We carried out a review of the data available to us about Greenacres Care Centre Limited 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 Greenacres Care Centre Limited, you can give feedback on this service.
The service is on two floors, with access to upper floors via a shaft lift or stair lifts. All bedrooms have ensuite toilet and washing facilities. There is a secure outside garden area.
We found the following examples of good practice.
Visitors to the service were prevented from catching and spreading the infection because safe and effective measures were in place. This included a vigilant check by staff to take visitors temperatures on entry, the completion of symptom questionnaires, and the prompting of the use of hand sanitiser and/or handwashing. Visit times were staggered, and a newly created visiting booth enabled people to visit their loved ones safely.
People were safely admitted to the service from hospital and/or the community in line with current guidance.
Staff had received infection, prevention and control training, they wore PPE correctly, understood the importance of it, and spoke confidently about how they put it on and took it off in line with infection control guidelines.
Cleaning routines at the service had been increased which now included high touch areas, such as door handles and light switches. The laundry area was safely managed, and staff spoke confidently about how to handle contaminated laundry.
There was an enthusiastic approach to testing, and the vaccine had been rolled out to people and staff. Risk assessments were in place as required and measures were being taken to protect people and staff who were assessed as being in a vulnerable category. There was an external clinical lead assigned to the service, who made contact on a weekly basis to offer guidance and support.
The registered manager had a good understanding of infection, prevention and control guidance and was confident in their decision-making processes, liaised with relevant agencies, and knew how to access local support.
To assess and monitor ongoing infection and control practices within the service, the registered manager had spot checks in place. Should an outbreak occur the registered manager had a robust contingency plan in place and staff were confident about what action to take.
Greenacres Care Centre, referred to hereafter as Greenacres is a residential care home. It is registered to provide accommodation and personal care and accommodation for up to 39 older people. The service supports people with physical disabilities, mental health and/ or dementia. Nursing services were provided by NHS community nursing services. At the time of the inspection there were 36 people living at the service.
The service is on two floors, with access to upper floors via a shaft lift or stair lifts. All bedrooms have ensuite toilet and washing facilities. There is a secure outside garden area.
People’s experience of using this service and what we found
People and their families told us staff were kind, commenting “Staff are lovely…can’t fault staff for being caring and kind”. We saw nice interactions between people and staff, with some people showing their fondness for staff by hugging them and kissing them on the cheek.
People were protected in line with the Equality Act 2010, with everyone being cared and supported as an individual. Staff promoted people’s independence.
Overall people’s privacy and dignity was mainly respected. However, on some occasions we observed people’s dignity and privacy was not always promoted. We spoke with the registered manager about what we had observed. They were disappointed to hear our feedback and told us they would act to improve staff’s understanding of the importance of privacy and dignity.
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.
People had the opportunity to participate in social activities which were tailored to encourage people to live healthier lifestyles. A new activities co-ordinator had recently been recruited and was in the process of getting to know people.
People and their families told us they felt safe living at the service. Staff had a good understanding of safeguarding procedures, which meant they knew what action to take should they suspect someone was being abused, mistreated or neglected.
People were supported by sufficient numbers of staff. People told us staff had the skills and experience to meet their individual needs and staff were complimentary of the training and support they received.
The design and decoration of the service took account of dementia best practice. People lived in a clean environment. There was a dedicated housekeeping team who were passionate about ensuring people lived in a clean, tidy and odour free service.
The food being offered, smelt nice and was pleasant in its presentation. Observations of the dining experience showed people did not always receive their meals promptly, and people were not always supported in line with the principles of good dementia care. We spoke with the registered manager about this, who told us they had already recognised action was required, and that they would be speaking with staff and making changes.
People had care plans in place relating to their health and social care needs. These were reviewed with people and/or their representatives on an annual basis to help ensure they were reflective of the care they wanted and needed. However, two out of 11 care plans were found to not be up to date. The registered manager took immediate action to update records.
People who were at the end of their life, had care plans in place so staff knew what their wishes were. There were good connections with external health care professionals, such as GPs, community nurses and the local hospice.
People and their representatives were regularly asked for their views about their care plans and the delivery of their service, and had their wishes respected.
Overall, people’s medicines were managed safely, and they received them as prescribed.
The registered manager had monitoring checks in place to help highlight where improvements were needed. They had identified that topical medicines (creams and lotions) were not always dated upon opening, body maps were not always completed, and that the recording on medicine administration records (MARs) needed to be improved. At the time of our inspection, we also identified these areas required improving, but action was being taking.
The management team (registered manager, general manager and provider) were visible within the service. The general manager and provider visited the service most days including weekends, arriving announced and/or unannounced. The provider and registered manager had a good understanding of regulatory requirements and were passionate about providing a quality service to people.
Overall, staff felt the service was well managed, describing the management team as “approachable”. However, some staff felt improvements to communication and consistency in managerial approach was needed. Families also felt communication needed to improve.
There was a transparent and open culture whereby mistakes were recognised, and related learning put into practice. People knew who to complain to and told us if there were things that they did not like, it would be changed.
Following our inspection, the registered manager informed us of actions being taken to make immediate and ongoing improvements.
We recommended the provider’s governance framework was strengthened to monitor and assess the ongoing culture of the service, and to ensure care plans were fully reflective of the risks associated with people’s care. In addition, we recommended the provider considered reviewing the overall dining experience, taking account of the principles of dementia care and that staff received training in dignity and privacy.
More information is in Detailed Findings below.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Please see the action we have told the provider to take at the end of the report.
Rating at last inspection (and update)
The last rating for this service was Good (published 11 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenacres Care Centre Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
whom are living with dementia. At the time of the inspection there were 37 people living in the service.
There was 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.
At the last inspection, the service was rated Good overall.
At this inspection we found the service remained Good in all areas.
Why the service is rated good.
One person said; “The whole atmosphere is very good – I don’ think you could find a better place than this.” Another person said; “Staff are always smiling and work well as a team” and a relative said; “There are plenty of staff and everyone chats. It’s a happy place.”
People remained safe at the service because they received their medicines safely. People, relatives, professionals and staff told us there were sufficient staff to meet people’s needs. Risk assessments were completed to enable people to retain their independence and receive care with minimum risk to themselves or others.
People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff were well trained and competent. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's healthcare needs were monitored by the staff and people had access to healthcare professionals according to their individual needs.
People said the staff were kind and very caring. One relative said; “The staff are very caring and patient with mum when she is getting confused.” There was a busy but calm atmosphere in the service. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received.
The service remained responsive to people's individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Complaints were fully investigated and responded to. A relative said; “I am confident that if I had any concerns they would be taken seriously.”
People were assisted to take part in a wide range of activities according to their individual interests. Entertainers visited the service and trips out were also planned for people.
The service continued to be well led. People, relatives, professionals and staff told us the registered manager and management team were very approachable. The registered manager and provider sought people's views to make sure people were at the heart of any changes within the home. The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.
Further information is in the detailed findings below.
The Inspection took place on 28 and 29 January and was unannounced. This was Greenacres Care Centre’s first inspection. The service opened in June 2014.
Greenacres provides care and accommodation for up to 39 older people, some of whom are living with dementia or have a physical disability. On the day of the inspection 38 people lived at the home.
The service did not have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However the home’s manager was in the process of going through the registration process with CQC.
During our inspection people and staff were relaxed and calm and there was a friendly atmosphere. We observed staff and people using the service chatting and enjoying each other’s company. Comments included; “Staff make me feel at home.” People, who were able to tell us, said they were happy living there.
People had their privacy and dignity maintained. We observed staff supporting people and being kind and compassionate.
People and their relatives were very happy with the care they received from staff and said they were knowledgeable and competent to meet their needs. People were encouraged and supported to make decisions and choices whenever possible in their day to day lives.
People were protected by safe recruitment procedures. There were sufficient staff to meet people’s needs and staff received an induction programme. Staff had completed appropriate training and had the right skills to meet people’s needs.
People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs such as district nurses and GPs. Staff acted on the information given to them by professionals to ensure people received the care they needed to remain safe.
People’s medicines were managed safely. Medicines were managed, stored, given to people as prescribed and disposed of safely. Staff were appropriately trained and confirmed they understood the importance of safe administration and management of medicines.
Safeguarding of vulnerable adults training had been completed and staff knew how to report any concerns and what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.
People were supported to maintain a healthy, balanced diet. People told us they enjoyed their meals and did not feel rushed. One person said, “Lunch was lovely - really really nice.”
People’s care records were computerised and of a high standard. They contained detailed information about how people wished to be supported. Records were regularly updated to reflect people’s changing needs. People and their families were involved in the planning of their care.
Staff confirmed the management of the service was supportive and approachable. Staff were happy in their role and spoke positively about their jobs.
There were quality assurance systems in place. Feedback to assess the quality of the service provided was sought from people and their relatives. Audits were carried out to help ensure people were safe, for example environmental audits were completed.