CQC report explained · a residential care home
What the CQC found at Greenbanks
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, improved medicines checks and effective infection control. Risks were generally identified and managed, although some risk guidance had not yet been fully transferred to the new system.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- The manager and staff were approachable, involved people and worked with other professionals. However, care plans, risk assessments and some monitoring records were not consistently complete or accurate.
What inspectors found, August 2021
Greenbanks was rated Good overall, but inspectors found well-led care Requires Improvement and some records were not accurate.
This was an unannounced, focused inspection on 10 June 2021. Two inspectors reviewed Safe and Well-led. They spoke with six people, staff, relatives and visiting professionals, and checked medicines, care plans, risk assessments, staff files and management records.
Inspectors found people were safe, with enough staff, safer medicines systems and suitable infection control. Staff knew people well, responded to their needs and supported their independence. People and relatives said they were happy with the care.
The home was moving paper records to an electronic system. Some care plans, risk assessments and other records were incomplete, unclear or inaccurate. The registered manager took action during and after the inspection, but inspectors rated Well-led Requires Improvement because these systems were not yet consistently reliable.
The overall rating improved from Requires Improvement at the previous inspection to Good. The home was no longer in breach of regulations. The other three question ratings were carried forward because they were not inspected this time.
Safer medicines
The home had introduced electronic medicines records, checks at the start and end of shifts, two-person administration and more frequent audits. Inspectors found that errors had reduced and mistakes were identified quickly.
“Staff had recently started to use an electronic system for the recording and administration of medicines. Errors in administering medicines had reduced.” from the report
Staffing and safety
There were enough staff to provide personal care and support people to go out. Recruitment checks were completed, and staff responded quickly when people needed help.
“There were suitable numbers of staff available to support people.” from the report
People felt safe and respected
People told inspectors they felt safe. Staff knew people well, listened to them and supported their choices and independence.
“People were supported to identify and mitigate risks associated with their care and support.” from the report
Infection control
The home was clean and well maintained. Inspectors were assured about its arrangements for PPE, testing, visiting and preventing or managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Incomplete care records
needs fixingSome electronic care plans and risk assessments did not contain enough information to ensure consistent support. Some plans could also be misunderstood by staff.
“Some of the electronic care plans and risk assessments were lacking the information needed to make sure people received consistent care and support.” from the report
Inaccurate monitoring records
minorWater temperature records were not accurate, and the problem had not been identified through checks. The manager said this was addressed during and after the inspection.
“Other records like water temperatures were not recorded accurately.” from the report
- 01Have all care plans and risk assessments now been reviewed and updated on the electronic system?
- 02How do you check that records accurately reflect my relative's individual needs?
- 03How are staff told about changes to care plans and risk assessments?
- 04What checks now confirm that water temperatures and other monitoring records are accurate?
- 05How are medicines audits and shift checks being maintained since the inspection?
This was an unannounced focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 17 August 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.
What inspectors found, September 2019
Rated Requires Improvement; inspectors found kind, person-centred care but repeated medicines errors and weak checks on safety.
The inspection visit took place on 9 August 2019. It was announced because people living there had complex support needs and benefited from knowing inspectors were coming. One inspector spoke with people, relatives and staff, observed care, checked records and looked around the home.
People and relatives were positive about the home. Inspectors found that staff were caring and respectful. People had choice over their daily routines, meals, activities and personal space. Staff supported people to communicate, access healthcare and stay in touch with family.
The main problem was medicines. There had been eight further occasions when people were not supported to take the right medicine at the right time. This included missed medicines, wrong timings, too much medicine and medicine that was not prescribed for one person. No direct harm was recorded, but the errors increased the risk of harm.
The overall rating was Requires Improvement. Safe remained Requires Improvement, and well-led fell from Good to Requires Improvement because quality checks had not fixed the medicines problems. Effective, caring and responsive remained Good.
Respectful care
Staff treated people with dignity and respect. They supported privacy, personal choices and different ways of communicating.
“Support staff were consistently courteous, polite and helpful.” from the report
Choice and independence
People were supported to make choices about their clothes, routines, meals and activities. Staff helped people do things for themselves rather than taking over.
“People spent their day as they wished and they were free to relax in their bedroom whenever they wanted.” from the report
Activities and relationships
People were supported to pursue hobbies, attend day opportunities and keep in touch with relatives. The home also helped people take part in community activities.
“People were also supported to pursue their hobbies and interests.” from the report
Staffing and training
Inspectors found enough staff on duty and safe recruitment checks. Staff had training and understood the support needs of the people living there.
“Records showed sufficient support staff were routinely on duty to provide people with the assistance they needed.” from the report
Repeated medicines errors
seriousEight further medicines errors had happened since the previous inspection. The report says people were not consistently supported to take medicines safely, creating an increased risk of harm.
“Failure to safely administer medicines so as to reduce risks to people's health and safety was a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Checks did not prevent problems
needs fixingThe home had quality checks, but these did not identify and resolve the continuing medicines shortfalls quickly enough. Inspectors said they needed further assurance that the new measures would last.
“These checks had not resulted in effective action being taken to eliminate continuing shortfalls in the management of medicines.” from the report
Safeguarding investigation
needs fixingA local safeguarding authority was investigating an allegation that a liquid medicine had been changed without authorisation. The report says this was ongoing, so no conclusion had been reached.
“The investigation was still in progress and so we did not look into this matter further.” from the report
- 01What has changed in your medicines system since the eight errors found at the inspection?
- 02How are two staff now checking medicines, and how do you make sure this happens on every shift?
- 03What results have your recent medicines audits shown?
- 04What was the outcome of the safeguarding investigation into the alleged change to a liquid medicine?
- 05How will you show families that the improvements to medicines safety are being sustained?
This was a planned inspection covering the home, its premises and care, with all five CQC questions rated; Safe remained Requires Improvement and Well-led deteriorated from Good to Requires Improvement. This explanation was written from the published report of 10 September 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.
Every inspection of Greenbanks
3 rated inspections over 5 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 January 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
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 £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.