Archived: Greengables Care Home

Greengables Care Home is a detached, two storey Victorian house standing in its own grounds. It is on the outskirts of Congleton, approximately one mile from the town centre. The centre is registered to accommodate up to 30 people who have nursing needs. At the time of our inspection there were 26 people living at the home.

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 2008 and associated Regulations about how the service is run.

At the last inspection on 07 February 2014, we found the provider was meeting the requirements of the regulations inspected.

During this inspection, we observed the administration of medicines at lunchtime. We observed people were not protected from the unsafe management of their medicines. We noted the nurse signed the medication administration record form (MAR) before they supported people with their medicines. We witnessed the nurse handle a tablet before its administration. This meant people were at risk due to the unsafe management of their medicines.

This was a breach of Regulation 12 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe Care and Treatment. You can see what action we told the provider to take at the back of the full version of the report.

Medicines were safely and appropriately stored and secured safely when not in use. We checked how staff stored and stock checked controlled drugs. We noted this followed current National Institute for Health and Care Excellence (NICE) guidelines.

We have made a recommendation regarding recruitment and selection related to the application form allowing gaps in employment to be fully explained.

We found staffing levels were regularly reviewed to ensure people were safe. There was an appropriate skill mix of staff to ensure the needs of people who used the service were met.

Staff received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff had received abuse training and understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure.

People and their representatives told us they were involved in their care and had discussed and consented to their care. We found staff had an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the management team had responded promptly when people had experienced health problems.

Comments we received demonstrated people were satisfied with their care. The management and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care and support to people who lived at the home.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People told us they were happy with the activities organised at Greengables Care Home. The activities were arranged for individuals and for groups.

A complaints procedure was available and people we spoke with said they knew how to complain. People and staff spoken with felt the registered manager was accessible, supportive and approachable.

The registered manager had sought feedback from people who lived at the home and staff. They had consulted with people and their relatives for input on how the service could continually improve. The provider had regularly completed a range of audits to maintain people’s safety and welfare.

We were told by the provider that, over recent months, five new staff, which included a senior nurse, had been employed at Greengables Nursing Centre. During our inspection, we noted that staff were always available to meet people`s needs as and when required. People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was evidence that learning from incidents / investigations took place and appropriate changes were implemented.

We spoke to four people who use the service and they told us that "the staff are very nice" and " its all quite nice here". We observed records and found evidence on how people were consulted on their day to day care and how family /friends were part of the consultation and informed of any changes that had been identified. We viewed records in respect of complaints and found evidence of how complaints were resolved and how family and people who used the service were consulted and listened to in this process.

We spoke to staff about their training and they told us that they had staff appraisals and supervision and regular training. We viewed records of training matrices and found evidence on how often training was provided and how this was updated in accordance with requirements.

We viewed records on infection control and inspection logs and we spoke to staff who told us they knew of the process for the control of an infection outbreak and how to prevent the spread of infection.