• Care Home
  • Care home

Archived: Green Lane

Overall: Requires improvement read more about inspection ratings

122 Green Lane, Addlestone, Surrey, KT15 2TE (01932) 857485

Provided and run by:
Together for Mental Wellbeing

All Inspections

14 September 2021

During an inspection looking at part of the service

About the service

Green Lane is a care home without nursing providing accommodation and personal care to 14 adults at the time of the inspection. The service can support up to 15 people. People who live in the home all have a diagnosis of a mental health condition. The home is an adapted building which includes three self-contained flats.

People’s experience of using this service and what we found

People were not always kept safe from the risk of infection. Cleaning schedules were not followed and updated consistently. This caused confusion as to what cleaning responsibilities had been completed.

People were not always supported with meaningful activities that were suited to their hobbies and preferences. We have made a recommendation in relation to this.

There was no registered manager in post at the home. This meant various day to day management responsibilities were not consistently completed.

Risks were assessed and reviewed and guidance was available for staff to follow to keep people safe. People were supported with their medicines by staff that had received relevant training.

Staff were recruited in a safe way and were up to date with all relevant training. Staff felt supported by the temporary management team.

People told us that staff were kind and caring and supported them to access social and health care professionals. Accidents and incidents were recorded, analysed and action taken to ensure preventative measures were put in place.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 this service was requires improvement (published 28 February 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, not enough improvement had been made and the provider was still in breach of regulations. The service remains requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by our data insight that assesses potential risks at services, concerns raised and based on the previous rating. This enabled us to review the previous ratings.

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 safe, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

30 October 2019

During a routine inspection

About the service

Green Lane is a care home providing personal care for to up to 15 people who may be living with a mental health condition. At the time of inspection, the service was supporting 12 people. The home accommodates people in one main building set on two floors and three flats in the grounds of the home.

People’s experience of using this service and what we found

The service was not consistently safe. People’s risks were assessed; however, assessments were not always accurate and management plans were not always in place or followed. There were not always enough staff to keep people safe. Infection control measures needed to be improved and medicines were not always managed safely.

Quality assurance measures in place were not sufficient to identify quality or safety issues including those highlighted in this report related to risk management, staffing levels, recruitment and training.

We received mixed feedback with regards to how supported staff felt in the service. People were supported and encouraged to engage in the service and community. Staff worked with other agencies to meet people’s needs.

Staff received mandatory training and inductions, however, staff had not always received training in specialist areas that would have helped to meet people’s needs more effectively. Staff told us that due to lack of staff that they were restricted to be able to attend training they felt would benefit them in their role.

People were supported to have maximum choice and control, however decisions made when they lacked capacity were not always evidenced. It was therefore unclear if these decisions were in their best interest or the least restrictive. Policies and systems were in place; however, these were not always followed.

People’s care and support needs were assessed. There was some inconstancy of information and detail in support plans and these were not always person-centred. The registered manager had identified this and was in the process of making changes to peoples care files.

Care workers had developed relationships with people they supported. Staff respected people's dignity and privacy and promoted their independence.

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 7 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing levels, good governance and safe recruitment 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 for 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.

8 February 2017

During a routine inspection

The inspection took place on 08 February 2017 and was unannounced.

Green Lane is a care home registered to provide accommodation and care for up to 15 people. At the time of our inspection there were 11 people living at the home. Green Lane provides long term support to people living with various mental health conditions. They also provide temporary support to people during periods of crisis.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our last inspection was in November 2015 where we identified concerns with risk assessments, infection control, premises safety, medicines management, staffing, care plans, consent and governance. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

The home environment was clean and systems were in place to maintain cleanliness as well as the environment. People were supported to maintain their home environment and were involved in decisions about the home.

There were sufficient staff present to meet people’s needs. People were safe and staff were able to spend time with people developing their daily living skills. The provider undertook checks to ensure staff were suitable. Staff had access to a wide range of training to support them in their roles.

Staff understood their roles in protecting people from abuse and acted appropriately where safeguarding concerns were identified. Risks to people were routinely assessed and where incidents had occurred, actions were taken to prevent a reoccurrence. Staff were trained in managing medicines, which they administered safely.

People’s rights were protected as staff had an understanding of current legislation. Staff understood the Mental Capacity Act (2005) and we saw examples of staff supporting people who were subject to conditions under the Mental Health Act (1983). People were able to access the local community freely.

People were supported by caring staff who supported them to make choices and develop independence. People made choices about activities they took part in. People’s dietary needs were met and people were supported to develop skills in managing their own nutrition. People had access to healthcare professionals and staff worked alongside them to meet people’s needs.

Staff knew the people they supported well and had built positive relationships with them. Staff promoted people’s privacy and dignity when providing support. Staff had access to person-centred care plans which highlighted what was important to people. People’s needs were regularly reviewed in order to identify any changes.

Systems were in place to measure the quality of the care that people received. The provider took action where they identified improvements. People and relatives provided feedback, which the provider acted upon. Staff responded to complaints. Staff felt supported by management and had input into how the home was run.

5 November 2015

During a routine inspection

This was an unannounced inspection that took place on 5 November 2015.

Green Lane Care Home is registered to provide accommodation with care for up to 15 people. At the time of our visit, there were ten people living at the home. People who live at the home are living with various types of enduring mental health issues, some have physical needs. The accommodation is provided over two floors. The home also provides additional accommodation for people who require assistance during a crisis situation.

Green Lane had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were at risk because systems and procedures to protect them from harm were not being followed correctly. Although risk assessments were in place there were inconsistencies in the recording of information on risk assessments which could put people at risk of harm.

The premises were not adapted to meet the needs of people living at the home; some people had mobility issues and found it difficult to manoeuvre around the home. There was no lift at the home and some of the home’s corridors and stairways were narrow.

There were not always enough staff effectively deployed to meet people’s needs. The lack of staff deployed had an impact on the care and support people received, for example people had to wait to go shopping.

People were at risk as they had access to items such as scissors and syringes that could cause harm. Protocols for people taking PRN (as when required medicines) were not in place therefore people were at risk of not receiving this type of medicine in a consistent way.

Staff had basic understanding of Deprivation of Liberty Safeguards (DoLS), the Mental Capacity Act (MCA) and their responsibilities in respect of this. Mental capacity assessments and DoLS applications had not been fully completed in accordance with current legislation.

People were not fully supported to have balanced nutritious meals. There were inconsistencies in the arrangements to identify and support people who were nutritionally at risk.

There were inconsistencies in the way people’s care and support needs were met. People were not always treated with respect. However people’s privacy was respected and promoted and we did see examples of caring practice from staff. People’s preferences, likes and dislikes had not always been taken into consideration and support was not always provided in accordance with people’s wishes.

Staff did not always respond to people’s needs in the right way and information around people’s care was not always detailed with the correct information.

People attended activities in the home and in their community, however there were not always sufficient activities to meet people’s needs or preferences.

Although there were quality assurance systems in place, to review and monitor the quality of care provided, they were not robust or effective to identify and minimise risk or correct poor practice.

People received their medicine on time and were administered safely and any changes to people’s medicines were prescribed by the person’s doctor.

Recruitment practices were in place and were followed to ensure that relevant checks had been completed before staff commenced work. People told us they felt safe at the home. Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place.

The registered manager ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team were knowledgeable about people’s care needs. People told us they felt supported and staff knew what they were doing.

People were supported to have access to healthcare services and healthcare professionals were involved in the regular monitoring of people’s health.

People told us if they had any issues they would speak to staff or the (registered) manager. People were encouraged to voice their concerns or complaints about the home and there were different ways for their voice to be heard.

People told us the staff were friendly, supportive and management were visible and approachable. People’s relatives and friends were able to visit at any time.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

22 November 2013

During a routine inspection

We visited Green Lane Care Home to look at the safety, care and welfare of people using the service. We found the home environment to be calm and relaxed. We saw staff being supportive of people's needs, demonstrating skill and empathy in their interactions with them. Staff were positive about their experience of working at the home. They felt supported to carry out their roles through effective management, supervision and appraisal systems and access to relevant training.

13 people were using the service and present at the outset of the visit. Two people later left the home to engage in community activities. We saw a group activity in progress. This was an interactive, stimulating session. People had been encouraged to contribute suggestions for a new social and educational activities programme.

We spoke with two people in some depth and more briefly with four others. People said that overall they were satisfied with arrangements for meeting their needs. They had been consulted and had agreed individual personal support and care objectives. Their comments included, 'Staff are okay, there is nothing wrong with the home' and ' I feel very positive about my admission here, it has given me time to rest'.

Risk assessment and risk management activities ensured the safety and security of the environment. Emergency procedures were in place. People told us that they had no complaints. There were systems for responding to concerns and complaints.

21, 26 February 2013

During a routine inspection

At the time of our inspection there were 12 people using the service and three members of staff on duty. We spoke with four people who were using the service and three members of staff. We also returned to the service to speak with the manager. All the people we spoke to who were living at Green Lane told us that they were very happy. However, two people said that they wish there were more outings and holidays.

We observed that there was a very relaxed atmosphere at the home. We saw that staff were communicating with people using the service in a calm manner and in a way that they could understand. We also saw that people were being supported to live independently. For example, everybody had their own fridge and cupboard which had their name on and a key for the lock. People using the service were also supported to manage their finances and their own food budget.

We observed that staff were interacting with people and provided active support when it was requested. For example, we saw a staff member assist with cooking. We also saw a staff member sitting and talking to a person who was upset. We spoke to the manager about their audit process. We saw that the quality of the service had been monitored on a regular basis. This had been done by staff, service user and relative surveys. We saw that an action plan had been produced as a result of their findings.

21, 22 February 2011

During a routine inspection

People said they were encouraged to participate in risk assessment and support planning processes and support plans generally reflected their wishes and goals. They were mostly offered the level of support determined by their support plans. They attended review meetings twice a year to discuss their progress with professionals, staff and interested others. Between review meetings they frequently met with their key workers to review their needs and support plans, adapting these when necessary. People were overall satisfied with the staff support. One person expressed opinion that some staff were better than others.

People were aware of the availability of advocacy services and individuals were accessing these services at the time of the visit. Some people managed their personal finances independently whilst others were supported to do so by staff. People decided how they spent their money and had a lockable facility to keep their money secure.

Overall people felt in control of their daily lives. A person who no longer wished to live at the home said professionals involved with their placement were actively looking at suitable alternative options. People described getting up and going to bed when they chose. They decided how they spent their time and with whom and chose the activities they engaged in. Some people had been recently allocated food budgets. They individually planned their menus, shopping for food and cooking their meals with support, as necessary. A small group who had not yet been allocated food budgets for various reasons told us they planned their menu with staff and had a choice of meals. Some of the people self-catering were unhappy about additional expense of this system they personally incurred for use of taxis to purchase food; also for attending medical appointments. They told us they used taxis because local public transport services were unreliable. People had a lockable cupboard to store their food in the kitchen and a key to their cupboard. They described being unable to lock the fridges as a significant problem. Whilst fridge shelves were labelled with their names they said their food was sometimes used by others.

People actively encouraged to contribute to the day-to-day running of their home. For example, they made collective decisions about choice of d'cor and furnishings, for planning communal activities and allocating responsibilities for cleaning communal areas. Some people expressed opinion that staff needed to be more pro-active in monitoring the cleaning rota, to ensure all people equally shared this responsibility. Some people felt there were too many house rules. All of the people consulted objected to being unable to access the kitchen at night.

People told us budget constraints had adversely affected them. They said an in-house activity of a weekly bingo sessions had ceased because there was no money for prizes. They told us that they missed celebrating birthdays with a take-away meal as a group, which they used to enjoy. They regretted the loss of a mini bus which was no longer included in service provision.