Archived: Greenhill

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question good. At this inspection the rating remained good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were protected from abuse and avoidable harm. People told us they felt safe with staff and well supported. Comments included, “The carers are brilliant, can’t fault them”, “The carers treat us with so much respect, I always feel comfortable”, and, “They know what they’re doing, and I never feel unsafe.” A relative told us, “I never feel anxious leaving my [relative] here. I know [relative] is being treated with kindness and dignity.”

There were safeguarding and whistle blowing policies and procedures in place and staff had a good understanding of them. Staff told us they would report any suspected abuse to the nurse in charge and the registered manager. Staff said they felt confident any concerns would be managed appropriately, and referrals would be made to the local authority safeguarding team. Staff also said they knew how to report safeguarding concerns to the CQC and local authority if they needed to. Training records confirmed that staff had received training on safeguarding adults from abuse. There were systems in place to support staff to learn when things went wrong, such as accidents and incidents. These were recorded and showed that appropriate actions were taken by staff where required following any adverse events.

Staff promoted people's rights and worked within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. People were consulted and supported to make choices and decisions for themselves. The provider had requested legal authorisations where restrictions were in place. Decisions around these were made in people’s best interests and for their safety.

Risks to people were assessed, planned for and reviewed to ensure their safety and well-being. People’s care plans and records included risk assessments for areas of their care such as, nutrition and hydration, skin integrity, communication and mobility. However, some records relating to areas of risk such as the management of epilepsy, personal care and food and fluid intake required greater detail. We drew this to the registered manager’s attention who on the second day of our assessment had addressed these issues.

Risk assessments included information for staff about actions to be taken to minimise accidents occurring. Where people had been assessed as being at risk of falls, we saw advice had been received from appropriate health and social care professionals to minimise the risk of recurrence.

Risks to people’s wellbeing was assessed and continually monitored. Staff told us how they supported people who were assessed as being at risk due to their medical or health conditions. One staff member told us how they supported a person at risk of choking to eat and drink safely. They explained what interventions they would carry out in an emergency for example, calling for help immediately, back slaps and abdominal thrusts. The nursing team would also assess the situation and call an ambulance if needed.

A staff member told us how they supported a person who had fractured their leg. They advised us that a physiotherapist had assessed the person. The physiotherapist gave the staff team some guidance and showed them what they needed to do to support the person to move around the home safely. They told us all this information was recorded in the person’s care plan.

A visiting professional to the service told us, “Information in regard to the health/welfare and needs of people is always current, up to date and detailed. The staff team are very proactive in responding to any concerns or issues promptly referring to the relevant professionals in a timely manner.”

The design of the premises was meeting people's needs. People had their own bedrooms which they could personalise with furniture and belongings. People had equipment they needed to keep safe, such as hoists, specialist beds and bath/shower equipment. These were regularly checked to make sure they were safe to use. People had individual emergency evacuation plans which highlighted the level of support they required to evacuate the building safely.

The registered manager showed us servicing certificates for the service's fire alarm system, portable appliances, gas safety, legionella testing and up to date fire risk assessments. They also showed us checks and audits carried out on the call bell system and regular fire drills were conducted.

There were no restrictions on visitors, and we observed relatives and people visiting the service freely throughout our assessment.

A visiting professional to the service told us, “It’s a warm, welcoming environment where care isn’t just a job but something the staff truly believe in. I feel lucky to work alongside such an amazing team who take pride in what they do.”

We observed there were enough staff deployed throughout the service to meet people’s needs when required. People told us they felt there was enough staff to meet their needs in a timely manner. One person said, “I never feel like I have to wait too long for help. The staff are always there when I need them.”

The registered manager showed us a dependency tool and told us they used this to work out the staffing levels required to meet people’s needs safely. When there are new admissions to the service or people’s needs changed, a review of the staffing levels would be conducted. The staff rota reflected the names and numbers of staff on duty during our assessment.

Staff told us there was always enough staff on duty to meet people’s needs. One staff member said, “We have enough staff, we have time to sit down and chat with people, we are not rushed to do things.” Another staff member told us, “We have plenty of staff to meet people’s needs.”

Robust recruitment procedures were in place. Recruitment records included proof of identification, application forms with employment histories, employment references, occupational health and right to work in the UK checks. Nursing staff’s National Midwifery Pin numbers were also sought and recorded. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out.DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff told us they received supervision and training in relation to people’s needs. They told us they were up to date with training the provider considered mandatory. One staff member said, “I am up to date with all my training. I recently had training on dementia awareness. I learned how to understand and meet the needs of people living with dementia.” Another staff member said, "The supervision here is excellent, we're not just learning skills, but understanding how to truly care for people."

We saw a training matrix which indicated that staff had completed training in areas such as person-centred care, dementia, diabetes and falls awareness, fire safety, emergency first aid, infection control, medication administration, moving and handling, safeguarding adults, LGBT awareness, the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.