Archived: Greenheys Lodge Residential Care Home

Updated 3 October 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 1, 2 and 6 August 2018 and was unannounced. The inspection was carried out by one adult social care inspector.

Before the inspection we asked for information from the local authority and we checked the website of Healthwatch Liverpool for any additional information about the home. We reviewed the information we already held about the service and any feedback we had received.

During our visit we spoke with four people who used the service, one person’s relative, three care staff, three domestic staff, the assistant chef, the maintenance officer, the manager, a quality support manager and the regional manager. We undertook a Short Observational Framework for Inspection (SOFI) which is a tool developed and used by CQC inspectors to capture the experiences of people who use services who may not be able to express their views for themselves.

We looked at care notes for four people who used the service, medication storage and records, four staff records, accident and incident report forms, health and safety records, complaints records, and other records for the management of the home.

Updated 3 October 2018

We carried out an unannounced inspection of Greenheys Lodge on 1, 2 and 6 August 2018.

Greenheys Lodge is a purpose built residential care home that provides care for up to 33 older people and forms part of the 'Sefton Park Care Village' situated near Sefton Park in Liverpool. Bedrooms are all single occupancy with ensuite facilities and there are several lounges, a dining room and accessible bathroom facilities throughout the home. There is a large garden and car parking is provided at the front of the building. At the time of inspection Greenheys Lodge was providing care for 23 people.

Following the last inspection in February 2018 we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring, responsive and well led to achieve a Good rating.

At this inspection although we found there had been improvements in some areas we found repeated breaches in relation to Regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities). Regulations 2014. These breaches related to safe care and treatment in relation particularly to staffing levels, good governance, staff support and infection control.

There was no registered manager in place, a new manager had been working at the home from 9 May 2018. 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. The manager in post was going through the process of registration with the Commission.

People received support with their health care. However, care plans and risk assessments had not been updated accurately and in some cases contained contradictory guidance that if followed would pose a risk to people's health and safety. Monitoring records including food and fluid charts and, repositioning records had not been completed fully by staff to inform that the care and support had been provided as required in the care plans.

Medications had not been safely managed,as required monitoring records for controlled drugs had not been completed appropriately and medication fridge temperatures not completed to ensure the safe storage of medication.

We found that the Mental Capacity Act 2005 and the Deprivation of Liberty (DoLS) 2009 legislation had been adhered to in the home. We saw that mental capacity had been assessed appropriately, consent had been sought, DoLS conditions that were being applied by the home for people that required updating had been applied for by the manager.

Accidents, incidents and complaints had been managed appropriately.

Infection control standards at the home varied we observed poor environmental issues specifically in the servery attached to the dining room. Audits of the service were ineffective and in some cases not carried out.

We saw no evidence of a robust induction process into Greenheys Lodge and the staff training we were provided with informed us that staff had not had relevant training or required updated training. Supervisions and appraisals were taking place but not all staff had received them.

The manager had reduced the number of agency staff being used however feedback we received from people using the service, relatives and staff all indicated there were still issues regarding staffing levels.

People we spoke with told us they felt safe at the home and they had no worries or concerns. People’s relatives and friends also told us they felt people were safe. The staff at the home knew the people they were supporting and the care they needed. We observed staff to be kind and respectful towards people. The home provided a range of activities to occupy and interest people.

People’s personal emergency evacuation plans did match their risk assessments and gave the relevant information required.

Ratings from the last inspection were displayed within the home and on the provider's website as required.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location from the providers registration.

The CQC was informed on the 14 August 2018 that Greenheys Lodge would be closing and de-registering with the CQC in September/October.