About the service Village Green Care Home is a residential care home providing personal and nursing care to up to 41 people. The service provides support to older people who may be living with dementia or a physical disability. At the time of our inspection there were 28 people using the service.
Village Green Care Home is a two storey building. The ground floor is used to support people who require nursing care and the first floor has been adapted to support people living with dementia. People share communal areas such as lounges, bathrooms and a garden and have their own bedrooms.
People’s experience of using this service and what we found
People were not always supported by the appropriate number of staff. Staff supported people with essential care needs but did not have time to spend chatting with them or supporting them with social interests. Not all staff had completed the training deemed as necessary in their job roles and systems were not fully in place to check staff competencies. Records were unclear as to whether people were always supported in line with their assessed needs.
People were not always supported safely with their medicines. Risks to people had been assessed, however assessments were not always sufficiently detailed to guide staff how to support people safely. Records were unclear as to whether people were always supported in line with their assessed needs. People were not always supported with a positive mealtime experience.
People were not supported to engage in social interests or leave the service to be a part of the community. Staff did not always support people according to their personal preferences. People were not always supported with kindness and compassion and their privacy and dignity was not always respected.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
Audits completed by the manager and provider were not effective in identifying where improvements could be made. Actions were not always taken to drive improvements and some aspects of quality monitoring had not been fully imbedded at the service.
People and relatives were happy with their or their family members care and support. One person told us, ‘‘Overall I am very happy here. Staff treat me kindly and with respect which is all I can ask for.’’
Staff were trained in safeguarding and knew who to report any concerns to. Systems were in place to learn lessons when things went wrong. Staff kept the service clean and followed good IPC practices. Staff felt well supported and could ask the manager for any help they needed. People were supported to see health professionals if this support was needed. People were asked for consent and staff respected their choices.
People were supported in a kind and caring way for the most part. Staff had made efforts to get to know people well as individuals. Plans were in place to support people with dignity and respect at the end of their lives. The manager had a complaints policy in place and complaints were responded to in a timely manner.
The manger and provider were keen to improve the experience of people living at the service. They took immediate action to address our concerns and had plans in place to continue making and sustaining improvements. We were assured this would address the issues we found during this inspection. People and staff were given opportunities to feedback about the service. Staff worked well with health professionals to help achieve good outcomes for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for the service under the previous provider was good (report published 18 November 2017).
We also visited this service to look at infection prevention control (IPC) practices (report published 11 February 2022) and found no concerns.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 have found evidence that the provider needs to make improvements. Please see the all 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 staffing levels, person centred care and good governance 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 continue to monitor information we receive about the service, which will help inform when we next inspect.