Archived: Green Acres Nursing Home

Updated 21 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

We inspected the service on 27 April 2016, 04 and 09 May 2016.The first day was unannounced and we told the provider we would be visiting on subsequent days. The inspection team on day one consisted of two adult social care inspectors, a specialist advisor in pressure area care, and a specialist advisor in adult social work and also 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. Day’s two and three consisted of one adult social care inspector.

Before the inspection we reviewed all of the information we held about the service. This included the information we received from safeguarding and statutory notifications since the last inspection. We also sought feedback from the commissioners of the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The registered provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

At the time of our inspection visit there were 58 people who used the service. We spent time with 14 people. We spent time in the communal areas and observed how staff interacted with people and some people showed us their bedrooms.

During the visit we spoke with the registered manager, operations manager, eight staff and five family members. We also spoke with three of the NHS staff who work on site.

During the inspection we reviewed a range of records. This included 14 people’s care records, including care planning documentation and medication records. We also looked at staff files, including staff recruitment and training records, records relating to the management of the home and a variety of policies and procedures developed and implemented by the registered provider.

Updated 21 June 2016

We inspected Green Acres Nursing Home on 27 April 2016, 04 and 09 May 2016. The first day of the inspection was unannounced which meant the staff and registered provider did not know we would be visiting. We informed the registered provider of our subsequent visits. At our last inspection in October 2013 the provider was meeting the regulations we inspected.

Green Acres Nursing Home is a large purpose built property. The service provides care and accommodation for up to 62 people who require personal care and/or nursing. The service can support older people and people who are living with dementia. The service is close to all local amenities.

The registered provider works in partnership with the NHS to offer beds for people requiring rehabilitation following hospital discharge or admission from the community. There are NHS therapy staff on site and an NHS community nursing team who support this service for people requiring rehabilitation.

The home had a registered manager in place. 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.

Risks to people’s safety were not always assessed by staff. Monitoring records to ensure people’s health did not deteriorate or to prevent ill health was not always completed by staff. We saw people’s care plans were not always person centred and were not written in a way to describe their care, and support needs. We saw little evidence to demonstrate people had developed or agreed to their care plans.

Systems in place for the management of medicines so people received their medicines safely were not always appropriate.

We saw staff had not received supervision on a regular basis or had an annual appraisal. Staff had not always received training and therefore may not have had the skills and knowledge to provide support to the people they cared for.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

People told us there were enough staff on duty to meet people’s needs. We found safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Staff did not always understand the Mental Capacity Act (2005) and the process to ensure people who lacked capacity to make their own decisions was not always followed or documented in peoples care plans.

There were positive interactions between people and staff. We saw staff treated people with dignity and respect. People told us overall they felt well cared for.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People had good access to healthcare professionals and services. People’s independence was encouraged and their hobbies and leisure interests were individually assessed. We saw there was a range of activities available for people to join.

The registered provider had a system in place for responding to people’s concerns and complaints.

The new system in place to monitor and improve the quality of the service provided we saw was robust and will be effective once fully implemented.

We found the registered provider was breaching The Health and Social Care Act 2008 (Regulated Activities) Regulations. You can see the action we told the provider to take at the end of this report.