We carried out a review of the data available to us about Greville House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Greville House, you can give feedback on this service.
Greville House is a nursing home for up to 59 older people, including people living with the experience of dementia. At the time of our inspection 56 people were living at the service.
The service is managed by Care UK Partnerships, a national provider of health and social care services.
People’s experience of using this service and what we found
Medicines were not always managed in a safe way. Some of the systems for monitoring this were not implemented effectively. However, people were receiving medicines as prescribed.
People living at the service and their relatives were happy. Many of them spoke about the positive, open and inclusive culture. People knew the staff and management team, they felt able to raise concerns and felt well informed about the service. People liked staff and had a good relationship with them.
People’s needs were assessed, monitored, planned for and met. The staff worked closely with other healthcare professionals to identify and address any changes in their needs. People had enough to eat and drink. They enjoyed the food. There was a wide range of different social and leisure activities and people were able to take part in these.
There were enough suitably qualified and experienced staff. They were well supported and had access to a range of training and information. There was good teamwork and communication. Staff felt supported by the registered manager.
The risks to people’s safety and wellbeing were assessed and planned for. Incidents, accidents and complaints were investigated and learnt from.
There was a range of systems designed to monitor and improve the quality of the service. These included checks by the management team and senior managers within the organisation. They made improvements when problems were identified and shared information about these with stakeholders.
The environment was suitable and well maintained. There were schedules for repair, redecoration and to make sure the building was clean.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 14 September 2018)
Why we inspected
We undertook this inspection as part of a random selection of services rated Good.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Greville House provides care and support to older adults some of whom have physical and learning disabilities and mental health needs. The care home specialises in supporting people living with dementia. Greville House can accommodate up to 59 people. At the time of inspection 51 adults were receiving support with personal care from this service. The care home is situated over three floors.
At the last inspection the service was rated Good, at this inspection we found the service remained Good.
This inspection was carried out on 21 August 2018 and was unannounced.
The service had a registered manager in post. 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.
People felt there was enough staff to meet their needs in good time. There were systems in place for recording and reporting any potential abuse to people and incidents and accidents occurring. People had sufficient risk assessments in place to ensure their safety. The service followed appropriate staff recruitment processes to employ suitable staff to take care of people.
People had support to move safely where they needed assistance with manual handling. People’s health needs were monitored and they had access to healthcare professionals when they needed it. Staff understood and applied the Mental Capacity Act 2005 (MCA) principles in practice to support people in the decision-making process. Staff regularly up-dated knowledge and skills to ensure they carried out their duties in line with their role requirements. Staff supported people to have meals according to their preferences and dietary requirements.
Staff respected people’s individual needs and attended to their care with kindness and respect. Staff were aware of how people wanted to be cared for and had time to have conversations with people which ensured that people were listened to. People had their religious and cultural needs identified and met by the staff that supported them.
People had assessments undertaken to determine their support needs and to inform staff of how people wanted to be cared for. There was a variety of activities facilitated at the service which helped people to build and maintain relationships with other residents if they wanted to. People told us if they made complaints, changes were made to the service delivery as necessary. Some people felt they were not supported to provide regular feedback about the service and the registered manager told us they would review the systems in place to ensure people’s involvement.
The service was led by a registered manager who we found being open minded, transparent and caring for people’s wellbeing. Staff were led by example and had a good understanding of their role expectations. The registered manager was available to support staff and listen to people’s wishes. The service undertook regular quality assurance checks to identify any improvements required.
We carried out an inspection of Greville House on 19 October 2015. The inspection was unannounced. At the previous inspection of 26 September 2014 the home had met all the regulations we inspected
Greville House is a home for up to 59 older people, including people requiring nursing care. At the time of our inspection there were 53 people living in the home. The home has dedicated nursing, dementia, residential and rehabilitation wings and is over three floors.
The home had a registered manager. 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.
People who lived at the home were protected from the risk of abuse happening to them. People told us they felt safe and well cared for at the service and they would not be afraid to tell someone if they had any concerns about their safety or wellbeing. Staff were able to demonstrate a sound understanding of procedures to follow if they had any concerns about someone.
Risk management plans clearly identified what the risk was and provided staff with instructions about how they needed to manage the risk to ensure people received safe care and support whilst enabling them to remain as independent as possible.
There were enough staff on duty to care for people, with between three and four care staff per floor, together with a team leader. Staff had been trained to use specialised equipment, such as hoists, safely. Specialist assessments had been completed in relation to complex moving and handling issues, for example, with the support of occupational therapists.
The provider had a Service User Guide which emphasised the rights of people to be treated with dignity, to have privacy and to be able to exercise choice. This was also reflected in the home’s policies and procedures and formed the basis for staff training.
The provider ensured that people’s independence and choice was promoted. People told us that they had been involved in making decisions and there was good communication between staff and themselves. They also confirmed that their consent was asked for before doing anything, such as going somewhere, or receiving medicines.
We saw that people’s health, nutrition, fluids and weight were regularly monitored. There were well established links with GP services offering a single point of access for people. This included dieticians, occupational therapists, physiotherapists and social services. Medicines were administered and managed appropriately.
Care records were individual to each person and contained information about people’s life history, their likes and dislikes, cultural and religious preferences.
Staff spoke with people in a professional and friendly manner and were able to demonstrate an understanding of each person’s needs. Keyworkers and named nurses were allocated to people in order to have a consistent and up to date knowledge of each person’s health and well-being.
People said they were able to get up and go to bed at a time that suits them and were able to enjoy activities and interests that suited them. People’s views on the range of interesting activities were mixed. The home also supported people to maintain relationships with family, relatives and friends.
The home’s philosophy placed great importance on ensuring that people who live at the home continued to lead as normal a life as they were able. The activity co-coordinators and staff spent time getting to know the individual, their background and life history.
In order to listen to and learn from people’s experiences the home had monthly meetings with people, the latest meetings having been held in September 2015. There were also relatives meetings held in June 2015 with a further one planned for December 2015.
The provider had an effective system to regularly assess and monitor the quality of service that people received. Audits were carried out monthly and a satisfaction survey sent out in September 2015. Records and other important data were held securely and confidentially.
Is the service safe?
People told us that the care staff treated them well and said they felt safe. Overall comments about the home included 'No complaints about this place', 'It's lovely, friendly', 'It's grand here, I'm well looked after' and 'Very nice.'
Staff had access to mandatory training such as moving and handling, safeguarding and fire safety. Records were kept by the service to ensure that this important mandatory training was kept up to date.
We saw the home environment was safe, clean and well maintained.
Is the service effective?
The care plans and assessments we looked at were up to date reflecting individual care needs across important areas such as nutrition, mobility, personal hygiene, communication and sleep. The electronic system in use prompted staff to regularly review and update individual care documentation.
People's identified needs were being met by staff with the necessary skills and knowledge. We saw that staff had access to the training and supervision that helped them do their jobs saying 'All sorts of training, it never stops' and 'I have done a lot of training here'.
We noted the positive work that has taken place to make the environment homely and personalised to the people living at Greville House. A new ground floor unit for people living with dementia had recently opened with a new conservatory area created to provide additional living space for the individuals staying there.
People we spoke with during our inspection commented on how clean the home was kept saying 'It's very clean here' and 'Everything is so clean.'
Is the service caring?
People told us that staff treated them with respect and upheld their dignity. Feedback included 'They are kind, they work hard', 'The staff are very nice', 'Mostly quite good' and 'Very nice, polite and respectful.'
Staff understood the importance of treating people with dignity and respect and said they would report any concerns immediately. Comments included 'The residents get treated well here' and 'I would speak out if I saw something'.
Is the service responsive?
We had positive feedback from people who used the service about the in-house activities provided. Some people said they would welcome more opportunities to do things outside of the home environment. Comments included 'I don't get bored', 'We had art this morning', 'There's enough going on but I'd like to get out a bit more' and 'We ought to go out more.' We recommend that the organisation arranges regular access to a suitably adapted vehicle.
Is the service well-led?
The service had a registered manager in post. Feedback was positive about his leadership with the majority of people knowing who he was and feeling able to approach him. Comments from individuals and their family members included 'A good manager, you can talk to him, a nice man' and 'Very good, he takes on board what we say'.
We were notified of a medication error that was being investigated by the home and the local authority and decided to check medicines and quality assurance systems. We found that the systems in place to check medicines had identified the issue and appropriate checks were being maintained on a regular basis. Staff understood the importance of medication administration and the effect of missed medication for people who use the service.
People told us "they look after you well here", "staff talk to me nicely" and "the food is very good". Comments about activities included: "there are exercise classes, board games, skittles, art groups and Bingo, there's always something going on", "plenty to do", "I have enough to do" and "there's not much to do here". People were not sure that anything could be improved. Two people said they did not always know who staff were, saying "I can't read their name badges, but am getting to know their names slowly" and "sometimes they tell me who they are, other times I guess".
Staff said "we provide good care here", "residents and relatives are happy, which shows we are doing a good job", "we get lots of training", "I am supported to carry out my job" and "I am happy to be working here". Staff were proud to be working at Greville House and thought things had improved.
Staff demonstrated detailed knowledge of people who use the service and how to meet their individual needs. We saw some good interactions with staff providing person centred care and support to meet individual's needs.
Overall people said they are happy living at the home, saying 'I chose to come here', 'I am happy with the care and support I get', telling us 'staff respect my wishes and feelings' and 'staff maintain my privacy and dignity'.
People told us they go out in the garden and have a variety of activities they can participate in, including musical bingo, bingo and skittles. Other people told us they 'read the paper', 'watch television', 'have visitors' and 'talk with other people'. Some people said there was not much to do and all they did was watch television.
We received mixed comments from people about the food, including 'I am happy with the food', 'the food is good', 'the food is very good', 'the food is not up to much' and 'I'm not happy with the food'.
People's comments about staff included 'staff listen and help', 'staff help', 'the staff are good' and 'staff are lovely'.
Relatives told us they were able to visit at times convenient to them and said staff offered them drinks, made them feel welcome and kept them up to date with information about their relative. They also said there were always activities with details displayed in the entrance for them to see. They told us 'staff are brilliant', 'staff are approachable', 'staff are good' saying that they had 'no concerns' and 'there are enough staff to meet people's needs'. The lift being out of order during our visit meant visitors were not able to take their relatives out of the building which was inconvenient and had happened on other occasions.
Visiting health professionals said 'staff are helpful and kind', saying 'staff are generally organised and work well together' and told us staff kept them updated with people's progress.
Visitors and relatives told us that they felt people were looked after and had everything they needed. They said that they were kept well informed about their relative's well being.
The staff told us that they were supported and were happy working at the home. They said that they felt there was a good atmosphere and they had the training and information they needed to care for people.