Background to this inspection
Updated
23 March 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The service did not have a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The provider told us that they planned to close the service in the near future which was why they had not recruited a registered manager.
Inspection team: One inspector carried out this inspection.
Service and service type:
Greenwood Lodge is a small residential care home. The service did not have a registered manager registered with the Care Quality Commission.
Notice of inspection:
This inspection was unannounced. Inspection site visit activity started on 19 February 2019 and ended on 28 February 2019. We visited the service on 19 February 2019 to meet the service manager, people and staff and to review care records and policies and procedures.
What we did:
Before the inspection we considered all the information we held in relation to the service, including statutory notifications. This information helps support our inspections. We also requested feedback from professional at the local authority commissioners.
During the inspection we:
• Spoke to one person using the service.
• Spoke with one care staff, one senior care staff, the service manager, and received feedback from two staff via email. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
• We reviewed information from two care files which included all aspects of care and risk assessments. which included their medicine records.
• No new staff had been employed since the last inspection when we reviewed two staff files. We looked staff support arrangements including supervisions, and training records.
• Health and safety and servicing records.
• Records of accidents, incidents and complaints.
• Audits and surveys.
We saw that there were systems in place to monitor the safety of the service. Is the service safe?
Updated
23 March 2019
About the service: Greenwood Lodge is a residential 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 service was a small home. It was registered to support up to five people. Three people with learning and physical disabilities were using the service at the time of the inspection.
The service had an overall rating of 'requires improvement' when we inspected it in May 2018, with two breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider needed to improve those four key questions to at least good. At this inspection, we found they had made the required improvements and the overall rating has improved to 'good'.
People’s experience of using this service:
People who lived at Greenwood Lodge received good person-centred care. The service ensured each person was treated as an individual with personal preferences being at the forefront of care. Person centred practices helped to achieve the best outcomes for people and reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.
Staff treated people kindly and communicated effectively in a way which people could understand. Staff were observed to be respectful, and staff promoted people’s dignity and privacy.
There were robust recruitment checks in place which included DBS (disclosure and barring checks) and past employment history to ensure the staff were safe and suitable to work in this type of service. Staffing levels were good and appropriate to meet the needs of the people in a timely way.
Care plans and risk assessments were in place and the service had changed to online care records, which were updated regularly. People were supported to choose how they wished to be supported and retain control of their lives, and staff supported them in the least restrictive way possible.
There were effective systems in place for managing medicines. Medicines audits and medicine administration records were correctly completed. The service manager completed a range of audits such as auditing records, and quality monitoring audits.
Staff were supported with regular training and supervision to enable them to support people effectively.
People were involved in the development and preparation of food and drinks and had access to a range of snacks, which met their individual needs and preferences.
People had good access to healthcare as needed and staff had a good understanding of people’s health needs.
Rating at last inspection: At the last inspection Greenwood lodge was rated requires improvement in two key areas. Effective and Well Led both had breaches of regulation.
Why we inspected: This was a planned, comprehensive inspection based on the requires improvement rating at the previous inspection. This inspection was unannounced.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.