Archived: Greengables Care Home

Updated 25 December 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Greengables Care Home is a care home. People in care homes receive accommodation and nursing and personal care. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at on this inspection.

The service had a manager who had made application and was in the process of registering with the CQC. When the manager is registered, both the registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We announced the inspection visit 48 hours before it took place. This was because we needed to give the manager time to prepare in advance of our visit due to the COVID-19 pandemic. Inspection activity started on 11 November 2020 and ended on 26 November. We visited the service on 11 November 2020.

What we did before the inspection

We reviewed the information we received about the service since the last inspection. We sought feedback from the local authority. We looked at the report published by Healthwatch subsequent to their visit to the home on 24 January 2020. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and five visiting relatives about their experiences of the care provided. We also spoke with the manager, and eight members of staff including a nurse, three care staff, the head of housekeeping and the quality manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We reviewed a range of records. This included several people’s care records and multiple medication records. We looked at the recruitment files for two staff employed since the last inspection. A variety of records relating to the management of the service were also reviewed.

After the inspection visit

Due to the impact of the COVID-19 pandemic we limited the time we spent on site. Therefore, we requested records and documentation to be sent to us and reviewed these following the inspection visit and continued dialogue with the manager by telephone. Our Expert by Experience spoke with people who used the service and some of their relatives on the telephone. We also spoke with a visiting doctor and sought their views of standard of care provided.

Updated 25 December 2020

About the service

Greengables Care Home is a residential care home registered to provide nursing and personal care to a maximum of 30 people. The premises is a detached, two storey Victorian house standing in its own grounds. Accommodation is provided over two floors accessed by stairs and passenger lift. There are two lounges and a large dining room for people to use within the building. People also have access to secure outdoor space. At the time of our inspection there were 20 people living in the home.

People’s experience of using this service and what we found

The atmosphere in the home was welcoming, warm and sociable. People told us they felt safe and well cared for.

Safeguarding systems, policies and procedures ensured people were safe and protected from abuse. Risks to people’s health, safety and welfare, were identified and managed safely with the involvement of the person or their representatives.

There were sufficient numbers of suitably trained and experienced staff on duty and safe recruitment procedures were followed.

Medicines were safely managed, and systems were in place for reporting accidents and incidents and learning from them.

We were assured by the additional measures in place to help prevent the spread of COVID-19. Risks relating to infection prevention and control (IPC), including in relation to COVID-19 pandemic were assessed and managed. Staff followed good IPC practices.

People’s care, treatment and support achieved good outcomes and promoted a good quality of life. A visiting general practitioner described the standard of care as “fantastic.” Staff were seen to be consistently caring. Staff treated people with dignity, kindness and respect and, promoted people’s choice. They sought people’s consent, promoted independence and offered emotional support when needed.

People and their visiting relatives praised the staff and the quality of care provided. Their comments included: “absolutely brilliant” “care is exceptional” and ““wouldn’t have mum anywhere else. They treat her with dignity and respect.”

The manager and senior staff team were clear about their roles and responsibilities and they promoted a positive, person-centred culture. Staff worked well together as a team, and there was good partnership working with others to meet people's needs. Staff morale was good, and staff felt well supported.

Effective systems were in place for checking on the quality and safety of the service and making improvements where needed.

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 July 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service In April and May 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, consent and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greengables Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.