CQC report explained · a nursing home
What the CQC found at Greenfields Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2020
Greenfields Care Home was rated Requires Improvement; inspectors found safe, kind care but inconsistent personalised support and management.
This was an unannounced inspection on 26 February 2020. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care records, medicines records, staff files, accidents, complaints and management checks.
The home was rated Good for Safe, Effective and Caring. People were protected from abuse, risks were assessed, medicines were managed safely and staff were trained. People were supported with healthcare, food and decisions about their care. Inspectors also found staff to be kind and respectful.
Responsive and Well-led were rated Requires Improvement. People did not always receive care that reflected their individual needs and preferences, especially in one part of the building. Management had been unsettled, with an interim manager in place and no clear long-term management arrangements.
The overall rating fell from Good at the previous inspection, published on 5 September 2017, to Requires Improvement. The report says the CQC would continue monitoring the home and could inspect sooner if concerning information was received.
People felt safe
People told inspectors they felt protected from harm. Staff had safeguarding training and knew how to respond to concerns.
“People were protected from the risks of ill-treatment and abuse as staff members had received training and knew how to recognise and respond to concerns.” from the report
Safe medicines and equipment
Staff were trained and checked as competent before giving medicines. Risks, emergency plans, equipment and the environment were also managed safely.
“People were safely supported with their medicines by staff members who had received training and had their competency checked before supporting people.” from the report
Good healthcare support
People were referred promptly to healthcare professionals when needed. Staff knew about people's health needs and how to support them.
“People had access to additional healthcare professionals including GP's, dentists, foot health practitioners and mental health teams.” from the report
Kind and respectful staff
People and relatives described staff as caring and respectful. Inspectors saw staff respond to anxiety and support people to express their feelings.
“People told us they were treated kindly and respectfully by a caring and considerate staff team.” from the report
Activities and social contact
People were supported to take part in activities they enjoyed and to socialise with others. Inspectors saw adapted sport and movement-to-music activities.
“We saw people were involved in activities they enjoyed, found interesting and stimulating.” from the report
Inconsistent personalised care
needs fixingPeople in different parts of the home received different responses from staff. In one unit, staff did not always know people's preferences and care could become reactive rather than planned around individual needs.
“People did not consistently receive personalised care that was responsive to their needs.” from the report
Unclear restriction
needs fixingOne person was told they could not leave the building alone, but there was no explanation in their care plan or risk assessment. The management team later said there were no restrictions and was reviewing how staff communicated this.
“There wasn't anything in their care plan or risk assessment to explain why.” from the report
Unsettled leadership
needs fixingThe registered manager was no longer carrying out that role, and the longer-term management arrangements had not been decided. Staff described conflicting instructions and a lack of consistency.
“Staff members told us they found the last few months to be disruptive and inconsistent.” from the report
Checks missed problems
needs fixingThe home's quality systems had not identified the difficulties staff had on one unit or the person's understanding that they could not leave the building.
“These systems had not identified the difficulties some staff members experienced when providing responsive and person-centred care on one specific unit” from the report
- 01What has changed on the unit where inspectors found that staff did not always understand people's needs and preferences?
- 02How do you make sure staff know each person's routines, preferences and communication needs when staff are moved between units?
- 03Who is currently responsible for the home, and what are the longer-term management arrangements?
- 04How do you check that staff receive consistent instructions, especially about medicines and people's freedom to leave the building?
- 05How will you show families that your quality checks now identify problems with personalised care promptly?
This was an unannounced inspection covering all five CQC questions, including both the care provided and the care home premises. This explanation was written from the published report of 20 March 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, September 2017
Greenfields Care Home was rated Good; inspectors found safe, kind and personalised care across all five areas.
The inspection was unannounced and took place on 15 August 2017. Two inspectors and an expert-by-experience spoke with people living at the home, relatives, staff and managers. They also reviewed care plans, medicines records, accident records, maintenance checks, recruitment information and quality audits.
The inspectors found that people were safe, had enough staff and received medicines safely. Staff were trained, understood people's needs and supported people to make choices. People were treated with kindness, privacy and dignity, and their care plans reflected their personal needs, likes and dislikes.
The home was rated Good in Safe, Effective, Caring, Responsive and Well-led. The report says improvements identified at the previous inspection had been discussed with staff and addressed in the areas inspected.
Safe medicines support
Staff were trained and checked as competent before giving medicines. Records were completed correctly and medicines were stored securely.
“People received their medicines safely.” from the report
Kind and respectful care
People described staff as kind and friendly. Inspectors saw staff respond calmly to distress and protect people's dignity during personal care.
“Staff behaviour was calm, caring and respectful and people confirmed that they never felt uncomfortable or undignified.” from the report
Personalised support
Care plans included people's health and social needs. Staff knew individual preferences and adapted support to people's choices.
“The care and support plans that we saw reflected people's individual health and social needs.” from the report
Activities and involvement
People were involved in activities they enjoyed and had regular contact with visitors, relatives and the wider community. Their faith and cultural needs were also supported.
“People told us that they were involved in a range of activities that they enjoyed and found stimulating at the service.” from the report
Open management
People, relatives and staff felt able to share their views. The provider used feedback and quality checks to identify and make changes.
“The provider had systems in place to monitor the quality of support given and to make changes when needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and review my relative's individual risks if their needs change?
- 02Which staff would support my relative with medicines, and how do you keep their training and competency up to date?
- 03How would you tailor daily activities to my relative's interests, abilities and preferences?
- 04How will you involve our family in care planning and decisions if my relative cannot make a particular decision?
- 05How can we raise a concern or complaint, and how will you tell us what action was taken?
This was an unannounced inspection of the overall service, covering all five CQC questions and reviewing care, medicines, staffing, records and quality systems. This explanation was written from the published report of 6 September 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 Greenfields Care Home
3 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- March 2020Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 24 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.
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
57 live-in carers within about an hour of Shropshire
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 £960 to £1,230 a week. 52 can care for a couple. 9 years' experience on average.
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.