CQC report explained · a nursing home
What the CQC found at The Green Care Home with Nursing, Dronfield
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, medicines, infection control, equipment and incidents were managed safely, although staff were not consistently deployed.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- People generally received personalised care that met their views and preferences. Improvements to food, mealtimes, social activities and related information were still being put in place.
- Well-led?
- Good
- Governance, records and communication were generally effective. However, staff reported workload pressure linked to inconsistent deployment, with an impact on morale, absence and turnover.
What inspectors found, January 2022
The Green Care Home with Nursing, Dronfield was rated Good; inspectors found safe, responsive care but concerns about staff deployment and morale.
This was an unannounced focused inspection. Inspectors visited on 23 November 2021 and then spoke by phone or video with relatives and staff on later dates. They spoke with people living there, relatives, staff and managers, and reviewed care records, medicines records, staffing information and quality checks.
The home was rated Good overall. Safe and Responsive were rated Good. Well-led was also rated Good, although inspectors found that staff were not always consistently deployed. Staff described workload pressure, and records showed high absence and turnover.
People were protected from abuse and avoidable harm. Medicines, infection control, equipment and incident monitoring were found to be managed safely. Care was generally personalised, but improvements to menus, mealtimes, activities and care surveys were still in progress.
The Good overall rating includes ratings carried over from the previous comprehensive inspection for areas that were not examined this time. Responsive had improved from Requires Improvement to Good since the last inspection.
People felt safe
People and relatives said they felt safe and could raise concerns. Staff knew how to recognise and report suspected abuse.
“People told us they felt safe at the service and their relatives felt people were safe there.” from the report
Safe medicines management
Inspectors found that medicines were given safely and on time. Staff checked people's understanding, comfort and safety before recording medicines as given.
“People were supported to take their medicines safely and when they should.” from the report
Infection control
The home was meeting the requirements checked for COVID-19 prevention and control, including PPE, testing, visits and vaccination arrangements.
“We were assured the provider was using personal protective equipment (PPE) effectively and safely.” from the report
Personalised communication
Staff generally knew people's needs and preferences. Information could be provided in formats such as large print or pictures.
“Staff knew how to communicate with people in the way they understood.” from the report
Staff deployment and morale
needs fixingStaff were not consistently deployed to provide care. Inspectors found no direct impact on people's safety, but staff reported workload pressure and records showed high absence and turnover.
“Staff said this impacted on staff morale, with high staff absence and turnover levels, which related records also showed.” from the report
Activities and mealtimes still improving
minorThe home had improvement plans for food menus, mealtime organisation and more social and recreational activities. These changes were not yet fully in place.
“Improvement plans were identified for implementation against identified timescales, to fully ensure this.” from the report
Care quality surveys
minorWork was in progress to re-establish regular care quality surveys with people, relatives and staff so their views could further inform improvements.
“Work was in progress to re-establish and ensure periodic care quality surveys with all groups to help fully ensure this.” from the report
- 01How many care and nursing staff are planned for each shift, and how do you respond when staff are absent?
- 02What has changed since the inspection to reduce workload pressure, staff absence and turnover?
- 03What progress has been made with the new food menus and improving the mealtime experience?
- 04What social and recreational activities are now available, and how are residents' choices used to plan them?
- 05Have regular care quality surveys with residents, relatives and staff been re-established, and what changes have resulted?
This was a focused inspection of Safe and Well-led, widened to include Responsive; Effective and Caring were not inspected and their previous ratings carried over. This explanation was written from the published report of 27 January 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, March 2019
Rated Good overall, but inspectors found that people's care was not always timely or personalised.
Inspectors visited the home without notice on 7 February 2019. They spoke with 15 people, five relatives and staff, and checked care records, medicines, staffing, complaints and management records.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found people were protected from harm, received suitable care from trained staff, and were treated with kindness, dignity and respect.
Responsive was rated Requires Improvement. Some people had to wait for care, and staff said they could not always follow people's preferred routines, such as their chosen rising or bathing times. The home had improved from Requires Improvement at the previous inspection.
Safe care
Inspectors found that risks were assessed and managed, staff were safely recruited, and medicines were given and recorded safely.
“People's medicines were safely stored, handled and recorded.” from the report
Kind and respectful staff
People were treated with kindness, dignity and respect. Staff supported people's choices and independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Suitable support
People's care needs were recorded and reviewed. Staff had relevant training and worked with health professionals when needed.
“People were supported to maintain or improve their health and nutrition and to access any relevant external health professionals when needed.” from the report
Management oversight
The provider monitored care quality, accidents, incidents, complaints, medicines and staffing, and used this information to make improvements.
“The provider operated effective management systems and regulalry monitored the quality and safety of people's care.” from the report
Delays and routines
needs fixingSome people had to wait for care because staff were busy. Staff said they could not always follow people's preferred rising or bathing times.
“However, most said they could not always adhere to people's preferred daily living routines, such as rising or bathing times.” from the report
No registered manager
minorThere was no registered manager when inspectors visited. A new manager had been recruited, and interim senior management arrangements were in place.
“There was no registered manager for the service. However, a new manager had been recruited pending commencement of employment and interim senior management arrangements were in place.” from the report
End of life standards still developing
minorWork was still in progress to achieve a recognised care quality award for end of life care. The report says staff understood best practice principles and one care plan included advance decisions.
“Nurse led work was in progress at the service, towards achieving a locally recognised care quality award for end of life care.” from the report
- 01How do you make sure people do not have to wait too long when they need help?
- 02How do you now ensure people's preferred rising and bathing times are followed?
- 03Who is currently managing the home, and has the new manager started?
- 04What improvements have been made to end of life care since the inspection?
- 05How do you monitor whether staff spend enough time speaking with people and providing personalised care?
This was an unannounced scheduled inspection covering all five CQC questions and the overall rating, following a previous Requires Improvement rating. This explanation was written from the published report of 15 March 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 The Green Care Home with Nursing, Dronfield
4 rated inspections over 6 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Green Care Home with Nursing, Dronfield →
- March 2019Goodup from Requires improvementSafe: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at The Green Care Home with Nursing, Dronfield →
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
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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