Green Pastures Christian Nursing Home

Green Pastures is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Green Pastures is registered to provide accommodation for up to 60 older people, some of whom may have a form of dementia who require nursing or personal care. At the time of the inspection there were 35 people living in the home. The home is purpose built and set on three floors. People only occupied the ground floor and the first floor with a view for the second floor to become operational when more people moved in.

We were welcomed by the registered manager and staff who were happy to see us and keen to show their caring nature.

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. The registered manager worked closely with the clinical nurse manager.

There was a positive culture within the home that reflected the provider's vision of 'Fullness of Life, Growth and Excellence'. The registered manager and the team had a clear vision about how they wished the service to be provided to people. Staff talked about 'personalised support' and they aimed to improve people's lives and enable them to live the lives the way they wanted. Staff effectively supported people in a way that recognised them as individuals and enhanced their well-being.

People had exceptional opportunities to enhance their social inclusion and participate in various activities that met their needs and took account of their preferences. Feedback from people reflected that activities provision enhanced their well-being and sense of purpose.

People's care plans were current and gave clear guidance to staff on how people wished to be supported. Staff knew people's needs well and used this knowledge to provide people with personalised care that put their well-being at the centre of the service delivery. People knew how to complain and complaints were dealt with in line with the provider's complaints policy. People's input was valued and they were encouraged to feedback on the quality of the service and make suggestions for improvements. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible. End of life care was provided in a compassionate way.

People told us they felt safe living at Green Pastures. Risks to people's well-being were assessed and

managed safely to help them maintain their independency. Staff were aware of people's needs and followed guidance to keep them safe. Staff clearly understood how to safeguard people and protect their health and well-being. There were systems in place to manage people's medicines. People received their medicines as prescribed.

Green Pastures had enough staff to meet people's needs and keep them safe. The home had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

People had their needs assessed prior to living at Green Pastures to ensure staff were able to meet people's needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.

People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management team. Staff support was through regular supervisions (one to one meetings with their line manager), appraisals and team meetings to help them meet the needs of the people they cared for.

People living at Green Pastures were supported to meet their nutritional needs and maintain an enjoyable and varied diet. Meal times were considered social events. We observed a pleasant dining experience during our inspection.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. The registered manager and staff had a good understanding of the MCA and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA. The registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety. People told us they were treated with respect and their dignity was maintained. People were supported to maintain their independency. The home provided information in an accessible format to help people understand the care and support that was available to them. The provider had an equality and diversity policy which stated their commitment to equal opportunities and diversity. Staff knew how to support people without breaching their rights.

People, their relatives and staff told us they felt Green Pastures was well run. The registered manager and management team promoted a positive, transparent and open culture. Staff told us they worked well as a team and felt valued. The provider had quality assurance systems in place which were used to drive improvement. The registered manager had a clear plan to develop and further improve the home. The home had established links with the local communities which allowed people to maintain their relationships.

The five questions we ask about services and what we found