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Greenwood Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 August 2018

We conducted an unannounced inspection at Greenwood Lodge on 25 June 2018. Greenwood Lodge is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Greenwood Lodge accommodates up to 19 people. There is a main building which accommodates 17 people and a flat which can accommodate two people. On the day of our inspection, 16 people were living at the home; these were people who had a learning disability and some people also had physical disabilities.

We inspected Greenwood Lodge in February 2017. During this inspection we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to safe care and treatment, the premises and equipment, staffing, person centred care and governance. During this inspection we found improvements were underway and there were no ongoing breaches of the legal regulations. However, some further improvements were needed to ensure people receive consistently good support. This is the second time the service has been rated as Requires Improvement.

There was a registered manager in post at the time of our inspection. 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.

During this inspection we found that the service provided at Greenwood Lodge was not consistently safe. Medicines were not stored safely as storage rooms were not always effectively secured. Medicines were stored above the recommended temperature which could have affected their efficiency. Environmental risks were not always safely managed. Storage cupboards were left open and this posed a risk to people living at the home.

Risks associated with people’s support were identified and assessed, and measures were put in place to ensure people’s safety whilst also promoting their independence. Some improvements were required to ensure people received safe and effective support with behaviours that could pose a risk. Systems to review and learn from incidents and unexplained injuries were not fully effective.

People told us they felt safe and there were systems and processes to minimise the risk of abuse. There were enough staff to meet people’s needs and ensure their safety. Safe recruitment practices were followed to reduce the risk of people being supported by unsuitable staff. The environment was clean and hygienic.

Some improvements were required to ensure people were supported to have maximum choice and control of their lives. People had access to healthcare and their health needs were monitored and responded to. People were supported by staff who had enough training to enable them to meet people’s individual needs. Staff felt valued and supported.

People had enough to eat and drink, they chose what they ate and received assistance as required. There were systems in place to ensure information was shared across services when people moved between them. The design and decoration of the building accommodated people’s needs and people had been involved in decisions about the environment.

People and their relatives told us staff were kind and caring. Staff respected people’s privacy and treated them with dignity. People were involved in day-to-day decisions about their care and support and had access to advocacy services if they required this to help them express themselves. People were encouraged to be as independent as possible.

People were offered some opportunities to take part in social activities. However, these were inconsistent and at times staff interactions were task focused. Further impro

Inspection areas

Safe

Requires improvement

Updated 2 August 2018

The service was not consistently safe.

Medicines were not stored safely. Risks associated with the environment were not always managed effectively.

There were systems in place to review and learn from adverse incidents; however, these were not fully effective. The system for investigating unexplained injuries was not robust.

Overall, people were protected from risks associated with their care and support. There were systems and processes to minimise the risk of abuse.

There were enough staff to meet people’s needs and ensure their safety. Safe recruitment practices were followed. The environment was clean and hygienic.

Effective

Good

Updated 2 August 2018

The service was effective.

Some improvements were required to ensure people were supported to have maximum choice and control of their lives.

Care and support was effectively planned and coordinated when people moved between different services.

People were supported to attend health appointments and staff were knowledgeable about people’s specific health conditions. People were supported to have enough to eat and drink.

Staff had enough training and told us they felt supported.

Caring

Good

Updated 2 August 2018

The service was caring.

People told us staff were kind and caring. Staff respected people’s privacy and treated them with dignity.

People were involved in day-to-day decisions about their care and support and had access to advocacy services if they required this.

People were encouraged to be as independent as possible and were supported to stay in touch with family and friends.

Responsive

Requires improvement

Updated 2 August 2018

The service was not consistently responsive.

People were offered some opportunities to take part in social activities.

People’s diverse needs were recognised and accommodated. However, further work was needed to ensure people had equal access to information.

People received the support they required from staff who had a good knowledge of their needs, wishes and preferences.

There were effective systems in place to respond to concerns and complaints.

Well-led

Requires improvement

Updated 2 August 2018

The service was not consistently well led.

Further improvements were required to ensure that governance and quality systems were fully effective.

Records of care and support were not always accurate or up to date.

People and staff were given the opportunity to provide feedback and make suggestions about the running of the home.

The registered manager was open, honest and was responsive to our feedback.