CQC report explained · a residential care home
What the CQC found at Greville House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe, staffing levels were considered sufficient and staff recruitment checks had been completed. Some medicines records needed improvement, including records about creams.
- Effective?
- Good
- Staff were trained and supported, people's dietary and healthcare needs were met, and staff followed the principles of the Mental Capacity Act.
- Caring?
- Good
- People and relatives described staff as kind and caring. People were involved in choices about their care, activities and daily routines, and were treated with dignity.
- Responsive?
- Good
- Care was personalised and staff understood people's needs and preferences. Some care records did not contain enough detail about how support should be provided or why changes had been made.
- Well-led?
- Requires improvement
- People, relatives and staff felt supported and said the manager was approachable. However, quality monitoring was not always robust and had failed to identify several record-keeping and safety-check issues.
What inspectors found, August 2019
Greville House was rated Good overall, with kind and safe care, but leadership and record-keeping still required improvement.
Inspectors made an unannounced visit on 17 July 2019. They spoke with people living at the home, relatives, staff and managers. They observed care and checked care records, staff recruitment files, medicines information, complaints, accidents and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. People said they felt safe and were treated kindly. Staff knew people's needs, supported their choices, provided suitable food and helped people access healthcare.
Well-led was rated Requires Improvement. Inspectors found that quality checks had not always identified gaps in care records, medicines records and other safety checks. The managers took action during or just after the inspection.
The overall rating was Good. This was an improvement from Requires Improvement at the previous inspection in August 2018. Caring improved from Requires Improvement to Good, but Well-led remained Requires Improvement.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff supporting people patiently and warmly, while respecting privacy, dignity and independence.
“The staff are just wonderful. They are caring compassionate and kind.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and saw that recruitment checks had been completed before staff started work.
“Checks were carried out on staff before they started work in the home to make sure they were suitable to work with people.” from the report
Staff understood people's needs
Staff received training, induction and supervision. They worked with health professionals and responded promptly when people became unwell.
“A visiting healthcare professional told us staff knew the persons needs very well and their care records were kept up to date.” from the report
Choice and personalisation
People could choose how to spend their time, what activities to join and whether to have a bath or shower. A housekeeper role also gave care staff more time with people.
“People told us they could choose to have a bath or shower.” from the report
Activities and relationships
There was a programme of activities based on people's interests, alongside access to the garden, visitors and community links.
“There was a programme of activities available organised by an activity coordinator who had taken time to get to know people and facilitate activities that met their interest.” from the report
Care records lacked detail
needs fixingSome care records did not explain clearly enough how staff should provide support or why care plan changes had been made. Inspectors said there were no concerns about the care people received at night, but the records needed improvement.
“some records required more detail about how care should be provided and reviews did not always detail why changes had been made to people's care plan.” from the report
Quality checks were not robust
needs fixingAudits had not identified all the gaps found by inspectors. High water temperatures in two bathrooms had not been escalated, although repairs were actioned during the inspection.
“These had not always been robust and had not identified some of the areas we identified during our inspection.” from the report
Fire drills needed testing
needs fixingFire drills had been discussed as scenarios rather than testing how staff would respond. A drill was carried out the day after the inspection and its outcome was shared with inspectors.
“Fire drills where talked through as a scenario however, they were not testing staff reaction to the drill.” from the report
- 01What changes have been made to ensure care plans explain exactly how support should be provided and why any changes were made?
- 02How are cream application records, self-administration assessments and 'when needed' medicines care plans checked now?
- 03What was found in the fire drill carried out after the inspection, and how were any learning points addressed?
- 04How are high water temperatures and other building safety concerns now escalated and followed up?
- 05Have the planned electronic care records system and improved quality monitoring audits been introduced?
This was an unannounced inspection covering all five key questions; the previous overall rating was Requires Improvement, published in August 2018. This explanation was written from the published report of 9 August 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.
What inspectors found, August 2018
Rated Requires Improvement; inspectors found safe, effective care but limited choices, limited time for conversation and weak record-keeping.
This was an unannounced inspection on 18 July 2018. Inspectors spoke with people living at the home, relatives, staff and visiting professionals. They looked at care plans, medicines records, recruitment files and quality checks.
The home was rated Good for Safe, Effective and Responsive care. People felt safe, medicines were given as prescribed, staff had the necessary skills, and people had activities, care reviews and access to health professionals.
The home was rated Requires Improvement for Caring and Well-led. Inspectors found that people could not always choose when to bathe or shower, breakfast choices were limited, and staff did not always have time to talk. Some care records and risk assessments were incomplete, and quality checks had not found all the problems.
The overall rating changed from Good in all five areas at the previous inspection in November 2015 to Requires Improvement. The report says some records and risk assessments were completed after the inspection, but it does not confirm that all improvements had been fully achieved.
Kind staff
Staff were described as kind and caring. They knew people's likes, dislikes and needs, and inspectors saw that privacy and dignity were maintained.
“People were supported by kind and caring staff who knew them well.” from the report
Activities and involvement
People had a range of activities and were supported to take part, including people who stayed in their rooms. People and relatives were involved in care reviews.
“People and relatives spoke positively about the activities that were available for them.” from the report
Access to health care
People could see health professionals when needed. Inspectors saw visiting professionals and found staff shared relevant information about people's needs.
“People were supported to manage their health needs and had access to health professionals when required.” from the report
Limited personal choices
needs fixingPeople could not always choose when to have a bath or shower. Breakfast was limited to toast or cereal, with a possible change discussed after the inspection.
“People's choices were restricted; they could not have a bath or shower when they wished and had limited options for breakfast.” from the report
Incomplete records
needs fixingSome care plans and risk assessments did not record the support people needed. The home completed some missing documents after the inspection.
“Improvement was required in relation to recording for areas such as care plans and risk assessments.” from the report
Quality checks missed problems
needs fixingThe home's monitoring systems did not identify all the shortfalls found by inspectors. This included missing records, staff training needs and concerns about managing a recruitment risk.
“These had not always identified the shortfalls that we found during our inspection.” from the report
Limited time to talk
minorSome people and relatives said staff were too busy with other tasks to sit and talk. Inspectors observed that staff were not always visible in communal areas, although people were supported by an activities coordinator.
“People and relatives told us that staff did not have time to sit and talk with them due to doing other tasks.” from the report
- 01How often can residents now choose when to have a bath or shower, and how is this recorded?
- 02What breakfast choices are available now, including cooked options?
- 03Have all residents' care plans and risk assessments been reviewed and updated?
- 04How do you check that staff have enough time to talk with residents as well as complete other tasks?
- 05What changes have been made to the quality checks since inspectors found they had missed shortfalls?
This was an unannounced inspection covering all five key questions, including the care provided and the home itself; the previous ratings from November 2015 were reassessed. This explanation was written from the published report of 15 August 2018 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 Greville House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Registered with the Care Quality Commission on 16 January 2012.
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
At least 100 live-in carers within about an hour of Birmingham
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 £950 to £1,230 a week. 79 can care for a couple. 9 years' experience on average.
“God doesn't make people like her anymore!”
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
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.