This comprehensive unannounced inspection took place on 13 and 20 November 2018.

RecoveryHub@East Leeds 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.

RecoveryHub@East Leeds provides personal care for a maximum of 37 older people. The service provides short term placements from both the hospital and community with the aim of people returning to their own home. There were 30 people using the service at the time of this inspection.

At our last inspection in May 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There was a registered manager in post. A registered manager is a person who has registered with CQC 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.

We found some improvements were needed to fully ensure the safe management of medicines. Systems for administration of medicines when people were out of the service needed to be strengthened and correct codes needed to be used when recording omissions or refusals of medicines. We recommend the provider keep medicines records under review to ensure the improvements discussed at the inspection are made and sustained.

People told us they felt safe and well- cared for. Staff were trained to recognise and report any signs of abuse. Staff were recruited safely and were deployed in suitable numbers to meet people's assessed needs.

Overall, where risks to people had been identified, action had been taken to reduce those risks. Some records needed to be updated to fully reflect this. The premises were clean and well maintained. Staff were trained in good hygiene practice and were supplied with personal protective equipment such as gloves and aprons.

We received very positive feedback about the effective care and support provided. Staff had received training and ongoing support to help with their development. They told us they received good support from the provider, which helped them to fulfil their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and procedures in the service supported this practice. People received care and treatment from a range of healthcare professionals as needed. Care records were reviewed regularly, or when people's needs changed. People were encouraged to eat a healthy, balanced diet of their choice. People told us they enjoyed the meals and snacks available.

People, relatives and health and social care professionals told us staff were skilled in enabling people to become independent and achieve their recovery goals. Staff knew people well and made sure people received care and support that was personal to their needs and was responsive to any changing needs. Staff demonstrated a good understanding of the recovery model of care provided

People and relatives were very complimentary about the caring nature of staff. People felt listened to and valued. Staff were motivated and showed a commitment to providing dignified and compassionate care.

A variety of meaningful activities were available to people and they were supported to develop new interests which contributed to their overall wellbeing and recovery. People were actively encouraged to give their views and make sugg

This was an unannounced inspection carried out on the 12 April 2016. At the last inspection in April 2014 we found the provider met the regulations we looked at.

The Green is a residential home providing personal care and support for up to 37 older adults; some of whom are living with dementia. The home also offers a respite care service. It is located near the centre of Seacroft. Leeds Local Authority manages and operates the home.

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 and associated Regulations about how the service is run.

People told us they felt very safe. Staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. Overall, individual risks had been assessed and managed to ensure people’s safety. However, some improvements were needed to ensure a consistent approach.

People were protected against the risks associated with medicines because overall the provider had appropriate arrangements in place to manage medicines safely. Recruitment procedures were safe.

Systems for monitoring quality were in place. Where improvements were needed, these were addressed and followed up to ensure continuous improvement; however, these actions were not always fully documented to show the effectiveness of the systems.

There were policies and procedures in place in relation to the Mental Capacity Act 2005. Staff were trained in the principles of the Mental Capacity Act (2005), and could describe how people were supported to make decisions; and where people did not have the capacity; decisions were made in their best interests.

People were very well cared for. Staff knew people very well and understood how to meet people’s needs. People or their relatives were involved in making decisions about their care and were involved in the care planning process. People engaged in social activities that met their needs. Friendship and family and friends involvement in the service was actively encouraged.

There were systems in place to ensure complaints and concerns were fully investigated and people who used the service and their relatives said they felt confident to talk to staff about any concerns.

People told us they got the support they needed with meals and healthcare. Health, care and support needs were assessed and met by regular contact with health professionals.

During our inspection we looked for the answers to five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

Is the service safe?

The service was safe, generally clean and hygienic. One relative we spoke with said, "We are happy with the cleanliness of the home, I've never found any issues." We observed the home generally had no malodours and most areas of the home were visibly clean.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

We asked staff if there was anyone subject to a deprivation of liberty safeguards (DoLS), and although there was nobody currently requiring a DoLs authorisation staff were aware of the requirements of the Mental Capacity Act and provided assurances they would refer people for a DoLS authorisation as necessary.

Is the service effective?

People's health and care needs were assessed where possible with them or their relative. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

Care staff were attentive and spent time talking with people and making sure their needs were being met. People commented, “I like the company, I like the home.”

People who used the service, and other professionals involved with the service had completed satisfaction surveys.

Is the service responsive?

People knew how to make a complaint if they were unhappy. We saw the complaints policy displayed in the reception area of the home. Staff told us they would help people to make a complaint. A staff member said, "I would report any concerns; I wouldn't think twice about it."

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result, the quality of the service was continually improving.

During our visit, we spoke with a number of people who used the service, they all told us they were happy living at The Green and received the care and support they needed. One person told us "I go shopping to Tesco and staff always go to hospital appointments with me." and "I try to help myself but these girls do work hard for you."

Evidence was provided that an infection control audit has been completed and was reviewed annually to ensure appropriate procedures for good infection control practice were being followed. One person said, "They are always cleaning, I am very happy with the cleanliness of the home."

Regular monthly medication audits had been carried out to make sure all medication reconciled with what was recorded on the MAR charts. Any unused medication had been returned to the local pharmacy for disposal. We looked at the control drugs which were kept in a separate locked cabinet with the controlled drugs log and found they were correctly stored and matched the log.

There were enough qualified, skilled and experienced staff to meet people’s needs.

People who used the service, their representatives and staff had been asked for their views on the care and treatment provided and their responses had been acted on. The home had conducted surveys of the people who used the service, their relatives, and the professionals, such as the community nurses and general practitioners, who provide a service to people who lived at The Green.

We spoke with the people who used the service and they told us they liked living in the home. They told us that the ‘staff are excellent’ ‘I have no complaints about the staff.’ We looked at the care plans of five people who used the service. We saw that they were detailed and focussed on individual need. We saw that risk assessments had been carried out and the action plans were designed to reduce the risk of harm to the person.

We spoke with three staff; one of whom said’ I love my job.’ They told us they felt supported by the management and felt that the training was adequate in meeting their needs. They told us that the staff ‘worked as a team’ and enjoyed the variety of work they did.

We looked at the files of five staff members. We saw that they received regular supervision and had their training needs identified at their annual appraisal.

We spoke with some family members and they told us that they liked the staff and thought they were ‘friendly’.

We saw that staff had training in safeguarding and there were policies in place to support them.

We saw that the interaction between the staff and people who used the services was friendly and considerate with lots of laughter.

It was not necessary to talk to people who use the service as this was a follow-up visit to assess if the provider had taken appropriate actions following the visit in November 2011.

People who use the service told us they could make decisions about what they did. Several people said they chose what time they wanted to go to bed and what time they wanted to get up on a morning. One person said, “It’s 100% perfect. They come and ask me when I want to go to bed. Last night it was midnight.”

People who use the service said they were treated well. One person said, “The staff are very nice. They’re careful when they put me in my chair and check my tea is not too hot.”

People we spoke to said staff asked them how they wanted their care to be delivered and never rushed them. People said they get good support with their healthcare needs and staff arranged appointments when they were required. One person discussed a recent event where they needed urgent medical attention. They said staff sorted it straightaway and praised the staff involved.

Staff said people received good care and were treated with respect. One member of staff said, “Everyone is treated as an individual. One person will get up early whereas another person will have a lie in and breakfast in bed. Some like to have a bit of independence and for example will wash up but others don’t want to do any jobs.”

Staff said good systems are in place to identify and meet people’s needs, and these are communicated well so everyone knows what they are doing.