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Archived: Greathouse - Care Home with Nursing Physical Disabilities Good


Inspection carried out on 25 January 2017

During a routine inspection

Greathouse Care home provides accommodation which includes nursing and personal care for up to 25 adults. They are a part of Leonard Cheshire Disability who are a charitable organisation providing care and support to people living with disabilities. At the time of our visit 22 people were living at the home.

This inspection took place on 25 and 26 January 2017. The first day of the inspection was unannounced. At a previous inspection which took place in November 2014 the provider required improvement in Safe, although this was not a breach of regulation. This related to the interactions of one person living at the home. We found on this inspection the provider had taken all the steps to make the necessary improvements needed to resolve the situation.

A registered manager was employed by the service and was present throughout 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.

We saw some areas of the home were damaged. For example, skirting boards were chipped and worn, paint was peeling off the walls and door frames were damaged. This meant the cleaning of these areas was difficult. This had been identified by the registered manager who developed an action plan of repairs. As the home is a listed building the registered manager was currently in the process of obtaining the necessary permission to undertake these repairs.

People spoke positively about the care and support they received. They described staff as kind, caring and friendly. People told us they felt safe living at Greathouse. Staff had taken the time to understand people’s care and support needs. Staff understood people’s communication needs and used non-verbal communication where required to interact with people.

People received care and support from staff who followed the guidance provided in their individualised care and support plans. These contained detailed information to assist staff on providing care and support in a manner which respected the person’s preferred individual requirements. People were supported and encouraged by staff to make choices about their daily living including how they wished to spend their day.

People were supported to participate in a variety of meaningful activities to prevent them from experiencing social isolation. A range of activities were available to people which included external day trips to places of interest to people.

People’s safety was assessed and risks that may cause harm had been identified and guidance put in place to support people to manage these appropriately. People were supported by staff who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe from potential harm or abuse.

The provider ensured people were kept safe by ensuring sufficient staff were deployed to meet people’s needs in a timely manner. People were protected from the risk of harm and abuse. Staff received safeguarding vulnerable adults training and were aware of their responsibility to report any concerns. Policies and procedures were in place to advise staff on what they should do if they had concerns.

People’s health needs were met. Staff engaged with healthcare professionals when required to ensure people’s identified health care needs were met. People were protected from the unsafe administration of medicines. Nurses and senior staff were responsible for the administering of people’s medicines and had received training to ensure people’s medicines were administered, stored and disposed of correctly.

People were supported to eat and drink enough to maintain their nutrional and hydration needs. People spoke positively about the food provided. They confirmed that snacks and drinks wer

Inspection carried out on 5 & 7 November 2014

During a routine inspection

We carried out this inspection on 5 and 7 November 2014. During our last inspection on 11 November 2013 we found the provider to be in breach of Regulation 20, Records. The provider wrote to us with an action plan of improvements that would be made to their record keeping.

During this inspection we found the provider had taken steps to make the necessary improvements. Care plans had been up dated and were well organised with required signatures and dates in place.

Greathouse Care Home are part of Leonard Cheshire Disability who are a charitable organisation providing care and support to people living with disabilities.  They provide accommodation and nursing care for up to 25 younger adults. At the time of our visit there were 24 people living at the home. The home was adapted to provide a safe environment for people living there. There was specialist ceiling hoists to support the safe moving and handling of people. Doors were wide enough so that people who were in wheelchairs could move freely around the building.

The service had a registered manager who was responsible for the day to day operation of the home. 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.

Some people told us they did not feel safe living at Greathouse. People were not always protected from abuse. This was mainly due to the interactions with one individual living at the home. There were clear procedures in place to recognise and respond to abuse. Staff had received training in this area. We spoke with the registered manager who explained the actions they were taking to try and resolve this situation and additional resources they were seeking.

The service had appropriate systems in place to ensure that medicines were stored correctly and securely. However people’s medicines were not always administered safely. Records we looked at contained significant gaps in recording when medicine should have been given.

The registered manager had knowledge of the Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety. They understood DoLS and where required had made applications to ensure people were supported appropriately.

People were protected from risks associated with their care because staff followed appropriate guidance and procedures. Staff understood the needs of the people they were supporting. We saw that care and support was provided in a considerate and compassionate manner. People spoke positively about the home and the care and support provided. Staff took time to talk to people. There was an ‘activities team’ which provided activities such as cookery, day trips and arts and crafts.

People were supported by staff that had been through a thorough recruitment process. Staff were appropriately trained and understood their roles and responsibilities. The staff had completed training to ensure that the care and support provided to people was safe and effective to meet their needs. Staff received a comprehensive induction. The registered manager explained that supervision of staff (one to one meetings with line managers) had previously been sporadic. However actions to address this were in place and staff were now receiving supervision to support them to carry out their roles correctly.

The registered manager and senior management had systems in place to monitor the quality of the service provided. Audits covered a number of different areas such as care plans and health and safety. Staff were aware of the organisation’s visions and values and there was a positive culture where people felt included and their views sought.

Inspection carried out on 12 November 2013

During a routine inspection

People were happy with the way they were looked after and life at Greathouse. One person who had recently moved in said �I am settling in and have made new friends with the staff and the other people who live here�. We asked about meals they were provided with and they said �We have a varied diet and the meals are well cooked� and �the staff will make us a hot drink whenever we ask�.

Medicines were well managed with safe procedures in place for the ordering, receipt, storage, administration and disposal of unwanted medicines. Where appropriate, people were supported to manage their own daily medicines.

The home was fully equipped to meet the needs of the people who lived there. All equipment was well maintained and serviced regularly.

There were effective recruitment/selection processes and appropriate checks were undertaken. Service user representatives participated in the recruitment process and had a say about who was offered employment. We found there were enough qualified, skilled and experienced staff to meet people's needs and the few vacant posts were being actively recruited into.

The provider used a variety of measures to check the quality and safety of the service provided but had not completed a �Customer Survey� for some time. Any complaints made about the service had been handled correctly. We have asked the provider to make improvements with people�s care records as we found some of them to be incomplete and not well organised.

Inspection carried out on 2 February 2013

During a routine inspection

We received information of concern prior to our inspection and visited at the weekend in order to check out the facts. We looked at those areas where concerns had been raised. However, evidence and observations made did not support the information given. We have referred to the concerns throughout the report.

When we visited there were 22 people living in the home and we were able to speak with seven of them. People said they were asked for their agreement before any care was delivered. They commented, �I have lived here for a number of years. I need a lot of assistance from the staff but they still ask before helping me, if it is OK for them to proceed�, �I get all the help I need and the staff are very good to me� and �I am included in making decisions about my care�.

People told us the meals were good, they were offered choice and they had plenty to eat and drink. �The chef is excellent and the standard of meals has really improved in the last year�. People told us that they felt safe and well looked after. �I feel very safe here� and �I am treated well and all the staff are very kind�.

We asked people about the staff and whether the staff were available to help them when they needed support. One person said �I always get the help when I need it� and another said �the staff are good and know how to look after me�. We were able to speak with visitors and they said that the �staff were marvellous� and �had made a big difference to our relatives life�.