Archived: Greyfriars Care Home

There was a registered manager 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 lived in a homely environment and were treated with kindness and compassion. We observed supportive positive interactions between people, the registered manager and the provider. There was an open, trusting relationship; it was clear they knew each other well and the registered manager understood people’s needs. People were involved as far as possible in planning the care and support they received.

People felt safe at Greyfriars. The registered manager and staff had received appropriate training in a range of subjects, including how to protect people from the risk of abuse and meet their individual needs. Staff were available when people required them.

The home was meeting the requirements of legislation designed to protect people’s rights. People’s needs were met effectively and they were supported to make their own decisions.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided information to promote independence.

There were suitable systems in place to ensure the safe storage and administration of medicines. Healthcare professionals such as GPs, chiropodists, opticians and dentists were involved in people’s care where necessary.

People enjoyed their meals and received a choice of suitably nutritious meals based on their needs and preferences. People were supported to engage in a range of ad hoc and individual activities of their choosing.

People were happy with the way the service was run. The provider sought informal feedback from people and had a process in place to deal with any complaints or concerns.

During the inspection we spoke with the provider and staff, spoke with five of the nine people living at the home, spoke with one visitor and viewed records relating to medicines management and the monitoring of the quality of the service.

We considered all the evidence we had gathered under the outcomes we inspected and used the information to answer questions we always ask:

Is the service safe?

Is the service well-led?

This is a summary of what we found:

Is the service safe?

The provider had taken the necessary action as detailed on the action plan they supplied. This meant medicines were now being managed safely. People were receiving their medicines as prescribed and the correct administrations procedures were being followed by staff. People said they received their medicines and could get as required medicines such as pain relief when required.

Is the service well-led?

We observed staff and people were able to approach the provider and give their opinions. Staff told us the provider was available at all times when not in the home and provided support whenever this was required.

The provider was also the homes registered manager and worked at the home on a day to day basis including some direct care shifts. They were therefore able to monitor the quality of service provided and spoke regularly with people at the home to gain their views about the service. The provider had introduced some formal monitoring of the quality of the service including surveys and monthly meetings with people. We saw records of meetings held with people to gain their views and the results of surveys which had been completed.

Is the service safe?

People told us they felt safe. We saw people were treated with respect and dignity by the staff. Staff had completed safeguarding and other essential training to ensure they had the necessary skills to meet people's needs in a safe way. People told us staff were available at all times and staff said they had enough time to meet people's needs. Risks to people's health and safety had been assessed and management plans were in place to reduce these risks. This all helped ensure people's needs would be safely met.

The provider was aware of the procedures to ensure people's rights were respected and legislation such as the Mental Capacity Act and Deprivation of Liberty Safeguards would be followed. The provider had contacted an external specialist where they had concerns about a person's ability to give consent for essential medical treatment. The provider and staff showed they were aware of people's rights and these would be protected.

We identified a concern with the way medication was managed. We have asked the provider to tell us what they are going to do to ensure the safe management of medicines in the future.

Is the service effective?

Staff were knowledgeable about people's care needs and how to meet them. Staff had received training to ensure they had the skills to care for people living in the home. Where necessary, the service sought advice from appropriate professionals to assist with the care provided for people.

People told us they were happy with the way they were cared for. One person told us how the provider had supported their wish to lose weight and provided the right meals for them. Another person told us they were 'very happy' and had 'no concerns' about the way they were cared for. A visitor also reported they felt the home met their relative's needs well.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers were patient and listened to people's requests and views. Staff said they had plenty of time to meet everyone's needs. People told us the staff were very kind and helpful. Care plans contained individual information which staff were aware off. Records of care provided showed people had received care as detailed in their care plans.

Is the service responsive?

The provider was frequently at the home including working directly with people. This meant they had time to listen to people and provide a service suitable for them. Where people had particular wishes or needs these were respected such as a person who wanted a particular diet. The provider was aware who to contact for specific advice or concerns and acted on their information and guidance.

When necessary, staff supported people to attend planned and emergency medical appointments. For example, the evening prior to our inspection a staff member had remained at the hospital accident department until 2am, so they were with the person until they went home by ambulance. This showed the service could be flexible and responsive to people's changing and urgent needs.

Is the service well-led?

We observed staff and people were able to approach the provider and give their opinions. Staff told us the provider was available at all times when not in the home and provided support whenever this was required.

The provider was also the home's registered manager and worked at the home on a day to day basis including some direct care shifts. They were therefore able to monitor the quality of service provided and spoke regularly with people at the home to gain their views about the service. However, audits were not being completed and the provider was unable to evidence how they monitored the quality of service.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to quality assurance.

We spoke with all staff on duty including the provider/manager. Staff were aware of how people should be supported, their individual likes and dislikes and the help they required. Staff stated they felt they had sufficient time to meet people's needs and had attended relevant training.

We spent time observing care in communal areas. We found people had positive experiences. We observed staff were courteous and respectful of people's views and choices were offered. The care we observed corresponded with care plans and risk assessments viewed.

There were appropriate recruitment procedures. Sufficient staff were available and they were receiving training, support and supervision. The environment was suitable for people's needs and quality monitoring procedures were in place.

We viewed records of staff training and spoke with staff about induction and training they had completed. We found that whilst some training had been completed there remained a need for further training. Some of this had been planned however some essential training was not included on the training plan.