Greenleigh

Greenleigh is a residential care home providing personal care and accommodation for up to 35 people some of whom may live with Dementia. The service was supporting 31 people at the time of the inspection.

People’s experience of using this service and what we found

Improvements were required with the systems in place to manage risks to people and their medicines. This is to make sure people's medicines were stored safely and to ensure risks to people were well managed to reduce potential risk of harm.

Equipment was not always used to ensure people's privacy and dignity was promoted for those people that shared a room. We were somewhat assured with some of the measures in place to prevent the spread of infection.

The systems and processes in place were not effective enough to enable the provider to identify where areas for improvement were needed and to take action to address these. Some of these shortfalls had been identified at the previous inspection and improvements had not been made. The registered manager did take action when information of concern was shared with them to address some of these shortfalls.

People were supported by staff that had been trained and understood how to protect people from abuse. People had access to healthcare professionals to ensure their healthcare needs were met. Systems were in place to review any incident and accidents to see if there were any lessons to learn from these.

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 enjoyed the food provided which met their preferences. People were supported to provide feedback about the way the service was managed. People were happy with the service provided and felt able to approach the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update.

The last rating for the service was requires improvement (published 21 May 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to management of people's risks, about the way people’s care needs were being met, and the overall management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed and the service remains requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenleigh on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to management of medicines, risk management and to the overall governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Greenleigh is a residential care home providing personal care to 33 people aged 65 and over at the time of the inspection. The service can support up to 35 people.

The care home accommodates 35 people in one purpose built building over two floors. There is access to both floors through a lift.

People’s experience of using this service and what we found

People’s care records had not consistently been kept up to date. Some of the systems around infection control were not in line with current COVID-19 guidance. Immediate action was taken to address these issues.

Whilst there were systems in place to monitor the quality and safety of the service, we found these needed further improvement. The registered manager and provider took action to immediately address the concerns we found at the inspection.

Whilst many aspects of staff recruitment and monitoring risk to people were safe, we identified further improvements were needed in some areas.

People received safe support with the medicines and were supported by staff who understood appropriate action to take should safeguarding concerns occur.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 18 September 2019).

Why we inspected

The inspection was prompted in part due to concerns received about specific incidents relating to the use of bed rails. We inspected the service to examine those risks. During the inspection we identified further concerns so expanded the inspection to review the key questions of Safe and Well Led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenleigh on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Geenleigh is a residential care home for up to 35 people. There were 35 people living at the home at the time of the inspection. The accommodation was established over two floors.

People’s experience of using this service:

People were kept safe by staff who knew how to report concerns of abuse and manage risks to keep people safe. Staff were safely recruited and there were sufficient numbers of staff to support people. Medications were given in a safe way. Lessons were learned following accidents and incidents.

People’s needs were assessed, and these considered protected characteristics under the Equality Act.

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’s dietary needs were met, and people had access to healthcare services where required.

People were supported by staff who were caring. People were involved in decisions around their care and were treated with dignity. Advocacy services were sought for people where needed to share their views.

Staff knew people well and supported them in line with their likes, dislikes and preferences. People were supported to access activities that met their individual interests. Where complaints were made, these were investigated.

People and staff felt well supported and told us that the service was well led. There were effective systems in place to monitor the quality of the service and gather feedback on people’s experiences.

Rating at last inspection

At the last inspection we rated Greenleigh as ‘Good’ (report published on 04 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Greenleigh provides accommodation and personal care for up to 35 older people. At the time of the inspection there were 31 people living at the home.

There was 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 told us that they felt safe in the home. They were confident that staff were aware of the risks to them on a daily basis and how to support them appropriately and keep them safe from harm. Staff had received training in how to safeguarding people from abuse and were aware of their responsibilities to report any concerns they may have.

Staff were aware of their roles and responsibilities on each shift and staffing levels were assessed in line with people’s dependency levels. People were supported to take their medication and staff competencies were regularly assessed to ensure they supported people safely and in line with their care needs.

People were supported by staff who benefitted from an induction and training that provided them with the skills and knowledge to support people safely and effectively.

People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards in their work practice.

People were supported to have sufficient to eat and drink and maintain a healthy diet. People were offered choices at mealtimes and where assistance with eating their meals was required, this was done discreetly and respectfully.

Staff were aware people’s healthcare needs and requirements. People were supported to access a variety of healthcare services such as the GP, optician, dentist and dietician, in order to maintain good health.

Staff were described as ‘kind’ and ‘caring’ by people living at the home. People were supported to make their own decisions on a daily basis by staff who respected their wishes. People were treated with dignity and respect.

People contributed to the assessment and planning of their care needs and staff were aware of how people wished to be supported and what was important to them.

There was a wide variety of activities available for people to participate in. Efforts were made to provide people with a number of opportunities to engage in activities that were of particular interest to them.

People had no complaints but were confident that if they did raise concerns, they would be listened to and acted on appropriately.

People were complimentary of the registered manager and the improvements she had made to the home. Staff felt well supported in their role and confident that if they had any concerns they would be listened to.

Staff were on board with the registered manager’s vision for the home and were motivated and worked well as a team. Audits were in place to assess the quality of the service provided and to drive improvement across the home.