The Green Care Home with Nursing, Dronfield

Accommodation is provided over two floors, in one adapted building. Each floor provides individual bedroom and communal living facilities and specialist bathing facilities.

Health incidents and any near misses were routinely monitored and analysed, to help inform or improve peoples' care and prevent any reoccurrence when needed. People's medicines were safely managed and people received their medicines when they should.

We were assured the provider was meeting with requirements and nationally recognised guidance concerned with the prevention and control of infection, including COVID-19.

The environment and equipment used for people's care, was visibly clean and regularly checked to ensure timely repair or renewal when needed.

Overall, we found a positive, inclusive culture within the service, where people mostly received individualised care in accordance with their views and preferences. Improvements were in progress for people's mealtime experience, social activities arrangements and related information access, to fully ensure this.

Staff knew how to communicate with people in the way they understood. A range of service information could be provided in alternative formats, to enable people to understand what to expect from their care.

People and their relatives were informed and knew how make a complaint or raise any concerns they may have. Complaints were accounted for and mostly used to inform care improvements when needed.

We found effective arrangements to ensure people's dignity, comfort, rights and choice in line with nationally recognised national standards for end of life care.

There was registered manager for the service. Both they and staff understood their role responsibilities for people's care. Regulatory requirements were being met. Effective partnership working also helped to inform and enhance people's care experience at the service

Overall, people were well supported to achieve good care outcomes. However, staff felt they were not always fully supported to ensure this because they were not consistently deployed for people's care. We did not evidence any direct impact on people's safety from this but there was a related impact on staff morale with high staff absence and turnover levels. We therefore recommend the provider further reviews this aspect of their service against nationally recognised guidance, which they agreed to do. See link below.

https://www.skillsforcare.org.uk/Documents/Standards-legislation/CQC/Safe-staffing/Guide-to-safe- staffing.pdf

Otherwise, people's care was effectively informed and ensured in accordance with their choices and rights; sector care practice guidance and the law. Management improvement actions had commenced to re- stablish formal care quality surveys with people and their representatives, to further inform and improve people's care experience.

The provider operated effective governance, communication, record keeping and information handling, to help ensure the quality and safety of people's care and continuous service improvement.

People and relatives said they were generally happy with the standard of care provided, which they felt was provided at an acceptable level and often 'more than.'