Greville House

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

The management team reviewed incidents and accidents to identify any trends or patterns and apply preventative measures to reduce the likelihood of them happening again. Staff informed us of their responsibilities in reporting incidents and were aware of how to respond should someone experience a fall.

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 had emergency care plans available should they need to access another service quickly. This included a synopsis of the persons needs as well as baseline observations and reasons for the need for emergency healthcare. This ensured continuity of care should a person need to move to another healthcare setting.

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. The provider shared concerns quickly and appropriately.

Staff understood their responsibilities in keeping people safe and told us what they would do should they have any safeguarding concerns. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that DoLS authorisations had been applied for appropriately and systems were in place to monitor when they needed renewing.

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.

Staff told us how they supported people to remain safe and the appropriate actions they took should a person experience a fall for example. Relatives told us about the clear communication that happened should any unexpected situations occur. One relative told us, “[Relative] is safe and happy.”

Risks to people had been identified with risk assessments in place to support staff in understanding how to mitigate identified risks. We did identify part of one person’s risk assessment in relation to a specific need, required further exploration and guidance for staff. The registered manager actioned this during the inspection.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

We identified a number of areas within the environment that required action to ensure safety for the people living at the home. For example, the window restrictors in the home were not at the restriction level needed to keep people safe from falling from a height. Immediate action was taken by the registered manager to address this and to ensure on-going monitoring was put in place.

We also saw evidence of regular checks that were carried out to support safety in the environment. These included checks on fire safety equipment, electrical testing and maintenance checks on equipment used.

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.

There were sufficient staff available to support people when they needed it. Staff were responsive to people’s needs and knew people well. One relative told us, “The home retain staff well with little or no agency staff. Staff work together, with good teamwork, staff know all clients by name and recognise [relatives name] when they visit.”

Staff had been safely recruited and had access to training to develop their knowledge in supporting people. Whilst a small number of training sessions needed renewing for some staff, the registered manager had plans in place to ensure this was completed. Staff had opportunity for supervisions with the management team which were used as a supportive mechanism.

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.

We saw the home was clean and free from odours. A dedicated domestic team were employed to maintain the cleanliness within the home. This benefitted people as care staff were then able to spend more time with people. A member of staff told us, “Being able to focus more on people rather than domestic tasks is important.” There were systems in place to monitor infection prevention and control to ensure standards were maintained. A relative told us, “Staff are really good, every time I visit my relatives room it is impeccable and [relative] is always neat and tidy.”

Whilst systems were in place to monitor daily medication administration, we noted that guidance was not available for all ‘as required’ medication. This guidance is important to ensure people received their ‘as required’ medicines consistently. Additionally, we noted prescribing instructions needed clarifying for two other medications to ensure the correct amount of medication was administered and the recording of room temperature checks needed improving. The registered manager took immediate action to address these issues.

People were involved in reviews of their medicines with local healthcare partners annually.

A relative told us, “I am aware of my [relatives] medications and changes to her medications as the manager lets me know.”