Archived: Greenmantle Care Home

Greenmantle is a 15-bed care home providing accommodation and care for older people, including people living with dementia. When we visited 12 people were using the service. At our last inspection on 23 and 30 November 2016 we found four breaches of the Health and Social Care Act 2014. Medicines were not safely managed and there were not enough staff deployed at nights to safely meet people’s needs. In addition people’s privacy and confidentiality was not maintained and the service had not been effectively monitored. Since that inspection action had been taken and some improvements made. People’s reviews were held in private, the registered manager had increased the checks they made on the service, medicines storage and administration had been reviewed and care plans had been changed. However, further work was needed to ensure that people received a good quality of service.

The service 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 and associated Regulations about how the service is run.

The arrangements for administering medicines were not always safe. Improvements had been made since the last inspection but did not ensure people received their prescribed medicines safely.

The provider had systems in place to monitor the service provided and changes had been made since the last inspection. However, the monitoring and development of the service was not robust as this did not identify the shortfalls we found during this inspection to ensure people were safe at all times.

Staffing levels were not sufficient to safely and effectively provide people with the care and support they needed.

Planned improvements to the environment were still pending and the registered manager was looking at ways to make the service more dementia friendly.

There was a stable staff team who knew people’s needs. Although changes had been made to care plans since the last inspection further work was needed to enable staff to provide consistent support.

Discussions and reviews about people’s care were held in private. Personal care was provided in private but the storage of incontinence products in the communal lounge was not discreet and compromised people’s dignity.

Systems were in place to safeguard people from abuse and staff were aware of how to identify and report any concerns about people’s safety and welfare. However, safeguarding incidents had not been reported to the local authority safeguarding team.

Staff received up to date training and support to enable them to carry out their duties.

People were supported to receive the healthcare that they needed. They told us they felt safe at Greenmantle and were supported by kind and caring staff.

We saw that staff supported people patiently and encouraged them to do things for themselves.

Information about complaints and activities was available for people and pictures and larger print formats were used to help those who might find it difficult to read or understand.

The provider’s recruitment process ensured staff were suitable to work with people who need support.

Systems were in place to ensure that equipment was safe to use and fit for purpose.

Complaints and concerns were investigated and information on complaints was clearly displayed. People knew who to raise complaints and concerns with.

Systems were in place to ensure that people received care and support in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s nutritional needs were met and this included cultural or religious diets and preference but the quality of mealtime support was not always consistent.

Activities were provided and had improved but people and their relatives told us that there were still not enough for people to do.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Greenmantle is a 15 bed care home providing accommodation and care for older people, including people living with dementia. When we visited 15 people were using the service. Greenmantle has been a care home for many years but was taken over by a new provider in May this year. This was the first inspection under the new provider but some people used the service and some staff worked there prior to the change.

The service 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 and associated Regulations about how the service is run.

The arrangements for administering medicines were not always safe. People who received their medicines without their knowledge (covertly) were not managed safely.

Staffing levels at night were not sufficient to safely provide people with the care and support they needed.

Although people’s privacy was respected in terms of personal care, discussions and reviews about their care were not held in private.

Systems were in place to safeguard people from abuse and staff were aware of how to identify and report any concerns about people’s safety and welfare.

Staff received up to date training and support to enable them to carry out their duties.

People were supported to receive the healthcare that they needed. They told us they felt safe at Greenmantle and were supported by kind and caring staff.

We saw that staff supported people patiently, with care and encouraged them to do things for themselves. Staff provided care in a respectful way that promoted people’s dignity.

Information was not readily available or accessible for people and we have recommended that information about the service be displayed so that people can see and read it. We also recommended that pictures and larger print format be used to help those who might find it difficult to read or understand.

The provider’s recruitment process ensured staff were suitable to work with people who need support.

Systems were in place to ensure that equipment was safe to use and fit for purpose. We have recommended that consideration be given to make the internal environment more dementia friendly.

Complaints and concerns were addressed but information on complaints was not displayed where people who used the service could see it. We have recommended that information about how to complain be displayed in an area that is accessible for people and also that it is in a format that helps them to see and understand it.

Systems were in place to ensure that people received care and support in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People’s nutritional needs were met and this included cultural or religious diets and preferences. We have recommended that lunchtime arrangements and support be reviewed to ensure that people receive the support they need in a timely manner.

Activities were very limited and people and their relatives told us that there was “not much to do.” We have recommended that the provider sources guidance and training to support staff to provide suitable activities for people living with dementia.

There was a stable staff team who knew people’s needs. Although their care plans were reviewed and updated, they were not sufficiently detailed to enable staff to provide consistent support.

The provider had systems in place to monitor the service provided but these were not robust. However, people were asked for their feedback about the quality of service provided.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.