CQC report explained · a residential care home
What the CQC found at Greenhill Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2022
Rated Good; inspectors found safe, kind and person-centred care after major improvements from an earlier Inadequate rating.
This was an unannounced follow-up inspection. One inspector visited on 4 and 7 April 2022, spoke with people, relatives, staff and health professionals, observed care and lunch, and checked care records, medicines, recruitment, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safer risk assessments, safe medicines systems, improved infection control, personalised care plans, kind staff and better activities. People and relatives said they felt safe and were happy with the care.
The home had previously been rated Inadequate and was in Special Measures. Inspectors found that the provider had made enough improvements and was no longer breaching regulations. The overall rating changed from Inadequate to Good, and the home left Special Measures.
Risk management
Choking and other risks were assessed and regularly reviewed. Staff had clearer instructions about how to support people safely.
“Peoples' risks, including risks relating to choking, were assessed and regularly reviewed.” from the report
Staffing and care
Inspectors found enough staff to meet people’s needs. Staff were observed to be calm, unhurried and available to spend time with people.
“We observed staff to be calm and unhurried.” from the report
Personalised support
Care plans included people’s routines, preferences and communication needs. Activities were adapted for people who preferred to spend time in their own flats.
“Every person living at Greenhill had a care plan in place that reflected their individual needs and preferences.” from the report
Kind and respectful care
People were supported with personal care and emotional needs. Families described staff as kind and caring.
“People were well supported by staff who were caring, respectful and kind.” from the report
Management improvements
The provider introduced new senior managers, regular audits and more structured reporting. Feedback from staff, families and health professionals showed confidence in the changes.
“A comprehensive quality improvement programme had been put in place underpinned by a statement of quality assurance.” from the report
Training was not yet complete
minorTraining had improved, but some areas were not complete for all staff at the inspection. The report recorded that 77% had completed safeguarding training and 65% had completed moving and handling training.
“77% of staff had completed safeguarding training, 65% had completed moving and handling training” from the report
- 01How have you completed the remaining safeguarding and moving and handling training since the inspection?
- 02How do you keep choking risk assessments and care plans up to date when someone’s needs change?
- 03How do you check that there are enough staff on each shift and that call bells are answered promptly?
- 04How do you make sure the new quality monitoring systems continue to identify and fix problems?
- 05What choices are currently available for meals, snacks and drinks, including for people who need support to communicate their preferences?
This was an unannounced follow-up inspection covering the five key questions and infection prevention and control, carried out to check action after the previous inspection. This explanation was written from the published report of 30 April 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, October 2021
Rated Inadequate and placed in special measures; inspectors found serious problems with safety, staffing, dignity, care planning and management.
Inspectors visited without notice on 21 and 27 May 2021. They first checked whether the home had acted on its previous improvement plan. Serious concerns about infection control, protective equipment and choking risks led them to expand the inspection into a full comprehensive inspection.
They found people were exposed to avoidable harm. Staff did not consistently use protective equipment, there were not enough staff, training was poor, and some people at risk of choking were not supervised or given the correct food. Some people also lacked care plans, oral care and meaningful social contact.
The home was rated Inadequate in all five areas: Safe, Effective, Caring, Responsive and Well-led. The overall rating fell from Requires Improvement at the previous inspection in June 2018. The report says the home was in special measures and would be re-inspected to check for significant improvements.
Regular medicines
Inspectors found that regular medicines were generally managed well. The home also had a good relationship with the local GP.
“People's regular medicines were well managed, and the service had a good relationship with their local GP.” from the report
Some positive interactions
Some people appeared comfortable with staff, and inspectors observed kind interactions. Some families also gave positive feedback about the care.
“We observed some kind interactions, and people seemed comfortable when interacting with staff.” from the report
Some personalised care information
Older paper care plans included useful personal details. Some people were also supported with activities that mattered to them.
“Care plans that had been completed prior to the introduction of the electronic system contained detailed and person-centred information.” from the report
Infection control
seriousOn the first inspection day, staff were often not wearing protective equipment correctly. There was also no hand sanitiser throughout the building, poor cleaning records and no Covid-19-specific staff training.
“People were not protected from the risk of infection.” from the report
Choking risks
seriousFood and drink guidance was recorded inconsistently. At least one person at risk of choking ate higher-risk food alone and without the recommended supervision.
“People were at risk of choking and these risks had not been mitigated.” from the report
Staffing and training
seriousThere were not enough staff to meet people's needs, and sickness made this worse. Many staff had not completed essential training, including safeguarding, moving and handling, medication and first aid.
“There were not sufficient numbers of suitably qualified, competent, skilled and experienced staff to meet people's needs which exposed people to the risk of harm.” from the report
Dignity and personal care
seriousPeople were not consistently supported with brushing their teeth, washing, clean clothes or appearance. Inspectors also found information about continence needs displayed where others could see it.
“People were not treated with dignity and respect.” from the report
Care plans and activities
needs fixingSix people had no care plan, and two electronic plans contained very little information. Some people had long periods without recorded social contact or meaningful activity.
“This meant staff had little or no guidance as to how to meet their needs or what their personal preferences were.” from the report
Weak management oversight
seriousThe provider did not make regular visits or effective checks. Managers knew about some problems but did not ensure they were fixed, including missing care plans and poor oral care.
“Systems and processes were not operated effectively to ensure the service was Well-Led.” from the report
- 01What has changed since this inspection to ensure staff use protective equipment, hand hygiene and cleaning procedures correctly?
- 02How do you now make sure people at risk of choking receive the correct food, drink and supervision?
- 03How many staff are on each shift now, and how do you cover sickness or other staff shortages?
- 04Does every person now have a complete, current care plan, and how do you ensure staff read and follow it?
- 05What action has been taken to improve oral care, dignity, meaningful activities and compliance with consent rules?
This began as a focused inspection to check the previous action plan, but concerns about infection control and choking risks led CQC to expand it to a full comprehensive inspection covering all five key questions. This explanation was written from the published report of 13 October 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 Greenhill Residential Care Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- April 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Greenhill Residential Care Home →
- October 2021Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
Read what inspectors found at Greenhill Residential Care Home →
- June 2019Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2018
Registered with the Care Quality Commission on 3 May 2018.
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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