CQC report explained · a residential care home
What the CQC found at Greene House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff to meet people's needs, but noted agency staff use, care worker vacancies and risks from chemicals that needed action.
- Effective?
- Good
- People's health, mental and social needs were assessed and supported. Staff had relevant skills and specialist epilepsy training, and people received enough food and drink.
- Caring?
- Good
- Staff were kind and compassionate. People were involved in their care, treated with dignity and supported to maintain their independence.
- Responsive?
- Good
- Care plans were detailed and tailored to people's needs, preferences and epilepsy care. Inspectors noted that daily notes were often task-based and that more easy-read signs and information were needed.
- Well-led?
- Good
- Inspectors found experienced managers, a positive workplace and effective quality checks. The home worked with health and social care professionals and acted when issues were identified.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with some improvements needed around chemicals, staffing vacancies and accessible information.
This was a planned inspection over 14 and 15 January 2020. One inspector spoke with people, staff, relatives and health and social care professionals. They reviewed care records, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, received appropriate health care, and were supported by kind staff who respected their dignity, choices and independence.
There were some shortfalls. Risks from chemicals had not been properly reduced at the time of the inspection. The home was using agency staff while recruiting to fill care worker vacancies. Most daily notes were task-based rather than person-centred, and the building did not have enough easy-read signs, symbols and pictures.
Specialist epilepsy support
Staff received specialist training and care plans included detailed information about seizures, emergency actions, blood tests and medicines.
“Epilepsy training was provided by specialist trainers within the organisation.” from the report
Kind and respectful care
People said they liked living at the home. Staff respected privacy, dignity and people's choices about their daily routines.
“The staff were mindful of dignity and respected people's privacy and promoted their independence.” from the report
Personalised care plans
Support plans described people's personalities, likes, dislikes, health needs and preferred ways of receiving care.
“There were a large range of support plans, individually tailored to a person's health and social needs.” from the report
Good health support
The home worked with a range of community health and social care professionals to support people's health and changing needs.
“The service worked in partnership with other health and social care professionals to ensure people remained healthy.” from the report
Strong management and checks
The management team was experienced and used audits, incident reviews and action plans to monitor care quality and safety.
“There was a robust quality management system in place to measure safety and the quality of the service.” from the report
Chemical safety
needs fixingRisks from chemicals had not been properly reduced when inspectors visited. The manager took action after the inspection and provided evidence of this.
“Risks related to chemicals were not mitigated and needed action to reduce risks to people and others.” from the report
Care worker vacancies
minorThe home was using agency staff to cover shifts while recruiting to fill care worker vacancies. Inspectors found staffing levels were enough at the time.
“Although the service was using agency staff to fill shifts, a recruitment drive was in place to fill existing vacancies.” from the report
Daily records
minorMost daily progress notes recorded tasks rather than describing people's individual experiences and care. The manager accepted this feedback.
“Most of the daily progress notes was task-based and not person-centred; the registered manager accepted this feedback.” from the report
Accessible signs and information
minorThe building lacked enough easy-read signs, symbols and pictures. The managers said they would discuss suitable signage with people and add more easy-read information to care documents.
“We noted an absence of easy read signage, symbols and pictures related to the building.” from the report
- 01What action was taken after the inspection to reduce the risks from chemicals, and how is this checked now?
- 02Have the care worker vacancies been filled, and how often is agency staff used now?
- 03How have daily progress notes been changed so they describe each person's care and experience, rather than only tasks?
- 04What easy-read signs, symbols and pictures have been added since the inspection?
- 05How are people's epilepsy care plans and staff seizure training kept up to date?
This was a planned inspection of the care home covering all five CQC questions, including both the premises and the care provided. This explanation was written from the published report of 14 February 2020 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, March 2017
Rated Good; inspectors found safe, kind and personalised care, but temporary staffing affected continuity.
This was an unannounced inspection on 21 and 23 February 2017. The inspector reviewed the home, spoke with people, relatives, staff and health professionals, and checked care plans, medicines, staffing and other records.
The home supported up to 14 people with epilepsy and related conditions. Eleven people lived there at the time. Inspectors found that risks and medicines were managed safely, staff were trained, and people's health, nutrition, privacy and dignity were supported.
People had detailed care plans, choices about their daily lives and access to activities. Staff were described as kind and caring. The home had a new manager, and systems were in place to monitor quality and make improvements.
The overall rating and all five question ratings were Good. This means inspectors found the service met the relevant standards at that inspection. The home had previously been rated Requires Improvement in January 2016, and inspectors said the earlier recommendations had been acted on.
Detailed risk planning
Care plans covered risks linked to epilepsy, mobility, communication, nutrition and other needs. Staff knew the risks and followed the plans.
“People's support plans included a range of risk assessments.” from the report
Kind and respectful care
Inspectors saw calm, positive interactions. Staff knew people's preferences and used respectful approaches.
“People were supported by staff who were kind and caring.” from the report
Personalised support
Care plans explained how each person wanted to receive care. People were involved in reviews and had choices about food, activities and daily routines.
“Care plans were detailed and specific as to the care required.” from the report
Improved management
The new manager was visible in the home and had introduced person-centred reviews and group supervision. Quality audits and provider monitoring were in place.
“The provider had made improvements to their monitoring of the service to enable them to pick up on current issues in a timely manner.” from the report
Temporary staffing
needs fixingPeople and staff said bank and agency workers did not always know people's needs. Vacancies and maternity leave meant temporary staff were used, and there were occasions when only three staff were on shift.
“Bank and agency staff do not know what care I require. We have new/different staff every week” from the report
Communication after an incident
needs fixingSome staff knew about an incident before the inspection, but others did not. The manager accepted that it should have been recorded so all staff were informed.
“The registered manager had taken the appropriate action in relation to the incident but had not followed it through to ensure that was communicated to all staff.” from the report
Complaints recording
minorTwo pieces of negative feedback had been dealt with but were not recorded as complaints. This reduced the accuracy of the home's records and learning from feedback.
“They had been acted on and addressed but should have been logged as complaints to ensure accurate reporting and learning from feedback.” from the report
Some flooring
minorInspectors found split flooring in hallways that had come away from doors. The provider agreed to look at what action was needed.
“Some flooring in hallways was split and had come away from the doors.” from the report
- 01How do you make sure bank and agency staff understand each person's care needs and communication methods?
- 02Have the staff vacancies and maternity leave cover been resolved, and how often are temporary staff now used?
- 03What system do you use to make sure incidents are recorded and communicated to every relevant member of staff?
- 04Were the two pieces of negative feedback formally recorded, and how are complaints now logged and reviewed?
- 05Was the planned appointment of a cook completed, and were the split hallway floors repaired?
This was an unannounced inspection to review the previous rating and assess all five key questions, including the action taken since January 2016. This explanation was written from the published report of 16 March 2017 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 Greene House
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 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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