CQC report explained · a residential care home
What the CQC found at Greenacres
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Rated Good; inspectors found kind, safe and improving care, with only minor points to keep under review.
This was an unannounced planned inspection after the previous rating of Requires Improvement. Inspectors spoke with nine people, seven staff, the manager and a healthcare professional. They observed care and checked care plans, medicine records, staff files and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they were happy with their care. Inspectors found safe risk management, medicines support, suitable food and drink, kind staff, personalised care and more activities.
The home had improved since the previous inspection in October 2018. A registered manager had been appointed, permanent staffing had increased, agency use had fallen and quality checks were now working effectively. The provider was no longer in breach of the regulations identified at the previous inspection.
Safer care and medicines
Risks were assessed and action was taken to reduce harm. Medicines records were complete, medicines were stored securely and errors were investigated.
“Medicine administration records (MAR) chart were fully completed with no gaps.” from the report
Kind and respectful staff
People described positive relationships with staff. Inspectors saw staff protect privacy, offer choices and support independence.
“Staff treated people with dignity and respect.” from the report
More consistent staffing
The home had recruited more permanent staff and greatly reduced agency use. Inspectors said this helped people get to know staff and build relationships.
“The home was now predominantly staffed by permanent staff, and agency usage had dropped dramatically since our last inspection.” from the report
Improved management
The home had a registered manager and stronger quality checks. Staff described a more open culture focused on learning when things went wrong.
“Quality assurance processes were now effective at identifying where improvements were needed, and that action taken had addressed the concerns.” from the report
Personalised support
Care plans included people's needs and preferences, and staff followed them. Activities had increased and included trips, hobbies and community links.
“Individualised care plans were in pace that had been developed with people and their relatives' input.” from the report
Staff could sometimes feel rushed
minorOne person said staff were sometimes a bit rushed, although inspectors found enough staff and saw call bells answered quickly.
“The staff do their best - sometimes they can be a bit rushed, but they help you all they can.” from the report
Activities were still developing
minorActivities had improved, but the provider was still reviewing how they were managed and how to match them more closely to individual hobbies and interests.
“The way activities were managed was under review by the provider under their 'Anchor Active' initiative at the time of our inspection.” from the report
- 01How has the refurbishment progressed since the inspection, including changes to the environment for people living with dementia?
- 02How are activities now matched to each person's hobbies and interests?
- 03How do you make sure staffing levels remain sufficient when staff feel rushed?
- 04How are medicines errors monitored and followed up?
- 05How are people's end-of-life preferences reviewed and kept up to date?
This inspection looked at both the premises and care, and assessed all five CQC questions; it followed a previous Requires Improvement rating. This explanation was written from the published report of 19 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2018
Rated Requires Improvement; inspectors found ongoing risks with medicines, legal consent, personalised care and management oversight.
Inspectors visited the home without notice on 8 May 2018. They spoke with people and relatives, observed care, and checked care plans, medicines records, staff files, training and management audits.
The home was not always safe or effective. Risks were not consistently managed, medicines records had gaps, and staff did not always follow the Mental Capacity Act. People’s dignity, independence, activities and end of life planning also needed improvement.
There were enough staff on the inspection day, the home was clean, recruitment checks were completed and people had access to healthcare professionals. However, the systems for checking quality did not reliably find or fix problems. All five areas were rated Requires Improvement.
Cleanliness
The home was clean and staff followed handwashing and protective equipment procedures.
“The service was clean and had good infection control in place.” from the report
Training and healthcare
Staff had relevant training and regular supervision. People were seen regularly by healthcare professionals.
“Staff were given consistent and relevant training and supervision by management.” from the report
Complaints
Complaints were recorded and answered quickly and in detail. People knew how to raise concerns.
“Complaints and concerns were taken seriously and used as an opportunity to improve the service.” from the report
Medicines
seriousMedicine records had gaps, including missing reasons for missed doses and missing guidance for some as-required medicines. Some medicines had expired but were still being given.
“Medicines administration records (MARs) contained gaps and did not always state the reasons why medicines were not administered.” from the report
Risks were not followed up
seriousSome known risks were not reflected in care or risk assessments. Inspectors found missed follow-up after a fall, unaddressed weight loss and unfixed furniture at the time of the visit.
“The provider was not always proactive in identifying risks and staff were not clear on how to manage individual risks to people.” from the report
Mental Capacity Act
seriousRestrictions were placed on some people without the required capacity assessments, best interest decisions or legal authorisations. Some assessments were not specific to the decision being made.
“People's legal rights were not protected because staff did not always follow the guidance of the MCA.” from the report
Dignity and independence
needs fixingInspectors saw examples where privacy, dignity and independence were not properly supported. People were not allowed to make their own cups of tea because staff considered this too risky.
“We found people were not always treated with dignity and respect.” from the report
Activities
needs fixingPeople reported boredom and isolation. Activities were limited and did not consistently reflect people’s hobbies, interests or preferred social setting.
“People did not have access to a range of stimulating activities which were person centred.” from the report
Management checks
seriousAudits had identified some problems, but actions were not always completed or sustained. Important incidents were also not always notified to CQC.
“There was a lack of governance at the home.” from the report
- 01What changes have been made to prevent gaps in medicines records and to make sure as-required medicines are given safely?
- 02How are capacity assessments, best interest decisions and any Deprivation of Liberty Safeguards authorisations now recorded and reviewed?
- 03How do you identify and respond to falls, weight loss and other changing risks in each person’s care plan?
- 04What meaningful activities are now available for people who dislike crowds or have particular hobbies and interests?
- 05How do your audits now show that identified problems have been fixed and remain fixed?
This was an unannounced comprehensive inspection covering all five CQC questions, and the report also checked whether concerns from the December 2016 inspection had been resolved. This explanation was written from the published report of 7 December 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Greenacres
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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