23 July 2014 and 24 July 2014
During a routine inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the home under the Care Act 2014.
The visit was unannounced, which meant the provider and staff did not know we were coming.
Greenleigh is registered to provide accommodation and support for 35 people.
There was a registered manager in post at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home and has the legal responsibility for meeting the requirements of the law; as does the provider.
Most people we spoke with were complimentary about the home and its staff, describing them as kind and caring. However, people, their relatives and some staff told us there were not enough staff to respond to people’s needs in a timely manner and our observations confirmed this.
Not all staff were aware of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which help to support the rights of people who lack the capacity to make their own decisions or whose activities have been restricted in some way in order to keep them safe. Some people’s care records lacked the correct documentation and demonstration of the legislation being properly used in order to support their rights.
Staff demonstrated awareness of what could constitute abuse and that matters of abuse should be reported in order to keep people safe. Staff were aware of how to report issues to the provider and to outside agencies.
We found that, while most of the home was well maintained, the external grounds and some parts of the home presented potential hazards to people which had not been addressed. These included areas of raised paving, an unsafe chair and tools left in a corridor area.
We observed some poor practice in respect of staff assisting people to move around the home. We found that some people’s care records showed that they did not receive adequate levels of hydration in order to promote their health. There were gaps in some people’s repositioning charts to shows that they had received pressure relief to maintain healthy skin. Staff did not always support people in the way described in their care plans. We saw that care was not always delivered in a way which supported people’s dignity.
People who lived at the home said that they were encouraged to be part of care planning and assessments of care. The home gathered people’s views in a number of ways, for example, through the use of surveys and meetings.
Staff said they received training in important areas of care, which supported them in their roles. However, we found that there were some gaps in staff receiving updated training.
People’s health and well-being was supported by staff arranging appointments with external healthcare professionals when required, such as GPs.
Regular audits were carried out by the manager and by one of the provider’s senior managers. However, we found a number of issues during our inspection which had not been identified by the provider’s own auditing and quality processes.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.