Greenleigh

Updated 23 December 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 undertaken by 2 inspectors 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.

Service and service type

Greenleigh 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. Greenleigh 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 18 October 2022 and ended on 7 November 2022 when formal feedback was provided. We requested and reviewed records remotely during this period. We visited the home on the 18 and 19 October 2022.

What we did before the inspection

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 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 used all this information to plan our inspection.

During the inspection

We spoke with 9 people and 2 relatives about their experience of the care provided. We also spoke with 9 staff which included care and senior staff, domestic, catering staff and activities staff. We also spoke with the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of documents and records including the care records for 4 people, 7 medicine records, 2 staff recruitment files. We also looked at records that related to the management and quality assurance of the service.

Updated 23 December 2022

About the service

Greenleigh is a residential care home providing personal care and accommodation for up to 35 people some of whom may live with Dementia. The service was supporting 31 people at the time of the inspection.

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

Improvements were required with the systems in place to manage risks to people and their medicines. This is to make sure people's medicines were stored safely and to ensure risks to people were well managed to reduce potential risk of harm.

Equipment was not always used to ensure people's privacy and dignity was promoted for those people that shared a room. We were somewhat assured with some of the measures in place to prevent the spread of infection.

The systems and processes in place were not effective enough to enable the provider to identify where areas for improvement were needed and to take action to address these. Some of these shortfalls had been identified at the previous inspection and improvements had not been made. The registered manager did take action when information of concern was shared with them to address some of these shortfalls.

People were supported by staff that had been trained and understood how to protect people from abuse. People had access to healthcare professionals to ensure their healthcare needs were met. Systems were in place to review any incident and accidents to see if there were any lessons to learn from these.

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. People enjoyed the food provided which met their preferences. People were supported to provide feedback about the way the service was managed. People were happy with the service provided and felt able to approach the registered manager.

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 was requires improvement (published 21 May 2021) and there were 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 the provider remained in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to management of people's risks, about the way people’s care needs were being met, and the overall management of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed and the service remains requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to management of medicines, risk management and to the overall governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.