Archived: Greenacres Grange

Updated 5 March 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 included checking the provider was meeting COVID-19 vaccination requirements. 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 team consisted of three inspectors, one of whom was a specialist medicines inspector, 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. The Expert by Experience supported the inspection by telephoning a sample of people's relatives to obtain their feedback on the care home.

Service and service type

Greenacres Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. One of the registered managers was on long term absence from the care home at the time of the inspection.

Notice of inspection

This inspection was unannounced.

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 four people who used the service and a relative of a person who lived there. We also spoke with nine staff members including, registered manager, healthcare assistants, nurse assistants, registered nurse, clinical lead, director, regional manager, catering and housekeeping staff. We also observed interactions between staff and people. We reviewed a range of records. This included four people's care records (in whole or in part), risk assessments and multiple medication records. We looked at three staff files in relation to recruitment and pre-employment checks.

After the inspection

The Expert by Experience and inspector spoke on the telephone with nine relatives of people who used the service. We received feedback on the service, by email or phone, from four members of Greenacres staff. A variety of records relating to the management of the service, including policies and procedures, were also reviewed. We looked at training and quality assurance data and continued to seek clarification from the provider to validate evidence found.

Updated 5 March 2022

About the service

Greenacres Grange is a care home which provides personal and nursing care for up to 80 people. At the time of the inspection, the care home had 28 people living there. Greenacres Grange is a purpose-built care home which can accommodate people across five separate units, each of which has separate facilities. However, at the time of the inspection only three units were being used. Two units mainly supported people who had nursing needs or who were living with dementia. The third unit supported people who had mainly residential care support needs.

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

Visiting arrangements were not in line with government guidance at the start of the inspection. The provider had not allowed relatives to be essential care givers. This was discussed with the provider who subsequently decided to allow all people to have an essential care giver if they wished. This meant the provider was then in line with government guidance on visiting in care homes.

People’s relatives gave us mixed feedback about how the provider responded to complaints. However, the provider had recently improved the way they responded to complaints, by enabling the registered manager to produce the initial complaint response, rather than the provider’s head office.

People’s prescribed medicines were safely managed, and the provider’s medicines audits had improved. Improvements had been made in the management of people’s individual risks. People were protected, as far as possible, from health infections by the provider’s infection prevention and control processes.

People were supported by enough staff to meet their care needs at the time of the inspection. Staff received safeguarding training which helped ensure people were safe from potential abuse and neglect. People’s care plans were comprehensive and available to staff. People were supported to have enough to eat and drink and had improved access to preferred snacks both during the day and at night.

People living in the areas of the care home, which were in use at the time of the inspection, benefited from the design and decoration of those areas. People were supported by staff who had received the necessary training to provide safe care. People were treated with kindness and compassion by the care staff. People’s dignity and privacy was maintained when care was being provided.

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’s communication and sensory support needs were detailed in their care plans. A range of daily activities were provided which people chose to participate in if they wished. People’s end of life wishes were included in their care plans so staff could be guided to ensure care was provided sensitively and in line with the person’s wishes.

The provider had improved their communication links with external health and care agencies which helped ensure people received the care they needed. The provider had improved their quality monitoring processes and care management systems. The provider had improved their approach to sharing information with statutory agencies who requested information as part of their role to safeguard people from potential harm or abuse.

Staff told us morale at the service had generally improved now they had a permanent registered manager in place. The provider continued to encourage people and relatives to give them feedback on the service so they could identify further areas they could improve on.

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 this service was inadequate (published 9 April 2021) and there were multiple breaches of regulation. CQC issued the provider with two Warning Notices.

The provider completed an action plan after that inspection to show what they would do and by when to improve. On 20 July 2021 (report published 8 October 2021) we carried out a targeted inspection to check if the provider had complied with the Warning Notices. We found some improvements had been made and the provider had complied with the requirements of the Warning Notices which related to regulation 12 (Safe care and treatment) and regulation 18 (Staffing).

At this inspection we found further improvements had been made and the provider was no longer in breach of any regulations.

This service has been in Special Measures since 9 April 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.