CQC report explained · a residential care home
What the CQC found at Greenfield House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely, and some building checks, repairs, care plans and risk assessments were not reliable or up to date. CQC found no evidence of harm, but said people were placed at risk.
- Effective?
- Good
- This area was not inspected during this focused visit. CQC used the previous rating for areas that were not inspected.
- Caring?
- Good
- This area was not inspected during this focused visit. CQC used the previous rating for areas that were not inspected.
- Responsive?
- Good
- This area was not inspected during this focused visit. CQC used the previous rating for areas that were not inspected.
- Well-led?
- Requires improvement
- Management audits and checks did not reliably identify missing medicine records, incomplete care plans, training gaps or other risks. CQC said governance systems were not robust enough.
What inspectors found, November 2023
Requires Improvement; inspectors found kind care and enough staff, but medicines, building safety and management checks were not reliable.
This was an unannounced focused inspection after concerns about management. One inspector visited on 11 and 12 September 2023, observed care, spoke with relatives and staff, and checked care, medicine, recruitment and management records.
The home was not always safe. Medicines records were incomplete or unclear, some care plans and risk assessments were out of date, and some fire, emergency lighting and water checks had not been completed. Some fire doors also needed repairs that had not been completed quickly.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. The previous overall rating was Good in 2019. The other areas were not inspected during this visit, so their earlier ratings were used.
Kind staff
Staff knew people and their care needs well. Inspectors said they promoted dignity and privacy.
“Staff were kind and promoted people's dignity and privacy.” from the report
Staffing and recruitment
Inspectors found enough staff available to support people. Required pre-employment checks had been completed for the staff files reviewed.
“People were supported by enough safely recruited staff.” from the report
Safeguarding knowledge
Staff knew how to report and record concerns about abuse and harm. The manager reviewed this information.
“Staff we spoke with told us where to access safeguarding policies and procedures, how to report and record incidents and this was reviewed by the registered manager.” from the report
Open culture
Relatives and staff said they could approach management. The home involved relatives in updates and meetings.
“Management promoted an open and inclusive culture among people, relatives and staff.” from the report
Medicine records
seriousThere were discrepancies and missing or unclear records for some medicines. This made it difficult to confirm that medicines had been given safely and as prescribed.
“This meant the registered manager could not be assured the person received this medicine safely and as prescribed.” from the report
Fire and building safety
seriousSome required safety checks were missed, and some fire doors did not close when the alarm went off. Repairs had not been completed quickly.
“However, repairs had not been undertaken swiftly and this meant people remained at risk of harm should there be a fire.” from the report
Care plans and risk assessments
seriousSome records did not reflect people's current needs. The report gave an example where a person's seizure information had not been updated after it changed.
“Some people did not have accurate and up to date care plans and risk assessments in place.” from the report
Weak management checks
seriousAudits did not identify several important problems, including missing medicine guidance, incomplete monitoring records and training that was not up to date.
“Governance systems were not robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.” from the report
- 01Have all missing or unclear medicine records been corrected, including records for pain relief patches and medicines given when needed?
- 02Have the fire doors, emergency lighting checks, fire checks and water temperature checks been brought up to date?
- 03How are care plans and risk assessments checked when a person's needs change?
- 04What system now makes sure staff complete required refresher training?
- 05What progress has been made on the action plan sent to CQC?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 17 November 2023 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, June 2019
Greenfield House was rated Good overall; inspectors found safe, kind and personalised care, but noted the home did not follow some best-practice design guidance.
This was an unannounced planned inspection on 14 May 2019. One inspector spoke with a person living in the home, three relatives, the registered manager and three support workers. They also observed care and reviewed care, medicines, recruitment, training and quality records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines systems, suitable care plans, prompt access to healthcare, kind relationships and activities that reflected people's interests.
The report noted that the home had not been designed in line with Registering the Right Support and other best-practice guidance. This included shared facilities for some people and a location next to two educational facilities rather than in a residential area.
The home was also rated Good at its previous inspection, published on 10 October 2016. The report says legal requirements were being met and that quality-monitoring systems were in place.
Safe support
Staff were trained to recognise abuse and risks. Inspectors found detailed risk assessments, safe recruitment and enough staff to provide prompt support.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Medicines
Staff were trained and assessed as competent to give medicines. The home had guidance for medicines given when needed and systems for dealing with errors.
“People were safely supported with their medicines by a trained and competent staff team.” from the report
Kind relationships
People and relatives spoke positively about staff, and inspectors saw many kind and compassionate interactions.
“During this inspection we saw many incidents of kind and compassionate interactions between people and staff.” from the report
Personalised care
People and those close to them were involved in care planning. Staff knew people's preferences, health needs and what mattered to them.
“We saw the care and support people received reflected their personal needs and wishes.” from the report
Activities and communication
People took part in activities such as walking and shopping. Information was provided in accessible formats, including easy-read information with pictures.
“People had information presented in a way that they found accessible and, in a format, they could easily comprehend.” from the report
Design and location
needs fixingThe home was not developed in line with Registering the Right Support and other best-practice design guidance. Some people were expected to share bathrooms and communal areas, and the home was next to two educational facilities rather than in a residential area.
“The care service had not been developed or designed in line with the values that underpin the Registering the Right Support and other best practice guidance.” from the report
- 01How would the shared bathrooms and communal areas work for my relative, and what privacy would they have?
- 02How would you manage and communicate any medicines error involving my relative?
- 03How would my relative be involved in care plan reviews and decisions about their support?
- 04How do you assess mental capacity and make sure decisions are made in the person's best interests when needed?
- 05What arrangements would be made if my relative needed end-of-life care?
This was an unannounced planned inspection covering the overall service and all five CQC questions; no one at the home was receiving end-of-life care at the time. This explanation was written from the published report of 4 June 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 Greenfield House
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2019Goodstayed GoodSafe: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 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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