
Health and dietary support
People received support with eating and drinking, including individual diets, and the home contacted health professionals when concerns arose.
“We observed people being supported to eat and drink with dignity and patience.” from the report
Medicine safety
seriousSome creams were stored in bedrooms without a risk assessment. Instructions for as-needed medicines lacked important detail, and inspectors observed concerns about consent and supervision around the medicine trolley.
“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.” from the report
Quality checks
needs fixingAudits had not identified the medicine and infection control problems found during the inspection. Some actions from an external infection control audit were also not completed promptly.
“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.” from the report
Communication with relatives
needs fixingSome relatives said they were not always involved in care planning and had not been asked for feedback for some time. The manager said meetings with relatives would be arranged.
“Relatives told us they did not feel always feel involved in the planning of people's care.” from the report
Staff culture and activities
minorStaff gave mixed views about whether they felt valued, and staff said they did not always have enough time to support activities. The manager described plans to address both issues.
“We received mixed feedback from staff about the culture of the service, some staff told us the service was improving and others told us they did not feel valued.” from the report
- 01What has changed in the way topical creams and other medicines are stored in people's bedrooms?
- 02How do you now make sure instructions for as-needed medicines are detailed enough, and that consent is obtained before medicines are given?
- 03How do you check that the medicine trolley is secured and supervised during medicine administration?
- 04What actions from the infection prevention and control audit have now been completed, and how are they checked?
- 05How will relatives be involved in care planning and asked for regular feedback?
This was an unannounced inspection covering all five key questions, including infection prevention and control under Safe; it was the first inspection since the new provider took over and registered the home. This explanation was written from the published report of 20 May 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Green Gables
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- May 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2019
Registered with the Care Quality Commission on 6 August 2019.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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