Greenacre Park

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 assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulations in relation to safe care and treatment. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff listened to concerns about safety. They investigated and reported safety events and were supported by managers when incidents occurred. Regular meetings and shift handovers took place with time afforded to discuss incidents and any lessons learnt. One staff member told us, “The system in place is good. Records are completed describing what happened, what we did and who we contacted. Managers always treat incidents seriously and families are informed”.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People and their relatives told us they were supported when they used different services.One relative told us, “The council and the home were involved in dealing with this. It was all handled satisfactorily when [name] moved here.” Staff supported people to their appointments demonstrating good collaboration with healthcare agencies to ensure their health and well-being was monitored effectively and safely.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff knew how to recognise signs of abuse and understood their responsibilities to report concerns. They were confident managers would take appropriate action if these were raised.

The provider shared concerns promptly and appropriately with statutory agencies in line with their responsibilities. Deprivation of Liberty Safeguards (DoLS) had been applied for, and best interest decisions made, where people lacked capacity to make informed decisions and consent to their care. There was a process in place to track and monitor DoLS application authorisations and subsequent reviews.

People and relatives we spoke with told us they felt safe care was provided. One person told us, “Yes, I feel safe.” A relative said, “Yes, absolutely. They [staff] are always very respectful. At Greenacre, they speak to the residents respectfully and treat them as adults despite their disabilities.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

We observed staff supporting people to move safely around the service who had been assessed to require constant supervision.

Staff told us information about people’s risks was now accessible via the newly implemented electronic care system. We saw staff using handheld electronic devices which provided them with ‘live’ information relating to people’s risks and care and support needs.

People’s specific risks were managed safely, for example, specialist diets where people were assessed at risk of choking. One relative told us, “I know that they do help with [name] with their eating. They can't eat anything that is too hard. The staff manage this well and they have their food prepared how it should be as recommended by the specialist.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The equipment and facilities were well maintained, monitored and managed safely to ensure people and staff were not exposed to avoidable risk.

One relative said, “Yes, I do feel the environment is safe and certainly when I compared to other services [name] has resided at.” Maintenance staff were continually deployed and undertook routine safety and compliance checks of the premises and equipment, including electrical installation and fire systems. Bedrooms and communal areas were kept free from hazards that could pose risk of injury. Records showed where issues were identified they were rectified promptly. Personal emergency evacuation plans were in place and accessible to staff and others, in the event people needed to be evacuated.

Whilst the environment was newly decorated it did not present or reflect the type of service provided for people. For example, walls and doors in communal areas displayed no signage which would support people to orientate themselves around the service easier. People could be stimulated more if colour, pictures and murals to walls were added. We brought this to the attention of the regional director who told us they were deploying their dementia lead to the service to undertake a full environment review following our feedback. This person held the national qualification of ‘Dementia Space and Place’. We accepted the regional director’s explanation their focus had been directed to bringing about improvements required following our previous assessment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Feedback we received confirmed most people, relatives and staff felt there were suitable staff numbers deployed. Our observations throughout the assessment confirmed this. One relative said, “From everything I see, this is noticeably improved compared to previously. It has improved since new managers came.”

We did receive some feedback regarding the use of agency staff. We were told people’s continuity of care was interrupted because these staff did not have established relationships with people. The provider had recently recruited more permanent staff, and they were close to a regular cohort of staff. However, they had an agreement with the agency the same pool of staff were to be deployed in order to reduce the use of different staff.

The provider had a robust recruitment policy and pre-employment checks were undertaken to ensure appropriate staff were employed. These checks also included when agency staff were deployed.

We observed staff were on hand in a variety of roles to provide care and support. This included suitable numbers of care staff who responded promptly to people’s requests for support. All areas of the service were being routinely monitored by staff including bedrooms, communal areas and outside spaces. Ancillary staff including, laundry, domestic, maintenance and activities were all deployed in sufficient numbers to ensure these areas of the service functioned well.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service and equipment were visibly clean, free from odour and risks associated with infections were assessed. Records also confirmed specific equipment to support people were cleaned frequently such as slings and hoists. Regular checks and audits of cleanliness and hygiene ensured the infection prevention and control (IPC) measures were managed effectively. Staff had received training in infection prevention and control.

Staff raised no concerns over the cleanliness of the service and had access to personal protective equipment (PPE) which we saw was continually in use when people were receiving care.

People and their relatives provided positive feedback on the cleaning arrangements at the service. A relative said, “It is very clean in the whole facility. In [name] bedroom, it is very clean and tidy the whole time. The kitchen is very clean and there is a conservatory which is also airy and very clean.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Notable improvements had been made to medicines management with one administrative improvement required.

Medicines were administered and stored safely, and records of administrations were kept electronically.

Where people were prescribed medicines on a ‘when required’ basis there were protocols in place to ensure people received these appropriately, and only when other less intrusive ways to alleviate these symptoms were unsuccessful. Clear and concise records were kept when medicines were used in these instances. We found medicine reviews had been requested when people were taking these medicines regularly. Associated care plans were person centred, addressed individual specific needs and were evidence based.

Staff who administered medicines had received the required training and their competencies were checked regularly. However, we identified a training issue for some staff in relation to recordings of transdermal patches within the medicines system. This was in relation to where in the system the administration of transdermal patches to a person’s body were recorded. These medicines are used to deliver a specific dosage at a constant rate over a set period of time. If patches are placed on a person’s skin at the same site of their body this can sometimes lead to irritation of the skin.

Interrogation of the medicines system found these were recorded however, were not always recorded in the same place. This was immediately addressed by managers and a single process for these recordings was implemented and refresher training put in place for those staff who required it.

We observed a medicine round and staff followed best practice. Medicines were audited regularly and any discrepancy recorded.