All inspections: Greenbushes Nursing Home

We spoke with one person who told us that staff did not ask how they preferred to be cared for. Another person told us that staff did not ask them how they preferred their care needs to be met and had to repeatedly tell staff how to support them in order to get their preferred care routine.

People's care needs were not consistently met. Whilst care was planned it was not delivered in line with the plan. People were not safely supported with their care needs.

People told us that they did not get a choice of some foods. The provider did not have an effective system to offer choice at meal times.

People were not consistently protected from abuse. Matters that should have been investigated by the provider had not been attended too.

The environment had not been safely maintained. Areas of concern that had been brought to the providers attention had not been addressed and there was no plan in place to ensure the building and services were maintained appropriately.

At times there were insufficient numbers of qualified staff to meet people's needs.

People who told us they were consulted about how the home was run but no action was taken to improve the service based on their comments. The provider had a system to assess the quality of service on offer but had not taken action to make improvements based on the outcomes of these audits.

The records used by the home did not effectively demonstrate that people's needs had been accurately assessed or met.

This inspection was carried out over two days beginning on 16 July and concluded on 17 July 2013.

At the time of writing there had been a change in manager and so the information provided relating to the registered manager is incorrect and will be amended in due course.

People told us that there needs were met by staff. We spoke with three people. One person told us, 'They give me all the care I need.' Another person said, 'They (Staff) always stop for a chat, nothing is too much trouble.' Staff understood people's needs.

People's bedrooms reflected their personal choice and were comfortable and clean. However some areas of the home had not been adequately maintained

There were sufficient staff on duty to meet the needs of the people living at the home but their skills and experience was not consistently verified which meant that people were at risk of receiving inappropriate care.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive.

The records used in relation to the care of the people at the home were not up to date or accurate. The records relating to the management of the home did not consistently contain accurate or validated information.

People we spoke with were complimentary about their care and staff at the home. One person told us "I'm happy here." We heard staff speaking with people in a kind and caring way. People's care notes demonstrated that staff had tried to involve them in their care where ever possible. We saw in people's notes that relatives and loved ones were frequently communicated with.

There was regular monitoring of services at Greenbushes and people had up to date risk assessments relative to their care needs. Whilst not all people were able to take part in discussions about their care due to the fragile nature of their illness, care notes demonstrated the involvement of loved ones and relatives where possible. This demonstrated people's care was being reviewed by on a regular basis.

Records of people who used services and of staff who cared for the them were kept safe. The staff archived old notes to ensure the current ones were uncluttered and fit for purpose.

People we spoke with said they felt safe at the home and thought staff were very respectful when care was being provided. We saw that the majority of interactions between staff and people were good. However, we also witnessed a small number of interactions were less respectful.

People said they had been involved in some aspects of their care and had control over their routines in the home and were able to go to bed and get up when they chose. One person said the only choice they were unable to make was whether to have a bath or shower, because the home did not have any shower facilities.

A visitor said that they had been informed of changes in their relatives care and felt included. This visitor also stated that they thought that 'care had been tightened up in recent weeks.'

People we spoke with said they saw the doctor when they needed to and said requests about their care were responded to and they felt in control. We saw that people received a good standard of care, although this was not reflected in the records.

People said they received their medication on time and requests for pain relief were provided promptly. People said the response to call bells was 'generally quick but depends on what else is happening in the home.'

People were complimentary about the staff and described them as 'kind', 'reliable' and 'caring.' One person said: 'Sometimes they know what I need more than I do. They are wonderful.'

There was a programme of activities advertised in the lounge area. This included memory box, quizzes, bingo, trips out, craft sessions, and film sessions. There were organised visits from a local minister of religion.

The two people we asked told us there was a choice of main meal and said there was always a meat dish and a fish dish. We were also told there was a choice of evening meal. People said they could request drinks and snacks when they wanted and that they were provided with biscuits at coffee time.

Nobody we spoke with could recall being asked their opinion of the service or asked whether they were happy with the care they received. The manager was very open about the lack of formal quality assurance procedures at the home but told us about some improvements that had been made as a result of accidents and incidents at the home.

People who live in the home were unable to comment on all aspects of their experiences due to their condition. We observed staff interactions and spoke with visitors.

We saw that people were treated with respect and were called by their preferred name. Staff explained to people what was happening before assisting them and people's privacy was maintained. A visitor told us that they were pleased with the care given to their relative.

People were able to choose how they spend their time and can participate in a range of activities. However, their care varied according to a person's ability and their ability to communicate.

We saw that people were left unsupervised for long periods of time and their needs were not consistently met.

People live in a home that needs improvement to the environment to make sure that they are kept safe and benefit from a homely environment.

People do not have the opportunity to provide feedback on the care they receive

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: Greenbushes Nursing Home

All Inspections

20, 21 November 2013

During a routine inspection

16 July 2013

During an inspection in response to concerns

8 January 2013

During an inspection looking at part of the service

12 June 2012

During a routine inspection

5 September 2011

During a routine inspection

Reports under our old system of regulation