Greycliffe Manor

Updated 21 September 2022

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 Health and Social Care Act 2008.

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

The inspection was carried out by two inspectors.

Service and service type

Greycliffe Manor is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Greycliffe Manor Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was no registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

During the inspection

We spoke with six people who used the service about their experience of the care provided. We spoke with six members of staff including the quality assurance director, quality assurance manager, care workers and auxiliary workers.

We reviewed a range of records. This included three people’s care records and four medicines records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 21 September 2022

About the service

Greycliffe Manor is a care home, which provides accommodation and personal care for up to 25 people living with dementia and other physical health needs. At the time of the inspection 24 people were using the service. The care home is an adapted building over two floors, with a shaft lift and/or stairlift giving people access to the upper floor.

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

The environment was safe and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place. However, we found the audits for checking the hot water taps had noted the water was extremely hot. No follow up or adjustment to ensure people where protected had been carried out. The area manager and quality assurance manager, who supported us through the inspection due to no registered manager in post, said they would contact maintenance straight away. We received confirmation from the acting manager after the inspection that the water temperature had been made safe for people. We also found that regular fire alarm testing had not taken place. This was raised and we received confirmation that this had been carried out and that the recordings of this was held in a separate file not made available on the day of the inspection.

We have made recommendations about the management and follow up of health and safety audits.

Medicines were ordered, stored and disposed of safely. However, medicines needing extra security where not signed by two staff as required.

We have made recommendations about the management of medicines and that the provider actions issues highlighted during our inspection.

The service currently has several people testing positive and isolating due to COVID 19. There were processes in place to prevent and control infection at the service including additional cleaning and safe visiting precautions. However, we found one bin holding used PPE over spilling with no lid on the bin. We also found another used PPE bin with a broken lid. This meant staff where having to open the bin manually which could cause an infection control issue. We received confirmation that the broken bin had been replaced.

We have made recommendations about the management of infection control.

People were supported by staff who completed an induction, training and were supervised. Staff were recruited safely in sufficient numbers to ensure people’s needs were met. There was time for people to have social interaction and there was a designated activities staff member to assist people. Staff knew how to keep people safe from harm.

Records were accessible and up to date. However water temperature audit, though completed had not been followed up immediately to help protect people. These taps have since been made safe. The management and staff knew people well and worked together to help ensure people received a good service.

People told us they were happy with the care they received, and people said they felt safe living there. Comments from people included; “Staff are very caring.” Another person said; “Staff definitely support me.” People looked relaxed, happy and comfortable with staff supporting them. Staff were caring and spent time chatting with people as they moved around the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received appropriate training and support to enable them to carry out their role safely, including fire safety and mental health training.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Records of people's care were individualised and reflected each person’s needs and preferences. Risks were identified, and staff had guidance to help them support people to reduce the risk of avoidable harm. People’s communication needs were identified, and where they wanted, people had end of life wishes explored and recorded.

People were involved in menu planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices. Special diets were catered for. One person said; “Food is very good, like homemade cooking.”

Staff told us the management team, currently supporting the service in the absence of an employed and registered manager, made themselves available and assisted them daily. They went onto say how they were approachable and listened when any concerns or ideas were raised. One staff member said; “It's run very well.”

People and their families were provided with information about how to make a complaint and details of the complaint’s procedure were displayed at the service.

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 the service under the previous provider was good, (published 4 October 2017.)

A focused inspection was carried out in April 2021 after concerns had been raised. That inspection was not rated.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.