Greenways Rest Home

Updated 21 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Greenways Rest Home Care home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Greenways Rest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 19 October 2022 and ended on 8 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people that use the service and 6 relatives. We spoke with 13 members of staff including the nominated individual, registered manager, care staff and domestic staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at a range of documents including 3 care plans and risk assessments, and 3 sets of recruitment records. We looked at audits, policies and procedures and rotas. We looked at how medicines were being stored and medicine records.

Updated 21 December 2022

About the service

Greenways Rest Home is a residential care home providing personal care to up to 30 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 18 people using the service.

The home is set over two floors and has an accessible lift. There are two communal lounges and a good size garden.

People’s experience of using this service and what we found

People were not protected as the security of the exits of the building was not sufficient to keep people safe. Further work was needed to become compliant with fire safety guidance. People were not always protected from the risk of unsafe medicines management. People were protected from the risk of accidents or incidents occurring again, and people were protected from the risk of abuse. The home was clean and tidy; rooms were decorated to a high standard and had a comfortable feel.

People were supported by staff that knew them well, a relative told us, “The quality of care is very good, and the staff have got to know him well.”

Some aspects of risk had not been mitigated well enough; however, improvements had been made in the governance of the service following the last inspection. Plans were in place to improve communication with people that used the service and their relatives, and the registered manager engaged well with staff. The registered manager was committed to further learning to make improvements, and we found a positive culture at the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 June 2022).

At our last inspection we recommended that the provider consider how to become compliant with fire safety guidance, how to make sure lessons were learned, and to make sure knowledge regarding regulatory requirements was up to date. At this inspection we found that improvements had been made regarding learning lessons and understanding of regulatory requirements, however actions regarding fire safety were still required.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part by a notification of an incident following which a person using the service was harmed. This incident is subject to further enquiry by CQC and a decision will be made about whether any regulatory action should be taken. This inspection did not examine the full circumstances of the incident but information about the incident indicated potential concerns and risks about the security of the building. Amongst other matters, this inspection examined those risks.

The inspection was a focused inspection looking at the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement.

We have found evidence that the provider needs to make improvements. Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenways Rest Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the security of the premises and the management of medicines at this inspection. Actions were put in place to address the concerns we found.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.