CQC report explained · a residential care home
What the CQC found at Greenacres Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments, care records and emergency evacuation plans were not always accurate or up to date. Staff deployment was inconsistent, although medicines were managed safely and infection control was effective.
- Effective?
- Requires improvement
- Staff did not understand the Mental Capacity Act well enough, and people were not always supported in the least restrictive way. There were also gaps in training, appraisals and care-plan reviews.
- Caring?
- Good
- This key question was not inspected in this report.
- Responsive?
- Good
- This key question was not inspected in this report.
- Well-led?
- Requires improvement
- Quality systems had not identified several problems with risks, staffing, care planning, consent and training. The home had also been without a registered manager since October 2021.
What inspectors found, November 2022
Greenacres Care Home is rated Requires Improvement; inspectors found gaps in risk management, consent and oversight, despite safe medicines and infection control.
This was an unannounced inspection on 20 September 2022. One inspector, a medicines inspector and an Expert by Experience visited the home. They spoke with 13 people, nine relatives, 10 staff and two healthcare professionals, and reviewed care files, medicines records, recruitment, training and quality checks.
Inspectors found that care records and risk assessments were not always up to date. Personal emergency evacuation plans did not give the right guidance. Some people were subject to restrictions without the required mental capacity and best-interest safeguards. Staff training had gaps, and staff said they were sometimes too stretched to provide flexible, person-centred care.
The home had improved its medicines management and infection control. People had enough food and drink and access to health professionals. However, the home had no registered manager, and its systems for checking quality had not found or managed several of the problems. The overall rating stayed Requires Improvement, as did Safe, Effective and Well-led.
Medicines
Medicines were stored, administered and recorded safely. There were also clear instructions for medicines given at particular times or when needed.
“People's medicines were managed safely and administered as prescribed.” from the report
Infection control
Inspectors were assured about infection prevention, hygiene, protective equipment and the home's ability to manage an outbreak.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Food and healthcare
People were offered choices of food and regular drinks and snacks. Inspectors also found that people could access healthcare professionals when needed.
“People were supported to access food and drink that met their dietary needs and wishes and were offered a choice for each meal.” from the report
Safe recruitment
The home's recruitment procedures were followed and staff were recruited safely.
“Staff recruitment procedures were followed, and staff were recruited safely.” from the report
Risk records
seriousSome care plans and risk assessments did not reflect people's current needs or explain how staff should reduce risks. Emergency evacuation plans also contained incorrect or incomplete guidance.
“Care records were not kept up to date to reflect people's current needs.” from the report
Consent and restrictions
seriousStaff did not understand who was subject to safeguards under the Mental Capacity Act. One person had items removed without a capacity assessment or best-interest meeting.
“People were not supported in the least restrictive way.” from the report
Staffing pressure
needs fixingStaff were not deployed consistently. People waited for long periods at times, and staff said they were focused on tasks rather than having time for person-centred care.
“They [staff] are rushing around and don't have time for us” from the report
Training
needs fixingStaff had not received all the training needed for people's health needs, including diabetes and catheter care. Some staff had never had an appraisal.
“Staff had not received the appropriate training to support the needs of people living at the home.” from the report
Quality oversight
seriousThe home's checks had not identified important problems with risk management, staffing, care planning, consent and training. The improvement plan was not yet fully part of everyday practice.
“The providers governance systems were not always effective.” from the report
- 01Which people's risk assessments, care plans and emergency evacuation plans have been updated since the inspection?
- 02How do you check that any restrictions on a person's freedom or belongings follow a capacity assessment, best-interest decision and the least restrictive approach?
- 03What training have staff completed for diabetes, catheter care and the needs of people living with dementia?
- 04How do you make sure staffing levels and staff deployment give people enough time for activities, outings and person-centred care?
- 05Who is now responsible for management, and has the manager submitted an application to register with the CQC?
This was an unannounced inspection that reported ratings for Safe, Effective and Well-led; Caring and Responsive were not inspected and the report says ratings for uninspected key questions were carried over from the last inspection. This explanation was written from the published report of 15 November 2022 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, July 2021
Requires Improvement; inspectors found no evidence of harm but identified risks, medicines, care planning and management systems that needed improvement.
This was an unannounced focused inspection on 12 May 2021. Inspectors reviewed information, spoke with people, relatives, staff and a health professional, and checked care records, medicines records, staff files and management records.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were also rated Requires Improvement. Inspectors found no evidence that anyone had been harmed, but some risks were not assessed or reviewed properly. There were also shortfalls in medicines management, care plans, staff training and supervision, and quality checks.
There were positive findings too. Staff understood safeguarding, people generally received their medicines as prescribed, infection control arrangements were satisfactory, people liked the food, and people could access health professionals. The home had brought in a consultancy team and was asked to send CQC an action plan. CQC said it would monitor progress and return to inspect again.
Safeguarding
Staff had safeguarding training and knew how to recognise and report abuse. The provider used safeguarding reporting systems when needed.
“People were protected from the risk of abuse.” from the report
Food and nutrition
People's nutritional needs were monitored, with choices, alternatives and fortified snacks available. Health professionals were contacted when there were concerns about swallowing or nutrition.
“The food is lovely, and you get plenty; they ask me what I want.” from the report
Health support
People could access GPs, community nurses, dieticians and other health professionals. A visiting health professional said staff made contact promptly and respected people's privacy and dignity.
“A health professional told us staff contacted them in a timely way, respected people's privacy and dignity” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including use of protective equipment and testing.
“We were assured that the provider was using PPE effectively and safely.” from the report
Risk assessments
seriousRisk information was not consistently complete or updated when people's needs changed. Some risks linked to anxious or distressed behaviour were not identified, and one person's bedrails were unsafe.
“Risk assessments did not consistently include full information to guide staff and had not always been updated when people's needs changed.” from the report
Medicines practice
needs fixingStaff practice during medicines administration fell short of good practice on two occasions. Stock control and instructions for medicines given when needed also required improvement.
“However, on two occasions during the inspection, staff practice regarding administration of medicines fell short of good practice.” from the report
Care plans and staff support
needs fixingCare plans did not always explain people's specific needs well enough. Training, supervision and appraisals had slipped during the pandemic, and staff reported low morale.
“However, training, supervision and appraisal for staff had slipped during the pandemic.” from the report
Quality checks
needs fixingManagement systems did not identify some problems with medicines, environmental risks and care records quickly enough. Behaviour-related incidents were also not consistently used to update care plans.
“The governance systems in place had failed to pick up some of the issues we identified during our inspection.” from the report
- 01How have you updated risk assessments and care plans for people whose needs or behaviour have changed?
- 02What changes have you made to medicines administration, stock control and instructions for medicines given when needed?
- 03How are you checking that staff training, supervision and appraisals are up to date?
- 04What does your current quality assurance system check, and how quickly are problems acted on?
- 05How do you make sure people who need extra help at mealtimes receive enough supervision and support?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 8 July 2021 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 Care Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 December 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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32 live-in carers within about an hour of North Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,300 a week. 29 can care for a couple. 11 years' experience on average.
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