Background to this inspection
Updated
23 January 2021
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 two inspectors and a specialist advisor.
Service and service type
Green Acres Care is a ‘care home’. 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. The service had a manager who was registered with the Care Quality Commission. This means that they 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
This inspection was announced. We gave a short period notice of the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We considered the information we gathered in the emergency support framework review gathered in May 2020. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
Whilst on site we spoke with two people who used the service. We telephoned six relatives about their experience of the care provided to their relations. We spoke with six members of staff including the registered manager, deputy manager, housekeeper and three care staff. We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. Whilst off site, we continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
23 January 2021
About the service
Green Acres is a residential care home providing personal and nursing care to 48 people aged 65 and over at the time of the inspection. The service can support up to 62 people. The home is purpose built and provides accommodation over two floors.
People’s experience of using this service and what we found
Following the last inspection in January 2020 and the emergency support framework completed in May 2020 improvements had been made to the care people received. The new manager had made significant improvements in a short space of time and concerns and complaints from stakeholders had reduced. Whilst improvements had been made over the last five months and the provider had a plan in place to continue to improve, the provider had yet to evidence sustained, high quality leadership over a longer period of time.
Staff and relatives told us the quality of care had improved and they consistently told us their relations were happy living at the home. Medicines were managed safely although some minor recording issues were found. Improvements to the management of medicines meant they were no longer in breach of any legal requirements.
The recent appointment of a new manager and deputy manager had supported the home to make the necessary improvements. All staff we spoke with showed the same passion and dedication to improve people’s experience of care at the service. Improved governance systems and regular audits meant ongoing actions had been taken to improve care.
Individual risks were being managed. When accidents or incidents occurred, learning was identified to reduce the risk of them happening again. Staff updated risk assessments and care plans to ensure people were kept safe and protected from abuse and avoidable harm. People’s needs were reflected in their risk assessments and associated care plans and there was a programme in place to ensure all records were regularly reviewed.
Infection control procedures were in place and the home followed current government guidance to ensure people were protected from the transmission of infection. PPE stations were in place and staff had been trained to don and doff personal protective equipment. A housekeeper had been appointed and this person ensured cleaning products and sanitising equipment met the required standards and was always in stock. Cleaning rotas and schedules were in place to ensure risks to people were minimised.
Relatives said the registered manager was approachable and listened to their concerns. Staff told us they were supported by the registered manager and they were happy in their roles. They were fully engaged in supporting the service to improve and could see how this impacted positively on people living there.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (Published 12 February 2020) and there was a breach 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 on 7 and 8 January 2020. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the management of medicines. We had ongoing concerns following on from this inspection about the consistency and quality of leadership within the service and although we did not inspect we carried out an emergency support framework review in May 2020. At this time the service needed external support to ensure risk and infection control was effectively managed. 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 and Well-led which contain those requirements.
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 remains requires improvement. This is based on the findings at this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Green Acres 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.