Greathed Manor Nursing Home

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

People received safe care and treatment from staff who understood their healthcare needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks. Staff knew people’s needs and ensured people were involved in managing their individual risk and could access safe support when needed. When people’s needs changed or lessons learnt were identified from incidents and accidents, staff took action to protect them from avoidable harm. Staff received ongoing training and support. Staff knew how to raise concerns when needed. Medicines were managed safely. The home was safe and clean.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and their relatives told us staff worked well to ensure individual needs were met whilst being good at delivering consistent care. For example, when people had been transferred to the home from hospital advice from professionals had been followed as well as thoughtful packages of care designed resulting in people’s conditions improving. For example, people being encouraged to join activities in communal areas where before they had been described as ‘bed-bound’.

Staff and managers told us how they worked with health and social care professionals to ensure people received effective care that met all of their health needs. We were told how staff ensured information was shared when appropriate and required so people received timely care. For example, if people required support from a specialist or had a record of ongoing treatment, medical advice was sought as soon as possible.

We saw positive feedback from partners during the assessment process. It was clear staff had followed advice and guidance from partners and integrated this in to care plans to ensure all staff were aware. We also received compliments from partners who confirmed the provider worked well with professionals and ensured clear, joined-up working which had the best possible results for people.

We saw evidence of clear processes and policies for staff to follow to ensure people were referred to health and social care services in a timely way. We saw when this was necessary processes had been followed by staff without delay. We saw good correspondence between a variety of professionals documented in care plans so all staff had access to an up to date picture.

People and their relatives told us people felt safe in the home and when staff were supporting them. One person said, “I have to say I would raise something I was not happy with or that was untoward in any way. I feel very safe here in the care of staff and have never seen anything that concerns me.” Relatives also said, “I think [SU] is safe and would not experience any unkindness.”; “[Service user] definitely identifies with this place; every time we go out, they are very keen to get back again.”; “[Service user] absolutely feels safe in the care of staff.”

Staff and managers were clear of their roles and responsibilities to ensure people were safeguarded from harm and any concerns should be addressed quickly in all circumstances. They were also aware of other professionals that needed to be included. One staff said, "We would first inform the nurse in charge and they would speak to the manager. If we do not think anything has been done to follow up, we can call the safeguarding team."

People were seen to be supported by staff safely and often asked to confirm how they were and if staff could do anything different.

There were clear safeguarding and whistleblowing policies and processes in place. Staff had also received regular, thorough training in this area. There was a clear pathway for staff to follow in the event of identifying and reporting any concerns. We saw examples of where the registered manager had worked with partners such as the local authority safeguarding team to ensure people were safe from any harm.

People and their relatives responded positively when asked how staff managed individual risks and confirmed they received safe care in relation to this. One person said, “Staff are just brilliant, and they really know me and what I need in particular.” A relative also said, “They manage [service user’s] needs very well. They are supported to make decisions about their care, for instance, if they wish to be a bit more adventurous about moving around.”; “Staff in general are very good, they seem to know everything about everyone, where risks may be with each person and they manage these well.”

Staff were knowledgeable in people’s individual risks and ensured these were managed well so people received safe care. Staff said, “I think it’s helpful that we know the people here really well. We know their risks, for example, [service user] is at high risk of falls but likes to be mobile. So we support them to do whatever they want whilst encouraging walking aids and monitoring for any trip hazards.”

We saw staff support people to manage their risks in a safe and respectful way. If people needed support eating this was completed by staff sat next to them talking to them and going at a pace the person wanted to eat at.

People’s care plans detailed individual risks with advice and guidance for staff to follow. We saw staff showing knowledge in these risk assessments when supporting people differently to meet their individual needs throughout the assessment. Care plans included a variety of risk assessments to manage falls, choking, eating and drinking, activities, skin integrity amongst others.

We received positive comments relating to the environment of the home. “Everything is kept very well maintained here, it [general environment] looks good.”

Staff and managers told us how they were confident in their knowledge of maintaining a safe environment. “We (staff) are all very aware of what is required to ensure infection isn’t spread, we also know what to do in an emergency to make sure the home is safe. For example, we take part in fire drills so we know who is responsible for what.”

The home environment was safely maintained and appropriate to meet people’s needs. There was an ongoing project of improvement for the home which included updating areas of the home. The management and maintenance staff had also worked hard to address any concerns raised about the property to ensure people lived in a safe environment.

There were clear policies, processes and audits in relation to maintaining a safe environment in the home. For example, we saw examples of regular fire safety checks that ensured if any action was required it was completed in a timely way. We also saw evidence the care equipment had regular safety checks completed by appropriate personnel.

People and their relatives told us there were enough well-trained staff to meet their needs. People said, “I think it [staffing] is pretty efficient; staff make sure they are in the right place at the right time. They respond to my needs when I ring my bell.”; “They are well trained and very caring; I wouldn’t be here if they weren’t, I have high standards and they meet my high standards.” Relatives also provided positive feedback, “There is definitely enough staff. They are always popping in when we are with [service user]; they are all very attentive.”; “They are certainly not understaffed here. The staff are never rushing and always offering lots of drinks, as well as popping into [service user’s] room to say hello.”

Staff told us there were enough staff and they were confident of the deployment throughout the home met people’s needs. Staff said, "It is fine, we have enough staff."; “Shifts are always covered by staff that are off, we don’t use agency staff, we haven’t needed to. We are one big family and always help if someone is off sick. Generally, there is always enough staff, if you ever need a colleague to help there is always someone available.” We were also told how the dependency tool was effective in ensuring safe levels of staffing, “There is a dependency tool which is regularly reviewed. The dependency tool is reviewed monthly as a minimum but also reviewed after every new admission.” Staff received regular training for relevant topics and the management team had good oversight of this through a training matrix that identified areas of required learning and refresher courses. Staff feedback about training was positive, “All my training is up to date. I have done wound training level 1 and 2 so I can help the nurses with the dressings. I am going to do the train the trainer for moving and handling.”; “I have all the mandatory trainings required on the company e-learning as well as face to face.”

During the assessment we noted there were enough staff to meet people’s needs. From reviewing rotas we saw evidence of staffing levels in line with the dependency tool. We observed staff were competent in their role and abilities and provided safe and effective care to people in line with training requirements.

Staff and the management team alike were responsible for ensuring safe staffing levels. There was oversight of the dependency model by the management team, however, the staffing team also were asked to reflect on deployment and the effectiveness of it. We saw evidence of a clear training schedule to ensure all staff were competent in their role to deliver safe care. The registered manager had followed safe recruitment processes to ensure the correct standard of staff were recruited and as a result people received safe care. Overall, we saw evidence of people being supported by well-trained staff in a timely way that were not rushed or task orientated and could take their time to provide safe care.

People and their relatives told us the home was kept clean and confirmed they had no concerns in relation to infection prevention and control. One relative said, “Her room is very well kept. The home is clean and tidy and there are lots of sanitisers around and staff are always cleaning.”

Staff were knowledgeable in what their responsibilities were to ensure a safe level of infection prevention and control. One staff told us, “We always make sure we follow all IPC guidelines, for example, regular wiping of surfaces and always wearing our aprons and gloves when providing care.”

On the day of the site visit we observed the home was clean and we saw regular cleaning staff completing tasks throughout the home. The home appeared hygienic and we did not observe any concerns in relation to infection prevention and control.

There were policies, procedures and clear training in infection prevention and control for staff to follow. The management team had also ensured regular infection prevention and control audits were completed and we saw these had been thoughtfully completed.

People and their relatives were positive when talking to us about their experience of staff supporting them with their medicines. A relative told us, “Meds have been a nightmare at home [person] was refusing, here (service) they have been great. On the whole [person] has been taking his meds. Complex health issues, they (staff) often re-try if [person] says he doesn’t want it. When he had carers at home there were piles of unaccounted tablets he had refused and been left with.”

Staff were competent in administering different medicines and knowledgeable in who needed what medicine. “It is important we know individual needs. For example, what medical condition people have and what medicine they need and at what time of day. We receive medicine training regularly and also the manager checks we are competent.” We observed staff confidently administer medicines and clearly explain to people what they were and why they needed them.

The process and policies in relation to medicine management were safe. All relevant records had been completed thoroughly and staff had good knowledge of ‘when required’ medicine and how to record these. The registered manager completed medicine audits that had been thoughtfully completed and where identified action had been taken in a timely way.