Greenbanks Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We reviewed 7 quality statements for this key question. We found staff and leaders now demonstrated a positive, compassionate, listening culture. Leaders monitored and reviewed the progress against the delivery of the strategy. Staff and leaders had now been provided with appropriate training to be effective in their roles. There were now mechanisms in place to allow people, relatives and staff to speak up and have their voices heard. There were policies and procedures in place to support workforce equality, diversity and inclusion. Learning, improvement and innovation had now increased since the last inspection. There was now evidence of the provider liaising with various health professionals to ensure safe care and treatment for people living in the service. There were now clear governance, management and accountability arrangements in place. However, we found that some of the audits completed by the provider were not effective and had not identified some of the concerns we found. This was in relation to medicines optimisation which resulted in a breach.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders monitored and reviewed the progress against the delivery of the strategy. There was now a service improvement plan, which was reviewed. The service values had been co-created with managers in 2019 and were now currently being reviewed along with the strategy. The leaders now collaborated with various stakeholders around their strategy. Communication methods were now in place for strategic information to be cascaded to the service and teams. For example, there was a “weekly flash notice” which communicated strategic information to staff.

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service and was focused on learning and improvement. Staff told us the culture had changed since the new manager had been in post. A staff member told us “Managers are not always watching us, they let us get on and listen to our suggestions.” Leaders told us “We want to establish a building block culture where we won’t turn our eye to things, everything is a learning opportunity, we need to make sure we are maintaining that.” They told us they had “upskilled the staff, identified champions within the service to complete risk assessments and audits. The staff had become more confident in their roles and there was more opportunity for personal development.”

Staff told us leaders were visible and they had their contact details to approach them if they had any concerns. The manager told us they had received support from the senior leadership team since they started in their role. Leaders told us that they were now visible at the service and “This has helped change the perspective for staff and residents, we are part of the furniture, people are not scared, we want to continue this going forward.”

Leaders were now knowledgeable about issues and priorities for the quality of services and were able to access appropriate support from professionals to be able to deliver in their roles. The service manager was currently going through the registration process to become the registered manager. The leaders had been provided with training to be effective in their roles. We received positive comments about the manager from professionals, people and relatives.

There was a raising concern, freedom to speak up and whistleblowing policy and procedure in place. Anonymous survey results showed where people had been consulted on their views and what action had been taken. Team meetings and supervisions showed staff were now able to have their voices heard. Where concerns had been raised, they had now been dealt with in line with the organisations policy and procedures.

Staff told us they were able to speak up and have their voices heard. Leaders told us they had mechanisms in place to allow people, relatives and staff to speak up and have their voices heard. For example, feedback was gained regularly through team meetings, handovers, supervisions, and anonymous surveys.

Staff felt empowered and were confident their concerns and ideas resulted in positive change to shape services and create a more equitable and inclusive organisation. One staff member told us the staff at Greenbanks are “multi-cultural and everyone works well together.” Leaders told us “This is a diverse place to work, we have a diverse team from all corners of the globe. The anonymous surveys help us examine our demographics. It’s important we celebrate people from all walks of life, different languages, we have a culture of acceptance and life experience.” They also told us “We recently held a multicultural day that the staff designed to celebrate their cultures and cuisines with the service users. We have a board celebrating their languages and a map with pins in their countries of origin.”

There were policies and procedures in place to support workforce equality, diversity and inclusion. Where staff had raised concerns about discrimination and bullying there was now evidence that the concerns had been dealt with in line with policies and procedures. There was evidence that documents had been translated into the native language of a staff member which supported them to understand their duties and responsibilities.

Staff understood their role and responsibilities and had opportunities to discuss their roles during supervisions and weekly team meetings. Leaders told us that they had focused on governance since the last Inspection. They were assured that the audits being completed maintained the level of oversight required.

The service had now made some improvements. There were now clear governance, management and accountability arrangements in place. There was a policy and procedure in place for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care. There was now a clinical risk register in place which the manager used to identify current and future risks. The regional risk manager now re-validated audits with the manager and staff weekly. However, we found that some of the audits completed by the provider were not effective and had not identified some of the concerns we found. This was in relation to medicines optimisation. We have asked the provider for an action plan in response to the concerns found at this assessment.

There was now evidence that the provider had liaised with various health professionals to ensure safe care and treatment for people living in the service. Professionals had been involved in care plans and provided training and support to staff.

People told us they had regular visitors. They told us there were lots of activities in the home including, bingo, nail painting, arts and crafts, chiropody and hairdressing. A person told us “They get me to my hospital appointments on time, I need treatment, they know what to look out for.” Another person told us there was a planned “bus trip out soon and they were looking forward it.”

Staff told us “Relatives can come and go as they like; they can send emails or talk to anyone of us, they mainly speak to the key workers.” They told us they liaise with GP’s, SALT teams and district nurses. Leaders told us they worked closely with the Local Authority and health care teams. They had planned to expand in community engagement and had already started this with local trips. They had explored bringing the community into the home and were in the process of building a local drop off and pick up point for books. They were also planning on delivering dementia friend’s sessions in the home for the local community.

A professional told us they had supported the home in training their staff in areas such as: catheter care, pressure ulcer prevention, falls management and management of challenging behaviours. They told us “The home has been very engaging and since the new manager has been in post we have noticed a change in culture. Staff are proactive in seeking support from outside agencies in a timely manner and implement advice being given to them. The home is working to improve the current environment to encourage a more dementia friendly environment.” Another professional told us they visit the service every 6-8 weeks to provide foot health treatments. The service had actively engaged with professionals to review their medication management since the last inspection and contacted professionals for advice.

Staff told us they were able to speak up with ideas for improvement and innovation. One staff member told us they had suggested an improvement for the way laundry was divided and this had been implemented. Leaders told us they had focused on training and developing staff. They had gained feedback from staff, residents, relatives and professionals on how to improve the service and provided innovative activities for residents.

The service now had improved. Staff had now received training relevant to their roles and were now encouraged to ask for additional training as required. There were now clear processes in place for people to provide feedback on what they would like to happen in the home. There was a refurbishment plan in place and people had been involved in the decoration and colour schemes. There was now evidence of reflective practice where things had gone wrong which ensured lessons were learned.