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Greensleeves Residential Care Home Good

Reports


Inspection carried out on 23 March 2017

During a routine inspection

This inspection took place on 23 March 2017 and was unannounced. The service provides accommodation for up to 21 older people with personal care needs. There were 19 people living at the service when we visited. All areas of the building were accessible via stairs equipped with electric stair lifts and there were lounges/dining rooms on the ground floor of the building. There was accessible outdoor space from the ground floor. All bedrooms were for used for single occupancy.

There was a registered manager at the service. 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.

At our last inspection in January 2016, we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements to ensure they assessed the mental capacity and best interests of people who lacked capacity to make specific decisions. At this inspection, we found that improvements had been made and the provider had taken steps to meet the requirements of this regulation.

The provider had a system in place to assess people’s capacity and make best interests decisions for people who were unable to consent to specific decisions. These systems helped to protect people’s rights and freedoms. Staff understood the need to obtain consent from people before delivering care. People were treated with respect and dignity. Their wishes around their care arrangements at the end of their life were documented to help ensure their choices were respected.

People were involved in the planning of their care and were consulted about changes to the service. The registered manager held regular residents meetings, which sought the feedback from people, engaging them for ideas to improve the service. The registered manager sent out formal questionnaires to people and relatives to gain further feedback about the care provided and suitability of the staff. Complaints were dealt with promptly and thoroughly to help ensure people who raised concerns were kept informed of findings from investigations.

People’s care plans were detailed and person centred. They helped enable staff to support people with their preferred routines around their personal care, and to manage risks associated with their everyday living needs and the home environment. When incidents occurred, the registered manager investigated possible causes to identify measures to reduce likelihood of reoccurrence. The registered manager informed CQC and local safeguarding bodies when significant events in the service occurred, which further helped to keep people safe from harm.

People had access to healthcare services when they were required and followed a diet in line with their preference or dietary requirements. Peoples can plans documented the support they required with their medicines and the provider had robust systems in place to help ensure people received their medicines as prescribed.

The registered manager was heavily involved in the day-to-day running of the service. The registered manager was also the provider and subsequently was in a position to monitor the quality of the service, quickly responding to issues to ensure they were resolved promptly and safely. People and staff spoke highly of the registered manager and felt the service was a pleasant place to live and work. The provider had made some adaptation to the environment to help make it suitable for people living with dementia.

Staff were caring and kind to people living at the service and had a comprehensive knowledge of people, supporting them in a personalised manner. Staff received training relevant to their roles and ongoing supervision and feedback to help maintain their effective prac

Inspection carried out on 7 January 2016

During a routine inspection

This inspection took place on 07 and 12 January 2016. This was an unannounced inspection. At our last inspection on 10 October 2013 we found the provider was meeting all the expected standards of care.

Greensleeves Residential Care Home provides accommodation and care for 21 older people, some of whom were living with dementia. The home is situated in Portswood, Southampton and is near to a main route into Southampton city centre and the Common (a large area of parkland).

The home had a registered manager who was also the registered provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This meant the manager was a dual registered person. 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.

Consent to care and treatment was not always sought in line with legislation. Mental Capacity Act assessments and best interest decisions had not been completed where people had been observed as lacking capacity to make certain decisions. This also applied to Deprivation of Liberties safeguards in that DoLS applications had been made without an assessment of the person’s mental capacity.

Care plans were personalised but lacked details on people’s likes, dislikes, preferences and personal histories. Care plans did not show how the person was involved in writing them. People were not always engaged in meaningful activities and seemed to spend a large period of the day in one area of the home.

People were protected from abuse as staff had attended training in safeguarding and knew how to recognise abuse and who they should report this to. The provider had a clear policy and processes in place concerning reporting of abuse and knew how to contact the local safeguarding team.

There were robust recruitment processes in place which ensured staff were suitable and safe to work with people. There were sufficient staff on duty to ensure care was provided to all people when they required it.

Risk assessments were carried out to identify risks associated with the delivery of care. These were reviewed and updated when people’s needs changed. Staff were trained to administer medicines safely. They were assessed to be competent to do this. Medicines were safely administered and were stored in an appropriate and secure location. Systems to order, audit and return medicines were safe and effective.

Staff received appropriate training and supervision to enable them to provide care. There were plans in place to improve staff knowledge and understanding of specific needs of individuals.

People received nutritious meals although they requested more fresh fruit and vegetables and more home cooked cakes. People received support around diets required to meet medical needs. People accessed local medical services and in some cases had maintained support from GPs they were registered with before moving to the home.

There were positive relationships between people and staff. People said staff knew their needs well and how best to help them to maintain independence. However some people did not feel involved in their care plans and were not sure of how to make changes to them. People and relatives were encouraged to make comments about the home and things they wished to do.

Staff were aware of how to maintain privacy and dignity for people and always asked for people’s permission before delivering care.

People knew how to make a complaint and there was a policy in place which was effective in managing complaints. Where people and relatives had raised concerns some of them did not feel they had been listened to.

The provider had effective systems in place for auditing the quality of the service. This included systems to ensure regular checks on fire, health and safety and medicines were completed.

Inspection carried out on 10 October 2013

During a routine inspection

At our last inspection in July 2013 we found procedures for recruiting new staff were not robust. References and employment history checks were not carried out in all cases.

At this inspection we found an effective system was in place to ensure new staff were suitable for employment. Checks were carried out and employment history was documented. New staff were subject to appropriate checks before they commenced employment.

Inspection carried out on 8, 22 July 2013

During a routine inspection

We carried out our inspection over two days as we received some information of concern between visits. We found no evidence to support the concerns raised. We spoke with six of the 20 people living in the home. They told us they were satisfied with the care they were receiving. One person told us “I have everything I need”. We used observation to help us understand the experiences of people with dementia. They appeared to be content and well cared for.

People were cared for according to their care plan. Visitors we spoke with said they were happy with the care their relatives were receiving. We also spoke with a district nurse who regularly visited the home. They told us “people seem happy”.

On a previous inspection in July 2012 we found there was not an effective system in place to record medication given to people ‘as required’. We also found auditing procedures were not followed. On this inspection we found medication audits were carried out and records of people receiving ‘as required’ medication were complete.

We observed there to be sufficient staff to meet people’s needs. Staff had completed various training applicable to their role in the home. However, thorough checks on staff employment history and references were not always completed. People and their relatives were asked for their views on the service and the provider acted on their feedback. A number of audits were carried out to ensure the service was meeting people’s needs.

Inspection carried out on 12 July 2012

During a routine inspection

We spoke with five people who were living at the home. Some people were unable to tell us about their experiences due to their cognitive problems. To help us to understand the experiences of people. We used a Short Observational Framework Inspection tool (SOFI), which helped us observe particular people and activities over a set period of time. We observed how people spent their time, the support they received from staff and whether they had positive outcomes. We also spoke to a relative and three of the staff.

We observed interactions between the staff and people who use the service. People told us that they were treated with respect and that the staff were very good and that they felt safe living at the home. They said they were well looked after and enjoyed the activities and the meals. A person told us that they did not like the lunchtime meal and we observed that they were provided with an alternative.

A relative told us that they visited the home a few times a week and found the care good and the staff were courteous. We were told that they would approach the manager or the provider if they had any concerns about the care.

Inspection carried out on 15 November 2011

During a routine inspection

People said that they were treated with respect ’always’. They said that the staff respected their privacy and dignity. Two people said that the staff had talked to them about their care plans. They told us that the staff were ‘very caring and helpful.’ They said that the staff responded in a timely manner when they requested any help. Comments about the staff were ‘they are so thoughtful.’ ‘They look after you very well. People told us they liked living in the home and they could talk with the manager and the staff.

Reports under our old system of regulation (including those from before CQC was created)