Archived: Greetwell House Nursing Home

Updated 2 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was 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.

We visited Greetwell House Nursing Home on 27 and 28 September 2017. On the first day our inspection team consisted of an inspector, a specialist advisor whose specialism was nursing 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. On the second day our inspector returned alone to complete the inspection.

In preparation for our visit we reviewed information that we held about the home such as notifications (events which happened in the home that the provider is required to tell us about) and information that had been sent to us by other agencies including the local authority contracting and safeguarding teams.

During our inspection we spent time observing how staff provided care for people to help us better understand their experiences of the care they received. We spoke with five people who lived in the home, four visiting family members, the registered manager, the cook, one of the activities coordinators, one member of the housekeeping team and five members of the nursing and care staff team.

We looked at a range of documents and written records including people’s care files and staff recruitment records. We also looked at information relating to the administration of medicines and the auditing and monitoring of service provision.

Updated 2 December 2017

Greetwell House Nursing Home is registered to provide accommodation for up to 25 people requiring nursing or personal care, including older people and people with physical disabilities.

We inspected the home on 27 and 28 September 2017. The inspection was unannounced. There were 12 people living in the home. This was because, following our last inspection in November 2016, we imposed an additional condition of registration preventing the registered provider admitting anyone to the home without our written permission. This was to give the provider an opportunity to focus fully on the needs of the people already living in the home and ensure they were receiving the service they were entitled to expect.

The home had a registered manager in post. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’) 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.

In November 2016 we conducted a first comprehensive inspection of the home. We found the provider was in breach of legal requirements in seven areas. We rated the home as Inadequate. We also placed the home in Special Measures and, as described above, took action to restrict further admissions.

On this inspection we were pleased to find significant improvement had been made. All seven breaches of regulations had been addressed and the home is longer in Special Measures. The overall rating is now Requires Improvement, reflecting the need for further action in two specific areas. Our additional condition of registration remains in place but we have advised the provider that we are now prepared to permit new admissions to the home, as long as this is done in a measured way which does not jeopardise the progress made since our last inspection.

Improvement was required to ensure staff were consistently person-centred care in their approach and to strengthen the management and administrative resources in the home. In all other areas, the provider was meeting people’s needs safely and effectively.

Although she had only been in post for eight months, the registered manager had won the loyalty and admiration of everyone connected to the home.

There were sufficient staff to keep people safe and meet their care and support needs. Staff worked well together in a mutually supportive way. Training and supervision systems were in place to provide staff with the knowledge and skills they required to meet people’s needs effectively.

There was a friendly, relaxed atmosphere and staff were kind and attentive in their approach. People were provided with food and drink of good quality that met their individual needs and preferences.

People’s medicines were managed safely and staff worked closely with local healthcare services to ensure people had access to any specialist support they required. Systems were in place to ensure effective infection prevention and control and to address other environmental hazards.

A comprehensive range of audits was in place to monitor the quality and safety of service provision. People’s individual risk assessments were reviewed and updated to take account of changes in their needs. Staff knew how to recognise and report any concerns to keep people safe from harm.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection the provider had been granted DoLS authorisations for 4 people living in the home. Staff understood the principles of the MCA and demonstrated their awareness of the need to obtain consent before providing care or support to people. Decisions that staff had made as being in people’s best interests were correctly recorded.