Greenacres is a residential service which provides care and accommodation for up to 62 older people some who have physical needs and some people who are living with dementia. People have varied communication needs and abilities. The service is set over two floors, and is divided into different living units; each unit has their own lounge and dining area. On the day of our inspection there were 59 people living in the home. This inspection took place on 20 December 2016 and was unannounced.
At the previous inspection in March 2015 we found one breach in the regulations. During this inspection we identified that improvements had been made in this area.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People did not always receive care and treatment that was appropriate to their individual needs and were at the risk of receiving unsafe care or treatment.
The registered manager had completed some audits of the service such as people’s weight and activities but not for other aspects of the service such as care plan audits and as a result actions were not always implemented to improve the quality of service people received. The registered manager acknowledged further work was required in this area. We have made a recommendation about this in our report.
Greenacres was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm.
The registered manager and staff did not always understand their responsibilities in relation to capacity and decision making. This was not always in line with the Mental Capacity Act (2005) Code of Practice.
Care was not always provided to people according to their agreed care plan. People had their needs assessed before being admitted to the home and care plans were drawn up from the information obtained from these assessments, input from people and their relatives.
People were well cared for and the atmosphere in the home was relaxed. People told they were treated well by staff who were kind and caring. People’s privacy and dignity was maintained and we saw staff knocked on people’s doors before they entered.
Staff had undertaken training regarding safeguarding adults and were aware of what procedures to follow if they suspected abuse was taking place. There was a copy of Surrey’s multi-agency safeguarding procedures available in the home for information. We saw staff were trained to carry out their roles and keep the people they supported safe from abuse.
People’s health care needs were being met. People were registered with a local GP and also had visits from other health care professionals. Regular health checks were undertaken and appropriate referrals made when required.
People were provided with a choice of freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. Specialist diets to meet medical, religious or cultural needs were provided where necessary.
People received their medicines when they needed them and medicines were managed safely. There were systems in place to ensure that medicines had been stored, administered, and reviewed appropriately.
There were enough staff working in the home on the day of our inspection to meet people’s needs. Staff recruitment procedures were safe and the employment files contained all the relevant checks to help ensure only the appropriate people were employed to work in the home.
People were engaged in some activities on individual units for parts of the day. People told us they were not always happy with the activities and would like to be supported to be more independent. The registered manager provided us with details of all the activities that were offered to people.
People had been provided with a complaints procedure and were confident that any complaints would be handled appropriately.
People were protected from unforeseen events and the provider had contingency plans in place. Each person had an individualised plan to support them in the event of an emergency such as fire or flood occurring.
During the inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.