CQC report explained · a residential care home
What the CQC found at Greenway House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staffing levels were sufficient and medicines were generally managed safely. Inspectors found that guidance for some medicines given only when needed was not always in place, although the provider confirmed this was corrected after the inspection.
- Effective?
- Good
- People's needs were assessed and staff had suitable training. Improvements had been made to mental capacity assessments and best-interest decisions since the previous inspection.
- Caring?
- Good
- People were treated with kindness, privacy and dignity. Staff knew people well, offered choices and encouraged independence.
- Responsive?
- Good
- Care plans reflected people's needs and were regularly updated. People had access to activities, communication support and healthcare, and knew how to complain.
- Well-led?
- Good
- The home had visible management and systems to check care quality. The provider used audits, feedback and complaints to identify and make improvements.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous Requires Improvement rating.
This was an unannounced, planned inspection on 22 January 2020. One inspector spoke with four people living at the home, two relatives and staff. They reviewed three care records and records about how the home was managed.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe, were treated kindly, received enough support and enjoyed the food and activities.
Inspectors found improvements since the last inspection. These included better records for mental capacity decisions, more staff training and stronger checks on the quality of care. They found one medicines recording gap during the visit, but the provider confirmed afterwards that the missing guidance had been put in place.
People felt safe
People said staff were available when needed and inspectors saw that people did not have to wait for support. Risks were assessed and reviewed.
“There is always someone about if I need them, I just give them a shout and they help me straight away.” from the report
Kind and respectful care
Staff knew people's preferences and supported their privacy, dignity, choices and independence.
“We saw staff had time to sit with people and chat.” from the report
Good food and activities
People could choose meals, drinks and snacks. They could take part in activities at the home and go out into the community.
“People had the opportunity to participate in activities they enjoyed.” from the report
Improvements were made
The provider had acted on issues from the previous inspection, including staff training, mental capacity records and quality checks.
“At this inspection this key question has now improved to Good.” from the report
Feedback was used
People and relatives were surveyed, and the provider made changes in response to suggestions, including better car park lighting.
“Where area for changed had been suggested the provider had listened and taken action.” from the report
Missing as-required medicines guidance
needs fixingAt the inspection, staff did not always have written guidance for medicines given only when needed. The provider confirmed after the inspection that all the guidance was in place.
“When people received as required medicines there was not always guidance in place for staff to follow.” from the report
- 01How do you make sure written guidance for medicines given only when needed stays complete and up to date?
- 02How would you assess and record my relative's capacity to make particular decisions?
- 03How would you update my relative's care plan as their needs, preferences or health change?
- 04What activities and opportunities to go out would suit my relative's interests?
- 05How would you use my relative's or family's feedback if we suggested a change?
This was an unannounced inspection of the whole care home and all five CQC questions; the previous overall rating was Requires Improvement, published 30 January 2019. This explanation was written from the published report of 1 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, January 2019
Rated Requires Improvement; inspectors found safe, kind and responsive care, but problems with decision-making records and checks on quality.
This was an unannounced inspection on 15 January 2019. One inspector observed care, spoke with people, relatives, visitors and staff, and reviewed care, recruitment and management records.
People were considered safe. There were enough staff, medicines were generally managed safely, risks were assessed and safeguarding procedures were followed. People described staff as kind and said they were happy with their care.
The home needed to improve how it followed the Mental Capacity Act. Capacity assessments and best-interest decisions were not always recorded, and not all restrictions had been properly considered. Management checks did not always identify problems or lead to changes.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard in every area. Safe, caring and responsive were rated Good. Effective and well-led were rated Requires Improvement.
Safe staffing and support
People did not have to wait for support and staff responded to call buzzers without delay. Staff were recruited with appropriate checks.
“There were enough staff available for people and they did not have to wait for support.” from the report
Kind and respectful care
Staff treated people with kindness, protected their privacy and supported them to remain independent and make choices.
“People were treated with respect and approached in a kind caring way.” from the report
Personalised care
Staff knew people's likes, dislikes and routines. The home considered cultural and spiritual needs and offered activities people enjoyed.
“The records we looked at showed us people's likes and dislikes were taken into account to ensure people received personalised care and support.” from the report
Learning from safeguarding incidents
The provider investigated incidents, reported matters when needed and introduced checks after a problem with a sensor mat.
“This meant the provider had systems in place so that improvements could be made and lessons learnt.” from the report
Capacity and best-interest records
seriousSome people did not have complete capacity assessments. Decisions said to be in people's best interests were not supported by recorded assessments or explanations of how the decisions were made.
“We found when people lacked capacity to make decision for themselves capacity assessments were not always in place.” from the report
Restrictions on liberty
seriousNot all restrictions were covered by the relevant checks or applications. The home had not always recorded how care would be provided in the least restrictive way.
“The provider had not considered further restrictions that had been placed on this person since this had been introduced.” from the report
Medicines records
seriousSome medicines had been given but the records had not been signed. There was also no guidance for medicines given when needed, and some handwritten records were unsigned.
“When we reviewed Medicines Administration Records (MAR) we saw there were gaps in recordings.” from the report
Weak quality checks
needs fixingAudits did not always identify concerns or show what action had been taken. Feedback from people and relatives was collected, but the home could not show how it had led to changes.
“There was no evidence to identify what action had been taken following this or how this information had been used to make changes for people.” from the report
- 01How are capacity assessments and best-interest decisions now recorded for each person?
- 02How do you check that all restrictions on a person's liberty have been considered and legally authorised where needed?
- 03How do you make sure every medicine given is recorded and signed for, including medicines given only when needed?
- 04How often are medicines, care plans and accident records audited, and what happens when a problem is found?
- 05What changes have you made in response to feedback from people and relatives?
This was an unannounced inspection covering all five quality questions, with observations, discussions and checks of care, recruitment and management records. This explanation was written from the published report of 30 January 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 Greenway House Residential Home
4 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Greenway House Residential Home →
- January 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Greenway House Residential Home →
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2013
Registered with the Care Quality Commission on 4 April 2013.
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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