CQC report explained · a residential care home
What the CQC found at Greenways
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were managed safely, risk assessments and environmental checks were up to date, and there were enough skilled staff. They also found safeguarding, infection control and incident reporting systems were working well.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- People had personalised support plans, communication plans and opportunities for activities, outings and maintaining independence. Complaints could be raised easily and were investigated.
- Well-led?
- Good
- Inspectors found clear management responsibilities, regular quality checks, staff and resident involvement, and a service improvement plan.
What inspectors found, June 2023
Rated Good; inspectors found safe, person-centred care and clear improvements since the previous inspection.
This was an unannounced focused inspection on 7 June 2023. One inspector spoke with people, family members, staff and managers, and checked care records, medicines records, staff files and quality checks.
The home was rated Good for Safe, Responsive and Well-led. Inspectors found enough skilled staff, safer medicines systems, updated risk assessments, suitable infection controls and activities based on people's interests and choices.
The previous rating was Requires Improvement, with breaches involving medicines and person-centred care. The home had completed an action plan, improvements had been made, and inspectors found it was no longer in breach of those regulations.
Safe medicines support
Medicines profiles were up to date and monthly audits were used to look for errors and check that staff followed safe processes.
“Medicines were managed safety and people received support from staff who followed effective processes to assess and provide the support they needed to take their medicines safely.” from the report
Choice and independence
Staff supported people to do what they could for themselves and helped them take part in activities and outings they chose.
“People's choices were at the forefront of decision making. Staff supported people to maintain their independence, where possible.” from the report
Activities and communication
People had communication plans and took part in activities such as gardening, karaoke and arts and crafts, as well as outings.
“During the inspection we saw people being involved in gardening, karaoke and arts and crafts.” from the report
Improved management
The home had quality checks covering areas such as the environment, support plans, medicines and health and safety. Managers also involved people and staff in improving the service.
“A quality assurance system was in place to monitor all aspects of the service like the environment, support plans, medicines and health and safety.” from the report
Inspectors raised no specific concerns in this report.
- 01How often are medicines audits completed, and what happens if an error is found?
- 02How will you make support plans even more accessible and person-centred?
- 03What new activities and local opportunities are being added through the service improvement plan?
- 04How are staffing levels checked when several people are out at activities or appointments?
- 05What improvements are planned for the environment?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 28 June 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, November 2021
Greenways is rated Requires Improvement; inspectors found unsafe medicines arrangements, limited activities and weak oversight.
This was an unannounced focused inspection on 26 August 2021. Inspectors looked at Safe, Responsive and Well-led, after concerns about medicines and people's safety. They spoke with people, staff and healthcare professionals, and checked care, medicines and management records.
The home was not always safe. Medicines records and storage checks were not reliable, including errors with controlled drugs and gaps on medicine administration charts. Inspectors were also not assured that staffing levels were always enough to meet people's needs.
People were treated with dignity and staff were described as kind and approachable. However, activities were not always meaningful or based on people's choices. Care reviews did not always record people's views, and management checks had failed to identify important problems.
The overall rating was Requires Improvement. The report says the service had deteriorated since the previous inspection, when there were no breaches. Two named breaches are set out in the report, relating to person-centred care and safe care and treatment.
Respectful care
People told inspectors that staff treated them with respect and dignity. Inspectors also saw positive interactions.
“People told us that care staff treated them with respect and dignity.” from the report
Risk planning
Risk assessments covered issues such as falls, choking, medicines errors, self-harm and behaviour that could put people at risk.
“Risks to people's safety, health and well-being were assessed and reviewed regularly.” from the report
Fire arrangements
Personal emergency evacuation plans, weekly fire alarm checks and fire drills were in place.
“Fire drills had been carried out in 2021.” from the report
Infection control
Inspectors were assured that infection prevention measures, testing and personal protective equipment were in place.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff recruitment
Most required recruitment checks had been completed before care workers were employed.
“The provider followed safe recruitment practices and had ensured appropriate pre-employment checks were completed satisfactorily before care workers were employed.” from the report
Medicines safety
seriousMedicines guidance and records were incomplete or inaccurate. There were also problems with controlled drug counts and fridge temperature monitoring, creating a risk that medicines might not be given or stored safely.
“Medicines were not managed safely.” from the report
Staffing levels
needs fixingInspectors were not assured that there were always enough staff or suitable deployment to meet people's needs. Some people said there were times when staff were insufficient.
“We were not assured that the deployment of staff and the staffing levels were adequate to ensure that people's care needs were attended to.” from the report
Limited activities
needs fixingPeople's requests for outings, religious involvement and other interests were not consistently acted on. There was no planned activities programme seen during the inspection.
“The service did not always provide people with therapeutic and stimulating activities.” from the report
Weak management checks
needs fixingAudits did not identify several problems, including medicines deficiencies, environmental issues, limited activities and recording errors.
“The service had not been well run as there was a lack of oversight and effective monitoring.” from the report
Premises checks
needs fixingInspectors found several environmental problems, including an improperly engaged window restrictor, a dusty air vent, a missing fly screen and a tied-up emergency pull cord.
“We noted that there was a lack of vigilance in the area of health and safety.” from the report
- 01What changes have you made to medicine administration records, controlled drug counts and fridge temperature checks since this inspection?
- 02How do you now make sure there are enough staff on each shift, including weekends and bank holidays?
- 03What activities and outings are currently available, and how are they linked to each person's choices and interests?
- 04Has a registered manager been appointed, and how often is senior management present at the home?
- 05What checks now identify and correct problems with care records, medicines and the building?
This was a focused inspection of Safe, Responsive and Well-led; the ratings for Effective and Caring were not looked at on this occasion and previous ratings were used to calculate the overall rating. This explanation was written from the published report of 16 November 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 Greenways
7 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2021Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: GoodWell-led: Requires improvement
- October 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- March 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- April 2012
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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