Greenhill

Updated 24 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 4 March 2021 and was unannounced.

Updated 24 March 2021

Greenhill is a care home for older people, some of whom are living with dementia. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Greenhill is registered to accommodate up to 64 people. There were 62 people living at the home when we visited.

This inspection took place on 7 and 8 August 2018 and was unannounced. The last inspection of the service took place 14 and 16 June 2017 where we found a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 because risks to people had not always been adequately assessed. We also found other areas that required improvement. These included the cleanliness of the service, medicine management, staff interaction with people, people did not receive their meals when due; and quality assurance systems. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions safe, effective, caring and well-led to at least good. The provider sent us an action plan on how they would improve. At this inspection, we found that the service had made the required improvement and complied with our regulations.

Risks to people were assessed and risk management plans developed. Staff knew the risks associated with people they supported and how to manage them safely. Incidents, accidents and near misses were reported. The registered manager investigated incidents and put actions in place to prevent them from happening again. Health and safety checks were conducted regularly to ensure the environment was safe.

Staff followed infection control procedures to prevent and reduce the spread of infection. People received their medicines as prescribed. Medicines were administered, managed and stored safely.

People’s nutritional and hydration needs were met. Staff provided effective support to people when eating and drinking, where required. People’s needs were assessed in line with best practice guidelines.

People, and their relatives told us that staff were kind, compassionate and caring. People felt comfortable with staff. Staff respected people’s choices. Staff understood the importance of respecting people’s dignity and privacy.

Regular checks and audits of the quality of care were carried out to improve on service delivery. The service maintained close partnerships with other healthcare professionals and with external agencies.

The service had a registered manager in post. 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.

There were systems and processes to safeguard people from abuse. Staff had been trained in safeguarding. They had the knowledge and understanding of the various types of abuse and how to report any concerns appropriately. The registered manager followed the provider’s safeguarding procedures when required in reporting any allegations to the local authority.

There were sufficient staff on duty with suitable skills and experience to meet people’s needs. Appropriate recruitment procedures were followed to ensure staff were suitable for their roles working with people. Staff were trained, supported, supervised and appraised to be effective in their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People gave consent to the care and support they received. The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People had access to a range of healthcare services and to maintain their well-being and good health. The service had systems in place to ensure people’s care was properly planned and delivered when they moved between services. The home had been adapted to meet people’s needs.

People received care personalised to their needs. Care plans reflected people’s needs. Staff knew people well and understood their needs, likes, dislikes and preferences. People were supported to take part in a range of activities which they enjoyed. People were supported in the way that they wanted at the end of their lives. People and their families were given the emotional support they needed. People were supported to maintain relationships which mattered to them. People received appropriate support which reflected their cultural, social and religious needs and preferences.

People knew how to make a complaint. Complaints were resolved in line with the provider’s procedures. The provider sought people’s feedback about the service and used this to plan and make improvements There was an open and transparent culture at the service. The registered manager was visible and approachable. Staff told us they received the leadership and direction they needed.