Archived: Greensleeves Care Home

Updated 29 January 2019

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 29 November 2018 and was unannounced. The inspection team consisted of three 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.’ Their area of expertise related to older people who were living with dementia.

This service was selected to be part of our national review, looking at the quality of oral health care support for people living in care homes. The inspection team included a dental inspector who looked in detail at how well the service supported people with their oral health. This includes support with oral hygiene and access to dentists. We will publish our national report of our findings and recommendations in 2019.

Before the inspection we reviewed information, we held about the service including previous inspection reports, any notifications, (a notification is information about important events which the service is required to send to us by law) and any complaints that we had received. The provider had submitted a Provider Information Return (PIR) before the inspection. A PIR asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. This enabled us to ensure that we were addressing any potential areas of concern at the inspection.

We 'pathway tracked' three of the people living at the home. This is when we looked at people's care documentation in depth and made observations of the support they were given. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care. We also looked at care records for two other people. We spoke with seven people who lived at the home and seven relatives or friends. We spoke with four members of care staff, the business manager and the registered manager. We also spoke with other staff on duty during the inspection. We looked at a range of documents including policies and procedures, care records for eight people and other documents such as safeguarding, incident and accident records, medicine records and quality assurance information. We reviewed staff information including recruitment, supervision and training information as well as team meeting minutes and we looked at the provider’s management systems.

Following the inspection, we received feedback from a health care professional who had provided support and advice to the registered manager about falls prevention and risk management.

The last inspection on 12 September 2017 we identified two breaches of the regulations.

Updated 29 January 2019

The inspection took place on 29 November 2018 and was unannounced. Greensleeves is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The house is situated in a residential area of Crawley and accommodation is provided over two floors. Currently accommodation was only available to women, the provider told us they would consider whether they could meet the needs of any men who wanted to live there. There were 34 people living at the home on the day of the inspection. Many of the people living at the home were living with dementia.

The provider of the home was also the registered manager. 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.

Following the last inspection on 12 September 2017 we identified two breaches of the regulations. We asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions is the service safe? and is the service well-led? to at least Good. At this inspection on 29 November 2018, we found that staff had followed the action plan and the overall rating for the service had improved to Good.

People were receiving their prescribed medicines safely. The storage, administration and disposal of medicines was managed effectively. Risks to people had been identified, assessed and managed. Care plans were comprehensive and provided clear guidance which was being followed by staff to keep people safe. Staff understood their responsibilities for safeguarding people from abuse.

There were enough staff with suitable skills and experience to care for people safely. The home was clean and staff protected people by the prevention and control of infection. Monitoring of incidents and accidents ensured that lessons were learned and improvements were made when things went wrong. One person told us they felt safe at the home because “There’s always someone (staff) around.”

Staff received the training and support they needed to care for people. They understood their responsibilities to gain people’s consent for care and treatment. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were receiving the support they needed to have enough to eat and drink. People told us they enjoyed the food at Greensleeves Care Home. Staff ensured that people had access to the health care services they needed and staff described positive working relationships with the local GP.

People were supported by staff who knew them well. Staff were kind and caring and respected people’s dignity and privacy. A person told us, “All the staff are very kind. I like them all.”

People were supported to be involved in decisions about their care and support. Staff were effective in supporting people with their communication needs. A relative told us, “I have been involved in the care plan and they do listen to what I say.”

People were receiving a personalised service. Staff understood the needs, preferences and wishes of people they were caring for. Staff were responsive when people’s needs changed and reviewed risk assessments and care plans regularly. People had enough to do and told us they enjoyed the activities on offer. People and their relatives said the registered manager was responsive to complaints and feedback.

Management systems and processes were robust and improvements had been made to meet the breaches of regulation that were identified at the last inspection on 12 September 2017. The registered manager provided clear leadership and staff spoke highly of the management of the home. Staff understood their roles and responsibilities and described positive working relationships and good communication both internally and with external agencies. We received feedback from a health care professional about improvements at the care home. They described positive engagement with the registered manager and staff at the home.