CQC report explained · a residential care home
What the CQC found at The Green
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, May 2020
Rated Requires Improvement; inspectors found kind, personalised care, but medicines systems and some safety and management checks were not robust.
The inspection took place on 27 February 2020. One inspector spoke with people living at the home, relatives, managers and care staff. They reviewed care records, medicines records and records about how the home was managed.
The home was rated Good for Effective, Caring and Responsive care. People were supported by staff who knew them well, treated them kindly and helped them make choices, stay independent and take part in activities.
Safe and Well-led were rated Requires Improvement. Inspectors found problems with medicines records and risk checks, and said the fire evacuation procedure needed review. Management audits had not found these issues, so the overall rating fell from Good at the previous inspection.
Kind and respectful staff
People and relatives said staff were kind, patient and caring. Inspectors observed natural and genuine interactions.
“People we spoke with confirmed that staff were kind, caring and patient.” from the report
Personalised support
Care plans recorded people's needs, wishes and preferences. Staff knew people well and supported them as individuals.
“Support plans were personalised to them and contained detailed information about the support they required, their needs and wishes.” from the report
Choice and independence
People were supported to make everyday decisions, maintain daily living skills and take part in work placements and community activities.
“People were supported to maintain day to day living skills such as cleaning their bedrooms, helping prepare their own meals and do their own laundry.” from the report
Communication support
Staff understood different communication methods and used pictorial aids and other approaches to help people express their wishes.
“Staff had clear guidance on how each person communicated and they worked hard to ensure they communicated with the person in the way they understood.” from the report
Medicines management
seriousRecords did not always show whether medicines had been given correctly. Assessments and guidance for people who self-administered medicines or used medicines when needed were not robust.
“Unsafe management of medicines places people at risk from of harm.” from the report
Fire evacuation arrangements
needs fixingThe fire procedure did not clearly explain how staff would keep people safe if they could not evacuate them to a place of safety.
“The provider's fire evacuation procedure however required review to ensure that arrangements were in place to keep people were safe.” from the report
Care records
needs fixingInformation about risks and behaviours was spread through care files and was not always consistent. This made it harder to see a complete picture of people's needs.
“Some of the information in people's care files relating to risks and behaviours was dispersed throughout the care file.” from the report
Management checks
needs fixingThe home's governance and audit systems had not identified the problems with medicines, fire procedures and care documentation.
“The governance arrangements in place to audit aspects of service delivery had not identified that these areas required improvement.” from the report
- 01What changes have been made to check that medicines given, remaining and self-administered are recorded correctly?
- 02How do you now assess whether a person can safely take their own medicines?
- 03What guidance is now available for medicines prescribed to be given when needed?
- 04How has the fire evacuation procedure been changed for people who may not be able to reach a place of safety?
- 05How do your audits now identify gaps or inconsistencies in care plans and risk information?
This was a planned inspection of the care home covering all five CQC questions, including care, premises, records and management systems. This explanation was written from the published report of 19 May 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, September 2017
The Green is rated Good; inspectors found caring, personalised support, but some as-needed medicines records were incomplete.
This was a comprehensive, announced inspection over 24 and 25 July 2017. Inspectors observed care, spoke with people living there, relatives and staff, and checked care records, medicines, staff files, complaints, safety records and management audits.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable training, kind relationships, personalised care plans and good support for people's independence, food choices and activities.
There was one important medicines recording shortfall. Some as-needed medicines, such as pain relief, were not recorded on the medicines charts or elsewhere, so the exact amount held could not be confirmed. The manager arranged extra communication and training after the inspection.
The home was last inspected in August 2015 and was also rated Good. The report does not say that the home was placed in special measures or that any regulations were breached.
Personalised care
Care plans included people's backgrounds, health, routines and other individual needs. People and relatives were involved in reviewing them.
“The care plans that we looked at were person-centred, detailed, regularly reviewed and met the needs of the people living at the service.” from the report
Kind relationships
Inspectors observed caring interactions, and staff were able to describe people's needs and how to support them.
“It was clear that staff had caring and well-established relationships with the people living at the service.” from the report
Support for independence
People were encouraged to make choices, cook, take part in daily tasks and follow their interests. Communication aids helped people understand information and routines.
“We saw that people's dignity and independence was both maintained and encouraged.” from the report
Staffing and training
The home had enough staff during the inspection. Staff received induction, supervision, appraisals and training linked to the needs of the people they supported.
“This meant that staff working at the service had the necessary training and skills to meet the specific and varied needs of the people living there.” from the report
Well-maintained home
Safety checks, fire drills and maintenance arrangements were in place. Several hazards identified during the inspection were dealt with before inspectors left.
“We observed that the home was clean with no offensive odours.” from the report
As-needed medicines records
seriousSome PRN, or as-needed, medicines were not recorded on the medicines charts or elsewhere. This meant inspectors could not confirm the exact amount of medicine held, and audits had not spotted the problem.
“This meant that we were unable to see an exact total of medication held by the service.” from the report
Obstructed fire exit route
minorA carpet cleaner partly blocked one corridor leading to an external fire door. It was removed immediately, and staff were to be reminded where the equipment should be stored.
“However, we found that one of the corridors leading to the door was partly blocked by a carpet cleaner.” from the report
Clutter in corridors
minorInspectors found equipment and waste materials in internal corridors and the garden patio. Extra storage was ordered or installed and the waste was removed by the end of the inspection.
“We found that some of the internal corridors of the premises were cluttered with various items, including a hoover, a dehumidifier, mops and buckets and a step ladder.” from the report
- 01How are as-needed medicines recorded now, and how do you check that the records match the medicines held?
- 02What extra medicines communication and training was provided after the inspection, and when was it completed?
- 03What was discussed with staff about the Mental Capacity Act and Deprivation of Liberty Safeguards after the inspection?
- 04How do you make sure corridors, fire exit routes and garden areas remain free from equipment and waste?
- 05What has changed at the home since this 2017 inspection, and can we see the most recent inspection report?
This was a comprehensive inspection covering all five key questions, based on observations, discussions and checks of selected records and documents. This explanation was written from the published report of 14 September 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 The Green
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- May 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
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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