CQC report explained · a residential care home
What the CQC found at Green Gables
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by safeguarding procedures, risk assessments, staffing arrangements and recruitment checks. Inspectors found that staff did not always sign medicine records for medicated creams and that some turning instructions lacked detail.
- Effective?
- Good
- People's needs were assessed before they moved in, and staff received training and supervision. The training records showed that not all staff were up to date with all required training.
- Caring?
- Good
- People told inspectors that staff were kind and caring. Staff supported privacy, dignity, independence, personal choices and equality.
- Responsive?
- Good
- Care plans were personalised and reviewed monthly. People had activities, support to maintain relationships, accessible information and arrangements for complaints and end-of-life care.
- Well-led?
- Good
- The home had a clear management structure and systems for checking quality and safety. People, relatives and staff gave mostly positive feedback.
What inspectors found, January 2020
Rated Good; inspectors found kind, personalised care, but medicines records and some risk and training records needed improvement.
This was a planned, unannounced inspection on 13 December 2019. The inspector spoke with six people, three relatives and eight staff, and reviewed care, medicines, recruitment and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable recruitment checks, supportive care planning and kind, respectful care.
There were some shortfalls. Staff did not always sign records for medicated creams. Some staff training was overdue, and some turning plans did not say how often people should be turned. The CQC made a recommendation about medicines records.
Kind and respectful care
People told inspectors that staff were caring. Inspectors saw staff interacting with people in a friendly and respectful way.
“People were treated with kindness and in a caring way. We saw that staff interacted with people in a respectful and friendly manner.” from the report
Enough suitable staff
People and staff said there were enough staff, and inspectors saw people receiving prompt support. Recruitment checks were completed before staff started work.
“There were enough staff working at the service to meet people's needs and robust staff recruitment practices were in place.” from the report
Activities and relationships
People could take part in activities they helped choose, maintain contact with relatives and access trips using the home's adapted transport.
“The provider supported people with a range of activities. People were involved in choosing these.” from the report
Medicines records
needs fixingStaff did not always sign the medicine administration records when they gave medicated creams. The CQC recommended that the provider make sure all medicines given are recorded.
“Although there were MAR charts in place for these, staff did not always sign them.” from the report
Overdue staff training
needs fixingThe training matrix showed that some staff had not completed all required training. The manager had told staff to become up to date by the end of December 2019.
“However, the training matrix showed that not all staff were up to date with all training they were expected to complete.” from the report
Turning instructions
needs fixingFor some people needing regular turning to protect their skin, risk assessments did not say how often this should happen. The manager said the assessments would be updated.
“for some people who required regular turning to protect their skin integrity, the assessments did not make clear how frequently the person should be turned.” from the report
- 01How do you now check that staff sign the medicine administration record whenever medicated creams are given?
- 02Which staff training was overdue, and has all required training now been completed?
- 03How are turning frequencies recorded for people at risk of skin damage?
- 04How are care plans reviewed when a person's needs or preferences change?
- 05How will you involve me and my relative in developing and reviewing the care plan?
This was an unannounced inspection covering the home and care provided, with ratings given for all five CQC questions. This explanation was written from the published report of 10 January 2020 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.
What inspectors found, May 2017
Green Gables rated Good; inspectors found safe, kind care, but activities and fluid monitoring needed improvement.
This was an unannounced inspection on 21 March 2017. One inspector and one expert by experience spoke with 15 people, seven relatives and staff. They reviewed care plans, risk assessments, medicines records, recruitment files, rotas and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training and good support from health professionals. People were involved in their care, treated with respect and able to have visitors when they wished.
There were two areas for improvement. The home needed to offer a wider range of activities. Staff recorded drinks, but did not total them at the end of the day to check whether people had reached their fluid targets.
Safe care
Risks to people and the environment were assessed, with clear guidance for staff. Fire checks and emergency evacuation plans were also in place.
“Risks to people were identified, assessed and plans were put in place to minimise them.” from the report
Kind relationships
People and relatives described staff as kind, helpful and respectful. Inspectors observed relaxed, reassuring interactions and support for people's independence.
“People and relatives told us that the staff were kind, caring, helpful and respectful.” from the report
Personal care
Care plans included people's histories, likes, dislikes and preferred support. People were involved in developing and reviewing their plans.
“People's care plans had details of their likes and dislikes, alongside their life history and interests.” from the report
Responsive management
People and relatives could raise concerns with managers, and complaints were recorded and answered. Feedback was collected and acted on.
“When complaints or concerns were raised they were recorded and responded to appropriately.” from the report
Fluid monitoring
needs fixingStaff recorded how much people drank and set daily targets, but did not add up the totals at the end of the day. The manager agreed this needed improvement because staff might not know whether someone had drunk enough.
“People's fluid intake was recorded and there was a target for people to have during the day; however people's fluid intake was not totalled at the end of the day to see if they had met their target amount.” from the report
Range of activities
minorPeople enjoyed activities such as music, films and gardening, but some people wanted more choice. The deputy manager accepted this as an area for improvement.
“People did tell us there could be more activities to choose from and the deputy manager agreed this was an area for improvement.” from the report
- 01How do you now total and check each person's daily fluid intake?
- 02What activities are currently available, and how do you make sure there is enough variety?
- 03How often are care plans and risk assessments reviewed and updated?
- 04How do you decide whether there are enough staff for people's changing needs?
- 05How are families told about changes in a person's health or visits to hospital?
This was an unannounced inspection covering the overall quality of the service and all five CQC questions; it was the first inspection since the provider changed in November 2016. This explanation was written from the published report of 3 May 2017 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016
Registered with the Care Quality Commission on 2 November 2016.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.