Greenfield View Care Home

During the inspection, we identified a breach of regulation concerning the governance of the service. Earlier in the year, the provider had received support from the local authority’s quality team and had engaged a consultant to assist them to further develop the service. A service improvement plan was in place, outlining actions required to enhance quality and safety. However, we were not sufficiently assured that internal systems and processes were fully effective, and further time was needed to embed and sustain improvements.

Risks associated with people’s care and treatment had not been consistently assessed or planned for. While care plans offered staff guidance on individuals’ needs, they did not consistently reflect current care and treatment. However, staff demonstrated good knowledge, and feedback from external professionals was positive regarding staff’s awareness, understanding, and competency. This indicated that the issue was primarily a recording problem.

The provider’s learning culture required improvement. Further action was needed to ensure that accidents and incidents were analysed for themes, patterns, and learning opportunities, and that findings were effectively shared with staff. The provider was in the process of implementing new procedures.

Steps were being taken to recruit additional staff. We identified that staff deployment required further review to ensure people received timely care and support, as well as opportunities to regularly engage in meaningful activities.

Medicines management required improvement to ensure adherence to best practice guidance and internal policies and procedures. People were supported to access health services when required, and a weekly ward round was completed by a clinician from the local GP surgery.

Staff understood their roles and responsibilities in protecting people from abuse and avoidable harm. People and their relatives were involved in discussions and decisions about how care needs were met.

The provider had processes to manage infection prevention and control. Overall, the service was clean and hygienic, and additional domestic staff were being employed to ensure standards were maintained as occupancy increased.

People were offered a choice of meals and drinks, and their religious and cultural dietary needs and preferences were assessed and accommodated. However, some concerns were observed in relation to meeting hydration needs.

Where restrictions were placed on individuals’ liberty, these were applied lawfully. Where people lacked mental capacity to consent to their care and treatment, mental capacity assessments and best interest decisions had been completed in accordance with the Mental Capacity Act 2005.

Staff were kind, caring, and respectful towards the people in their care, including being responsive to individual care needs. However, people’s mealtime experience identified that dignity and respect were sometimes compromised.

People’s communication needs had been assessed and planned for. Information was provided in various formats to meet the needs of individuals. People, relatives, and visitors were given opportunities to share their experiences of the service.

Staff were positive about working at the service. They confirmed they received ongoing training and support to enable them to safely and effectively meet people’s individual care needs