Archived: Greatwood House

We found the following examples of good practice.

¿ Temperatures were taken, and a comprehensive risk-based questionnaire was completed with visitor’s prior to entry to the care home. The home had clear guidance and expectations for visitors.

¿ Staff were supported to maintain social distancing guidance both whilst in work, and during the journey to and from work. This included senior staff undertaking reviews and coaching with staff on high risk times, such as during breaks, and developing processes to reduce risks. Staff were supported to travel independently to work as required.

¿ Guidance regarding safe admission to care homes was followed. The home had a separate quarantine unit where new admissions would live for the first 14 days.

¿ Two infection prevention and control leads were in place in the home. These members of staff undertook regular checks of personal protective equipment (PPE), cleanliness of the environment and observations of staff to ensure good practice was being followed.

¿ The home was fully engaged with testing staff and residents for Covid 19, following current best practice guidance. Residents were supported with daily health checks to support early identification of people becoming unwell.

¿ The home was clean, and any issues were quickly addressed. Regular checks of the environment were undertaken, and housekeeping staff completed additional cleaning tasks and followed a decontamination checklist. All staff were responsible for regular cleaning of high contact areas, such as door handles and frames, handrails and keypads.

We asked the provider to complete an action plan to show what they would do and by when to improve the key questions of is the service safe, is the service responsive and is the service well led to at least good. At this inspection we found improvements had been made to these areas and the service was now meeting these regulations.

Greatwood House is a single storey building in the Haughton Green area of Denton in Greater Manchester. The home provides accommodation and support for up to 60 people who require personal care without nursing care. At the time of our inspection 46 people were living in the home. Greatwood House is owned and managed by HC-One.

At the time of our inspection there was a manager in post who had applied to the Care Quality Commission to become the registered manager. The 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. The manager had recently started working at the home and had previously been a registered manager of a nearby home owned and run by the same company.

People told us they felt safe. Staff demonstrated they knew how to identify signs of abuse and felt confident raising any concerns they had. The home had processes in place to ensure any concerns were investigated appropriately.

Changes had been made to improve staffing levels at mealtimes. We saw people were supported patiently to eat and drink at their own pace.

Checks were made on staff before they started work to help prevent employment being offered to people who were unsuitable to work with vulnerable people.

People’s medicines were stored appropriately and senior care workers had received training from a pharmacy so they knew how to support people to take their medicines safely.

The ability of people to consent to receiving support was assessed. Where people lacked capacity and decisions had to be made on their behalf, meetings with appropriate people were held so that any decisions were made in the person's 'best interest'. Where people needed to be deprived of their liberty for their own safety applications were made to the local authority for them to authorise this.

People’s needs were kept under regular review and where their needs had changed and they needed support from other healthcare providers, prompt referrals were made and staff supported people to attend appointments if family members were not able to.

People working in the home told us they felt well supported by the manager although some care workers commented they did not always have sufficient time set aside for them to complete training.

People told us they were supported in a caring and respectful way. Throughout the inspection we observed people being supported in a friendly compassionate way.

Care workers knew the people living in the home well and supported them to make choices and respected their decisions.

People were encouraged to remain as independent as possible and were encouraged to do the things they could for themselves. People were also encouraged to be part of the local community and trips outside the home were facilitated by staff.

In addition to the activities outside the home, a variety of activities was available within the home both as groups or individually with the wellbeing coordinator.

Complaints and comments about the service were encouraged and viewed by the management as an opportunity for learning. We saw examples where improvements to the service had been made as a result of complaints.

People were encouraged to raise issues with management and regular meetings were held with people living in the home, their relatives and staff. People told us they felt their ideas were listened to.

The service had a quality management system in place where results of regular quality checks and audits were entered to allow the results to be analysed and areas of improvement identified.

The service worked well with other organisations to ensure good outcomes for people.

Greatwood House is situated in the Haughton Green area of Denton in Greater Manchester. The home provides care, support and accommodation for up to 60 people who require personal care without nursing.

At the time of our inspection 41 people were residing in the home, including two people on respite stays.

All rooms provide were single occupancy with 37 of those rooms having en-suite toilet facilities. The home was split into three units named Elderberries, Green End and Shrewsbury. These units provided separate communal and dining areas that supported people spending time together. There was a paved garden / courtyard to the rear of the property and a small car park.

There was a registered manager in post at the time of this inspection. 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.

The service was last inspected in June 2015, at which time we found there were multiple breaches of the Health and Social Care Act (Regulated Activities) 2014. During this inspection we found that some improvements had been made and a number of breaches of the Health and Social Care Act (Regulated Activities) 2014 found at the last inspection had been satisfactorily addressed. However we still found breaches of the Health and Social Care Act (Regulated Activities) 2014 in relation to staffing levels at certain time of the day and records and governance systems. We also made one recommendation which relates to securing the satellite kitchen on Shrewsbury Unit. You can see what action we told the provider to take at the back of the full version of the report.

We saw there were insufficient staff on duty during the main meal times to ensure that people received a calm, relaxed and supportive dining experience.

People living in Greatwood House told us they felt safe and had no worries about the care being provided to them.

We looked at a sample of staff personnel records which indicated a robust recruitment process was used when employing new staff to work with vulnerable adults.

Staff we spoke with understood their roles in keeping vulnerable people safe and what procedure they should follow if they had any concerns about a person’s safety.

Although new care plan documentation had been put in place, further work was required to ensure all relevant details about a person’s individual support needs, including identified risks to their health and safety had been included.

Medicines were being safely managed and staff with the responsibility for administering medicines in the home had been appropriately trained, with competency checks taking place.

On-going maintenance and improvements to the building were taking place, including the replacement of furnishings, carpets and equipment.

We found that applications had been made to the appropriate authorities for Deprivation of Liberty Safeguards (DoLS) authorisations, to ensure that people using the service who lacked capacity to make certain decisions received care lawfully.

We saw positive relationships between individual staff and people who used the service and we saw that care was provided with sensitivity and kindness. Staff employed at the home had received training in various topics to help them provide care and support to people that would help to meet people’s needs.

People using the service and their relatives had opportunities to say how they found the management of the service by completing an annual quality audit questionnaire and attending resident/relative meetings held by the registered manager of the service.

We found improvements are needed to the quality auditing processes used to monitor the effectiveness and suitability of the service being provided to people.

"It's lovely here, the staff can't do enough for me. They ask me if there's anything I need. They always talk to me."

"Some people need much more help than me, but the staff are really kind to them and really help."

I'd rather be at home, but I can't fault the staff, they are so helpful. My friend needs more help than me and they (the staff) are very good to her. There's plenty going on and there's entertainment."

One person visiting her relative said, "They (the staff) always acknowledge me. They keep me involved and tell me what's going on with my relative."

We found that the home was meeting the essential standards we looked at on this inspection and we found that people were well cared for.

You can see our judgements on the front page of this report.

We gathered evidence of people's experiences by observing people going about their daily lives and we saw how staff were supporting and interacting with people. We also looked at records in the home and how the staff used them to inform their work in providing care and support.

From our observations and from talking to people living in the home we saw that staff appeared to have a good understanding of the individual needs of people. We saw numerous examples of good practice where staff took time to listen to people and provide support in a caring and sensitive way.

We saw that care records clearly explained peoples care needs and provided staff with guidance on how to support people appropriately. We saw that systems were in place to regularly review individual care needs and that care plans were updated to reflect any changes in support needs.

We made a tour of the building and we saw that all areas were clean and tidy. We did not detect any unpleasant odours. People we spoke with spoke highly about the standards of hygiene in the home. One person told us that they felt 'proud' of their room and comfortable in inviting relatives and friends.