Greathed Manor Nursing Home

Updated 16 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection, we reviewed information we held about the service including statutory notifications sent to us by the registered manager about incidents and events that occurred at the service. Statutory notifications include information about important events which the provider is required to send us by law.

This inspection took place on 11 April 2018 and was unannounced.

The inspection was carried out by two inspectors, a specialist nursing advisor and an expert by experience. A specialist nursing advisor is a person who has special knowledge and experience in caring for people with physical nursing needs and who uses this type of care service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of and relatives.

We spent time observing people in areas throughout the home and were able to see interaction between people and staff. We watched how people were being cared for by staff in communal areas. This included the lunchtime meals in the dining room and in people’s rooms.

We spoke to five people using the service, two relatives and four staff. We viewed four care plans, three staff files, training programmes, medicine records, duty rotas, maintenance records, menus and quality assurance records. We observed medicines being administered to people, lunchtime, the home environment and activities. We also asked the provider to send us information following the inspection, which they did. We spoke to the manager and the regional manager and the lifestyle coordinator.

Updated 16 June 2018

Greathed Manor can accommodate up to 32 people. The service provides convalescence care, post-operative care, rehabilitation, respite care and palliative care. Facilities include single en-suite bedrooms, three lounges, a dining room, library and assisted bathrooms.

Greathed Manor 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.

The inspection took place on Wednesday 11 April 2018. It was unannounced.

The service was last inspected in January 2016 when it was rated good. No breaches of legal requirements were found. We made two recommendations about activities and the use of best practice in care planning. Improvements had been made. People nursed in their rooms had an extra member of staff to help them engage in activities and be less isolated. Care plans were linked with the nursing needs of people in line with Social Care Institute for Excellence (SCIE) and National Institute for Health and Clinical Excellence (NICE) guidance. This helped staff to understand the needs of the whole person.

There was no registered manager in post at the time of our inspection. The previous registered manager left and the current manager took up their post in February 2018. They had submitted an application for registration with the Care Quality Commission.

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.

A relative told us, “I have only good things to say [about the home]. It’s a lovely place to live. The atmosphere is very welcoming” and the staff are, “always friendly, always helpful.”

People stated that Greathed Manor was a safe place to live, and that staff did their utmost to ensure that anyone who entered the home was safe and secure. Relatives and people commented that there was a cosy, homely feel to the home, and that staff and management were welcoming and happy.

Medicines were managed safely and there were effective infection control procedures. We saw evidence that lessons had been learned when things had gone wrong by adopting procedures to prevent incidents happening again. Staff had a good understanding of safeguarding procedures.

One told us, “it’s about keeping people safe and protecting them from abuse.” There were enough staff on duty, and they interacted very well with people, visitors and each other in an appropriate manner.

People’s care plans took into account their wishes and preferences. People were provided with a choice of food and drink throughout the day and were supported to maintain their nutrition and hydration needs. The home was well adapted and designed to meet people’s individual needs. There were no locked doors or keypads. People had access to healthcare services and were receiving ongoing healthcare support.

We saw staff being caring and compassionate, treating people with dignity and respect. Staff knew people well and had a good understanding of them as individuals. Staff had received the training they needed to deliver care in a way that responded to people’s changing needs. Staff had regular supervision and appraisal.

Complaints were taken seriously by the manager and robust efforts made to resolve any outstanding issues.

People and staff praised the new manager for being approachable and always visible. One person told us, “She’s very nice, and I always see her around all of the time”. People told us that the manager had improved communication with staff, people and relatives. People told us that the manager listened to people when they had suggestions or if they had a problem. There was a lifestyle coordinator delivering activities to people.

There were quality assurance systems identifying where improvements were needed.