Greenwood Court Care Home

We reviewed all 8 quality statements under this key question; learning culture; safe systems, pathways and transitions; safeguarding; involving people to manage risk; safe environments; safe and effective staffing; infection prevention and control and medicines optimisation. During our onsite assessment visit, people told us they had to wait when calling for assistance as often staff told them they were 'busy'. We reviewed call bell reports, requested after our visit, which highlighted extremely poor staff response times. People’s medicines were being managed and administered by trained staff whose competencies had been reviewed. However, poor record keeping and ineffective clinical governance systems meant we could not be assured medicines were being safely managed.

We found concerns about safety were listened to, investigated, and reported to the relevant authority where required. Lessons were learned when things went wrong and systems were in place to investigate incidents and accidents. However, the lack of effective governance systems and processes meant not all concerns had been identified.

Staff meetings, group supervisions and 1:1 supervision were used to share information with staff and improve the quality of the care provided. Safe recruitment processes were followed. Effective infection prevention and control measures were found to be in place.

We reviewed all 6 quality statements under this key question: assessing needs, delivering evidence-based care and treatment, how staff, teams and services work together, supporting people to live healthier lives, monitoring and improving outcomes and consent to care and treatment.

People were involved in planning their care and staff sought their consent before supporting them. Where people could not consent to care, a representative was provided to be the agreed decision maker for more complex affairs. People were supported to have their nutrition and hydration needs met where required. There were effective approaches to monitor people’s care and treatment and their outcomes.

We reviewed all 5 quality statements under this key question: kindness; compassion and dignity; treating people as individuals; independence; choice and control; responding to people’s immediate needs and workforce well-being and enablement.

There were not always enough staff available to listen and attend to people’s immediate needs, or to minimise their concerns or distress. However, we observed staff respecting people’s privacy and dignity and encouraged people to remain independent. People were supported by a caring staff group who respected their choices and preferences. Staff felt supported by their leaders and colleagues and were able to contribute to decision making.

We reviewed all 7 quality statements under this key question; person-centred care; care provision; integration and continuity; providing information; listening to and involving people; equity in access; equity in experience and outcomes and planning for the future.

Whenever possible, staff supported people to make decisions about their care and support. The provider had recently recruited several new members of staff who were and getting to know people’s likes and dislikes. People had access to external health care professionals to ensure their health needs were met. Where possible, staff supported people to plan and document their end of life wishes.

We reviewed 7 quality statements under this key question: shared direction and culture; capable, compassionate, and inclusive leaders; freedom to speak up; workforce equality; diversity and inclusion; governance, management and sustainability; partnerships and communities; and learning, improvement and innovation. We identified a breach of legal regulation during this assessment. The providers governance systems were not effective and did not identify the shortfalls found during the assessment, including: concerns relating to the effective monitoring and oversight of call bell response time and the safe management of medication. The manager was committed to improving outcomes for people and adhering to the providers values. However, further learning and development was needed to provide a more robust and effective monitoring of the service and ensure the management team had effective oversight.

Staff were clear about their responsibilities and roles and felt supported by the manager and management team. Staff spoke positively about the change in leadership. They felt able to speak up and were confident the manager would actively listen and address any issues raised. The service worked in partnership with others to achieve better outcomes for people. The manager participated in peer support meetings to share information and learning.