Greenfields Care Home

Greenfields Care Home provides accommodation and nursing or personal care for up to 75 people. On the day of our inspection, 72 people were receiving services, some of whom were living with dementia.

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

People did not always receive care and support in a way that reflected their personal needs and preferences. People in different parts of the building received differing responses from staff.

At the time of this inspection the registered manager was not completing the duties of a registered manager at Greenfields Care Home. However, they were still employed by the provider in a different role within the organisation. Although an interim manager was in post the support provided by the management team was inconsistent.

People received safe care and support as the staff team had been trained to recognise potential signs of abuse and understood what to do to safely support people.

Staff members followed effective infection prevention and control procedures when supporting people. Staff members had access to, and used, appropriate personal protection equipment. Risks associated with people’s care and support had been assessed. Staff members understood how to safely support people.

The provider supported staff in delivering effective care for people through care planning, training and one-to-one supervision. 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 at Greenfields Care Home supported this practice.

People were promptly referred to additional healthcare services to support good health. Staff members knew people’s individual health needs. People were supported to maintain a healthy diet by a staff team which knew their individual preferences. When it was needed the provider had systems in place to identify and seek additional support.

People were supported by a kind and respectful staff team who were aware of their individual protected characteristics like religion, age, gender and disability. People were provided with information in a way they could understand.

The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them. The provider, and management team, had good links with the local communities within which people lived.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was ‘Good’ (published 05 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Greenfields is registered to provide accommodation with personal care for up to a maximum of 75 people. There were 64 people living at the home on the day of our inspection. Some people were living with dementia.

A registered manager was in post and present throughout this inspection. 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.

People received support with their medicines from staff who were trained to safely administer them. Medicines were locked away safely and in accordance with their individual risk assessments.

People were safe as staff had been trained and understood how to support people in a way that protected them from harm and abuse. People’s records had individual assessments of risk associated with their care. Staff knew what to do in order to minimise the potential for harm.

People were supported by enough staff to safely meet their needs. The provider followed safe recruitment practices and completed checks on staff before they started work. The provider had systems in place to address any unsafe staff practice including retraining and disciplinary processes if needed.

People received care from staff that had the skills and knowledge to meet their needs. New staff received an introduction to their role and were equipped with the skills they needed to work with people. Staff attended training that was relevant to the people they supported and any additional training needed to meet people’s requirements was provided.

People’s rights were protected by staff who were aware of current guidance and legislation directing their work. People were involved in decisions about their care and had information they needed in a way they understood.

Staff received support and guidance from a registered manager who they found approachable. People and staff felt able to express their views and felt their opinions mattered. People had good relationships with the staff who supported them. People’s likes and dislikes were known by staff who assisted them in a way which was personal to them.

People had their privacy and dignity respected by those supporting them. People had access to healthcare when needed and staff responded to any changes in needs promptly. People were supported to eat and drink sufficient amounts to maintain good health.

The registered manager completed regular quality checks of the service. The operations and performance manager visited regularly and produced a report of the oversight of the service. The provider engaged with people and their families at their visits to the service. The provider encouraged feedback from people in order to improve the service. People felt confident they were listened to and their views were valued.

Greenfields is registered to provide accommodation with nursing and personal care to a maximum of 75 people. There were 75 people living at the home on the day of our inspection. The home provides care and support for older people some of whom were living with dementia, mental health or learning disabilities.

A registered manager was in post. They were not present during our inspection due to prearranged annual leave. We saw that they had arranged managerial cover during their leave. 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.

Staff had received training in and understood how to protect people from the risk of harm and abuse. Systems were in place for staff to follow which protected people and kept them safe. Staff were confident in how to report any concerns they may have about a person's safety. Risks to each person's safety were assessed and ways found to support people to be as independent as possible.

People were not always supported by sufficient numbers of staff to safely meet their needs. When agency staff were used, they received a good level of introduction to the service and were supported to be part of the team. Checks were completed on potential new staff to make sure they were suitable to work with people living at the home.

People were supported to take their medicines safely and when they needed them. Medicines were stored safely and only staff who had received training and been assessed as competent were able to support people with their medicines.

Staff asked people's permission before they helped them with any care or support. People's right to make their own decisions about their own care and treatment were supported by staff. Where people were unable to make their own decisions these were made in their best interests by people who knew them and other relevant professionals.

People were supported to maintain a healthy balanced diet and to make their own choices about what they wanted to eat and drink. When people needed support to eat and drink, this was provided in a kind, discreet and caring manner.

People's routine health needs were met. Healthcare support from the GP practice was provided in the home, and external referrals were made quickly when people needed other healthcare support.

People were supported by staff who knew them well and had good relationships with them. People were treated with dignity and respect by staff. Staff did not always respect people's diversity and how this could impact on their day-to-day life in the home.

People and their families were not consistently involved in the planning of their own care. People's diverse needs were not always taken into account when planning care. Care plans were not always evaluated in a meaningful way.

People and their families knew how to complain. The provider did not always recognise that people remained dissatisfied about they had managed their complaint.

The provider had systems in place which assessed and monitored the quality of care and support staff provided at the home.

We observed that people received caring support from staff on duty. We saw care that was not rushed and the staff knew the people and their individual personal needs.

We considered that people who lacked the ability to manage their own care received caring support that was responsive to their changing mood and need. Care records were in place that provided staff with instructions on how people should be cared for and why. This meant that the care was responsive to people's needs.

Staff understood the importance of keeping people safe from harm.

Records showed that staff were well trained to do their job and we observed that compassionate care was provided by staff.

There was a complaints policy and procedure in place. Information provided about the complaints process meant that people were assured that they could raise concerns and that these would be addressed.