Archived: Greenacre Care Home

We met and talked with some of the people who were living at Greenacre Care Home, the provider and the four staff on duty during our visit. There were 10 people living at Greenacre Care Home on the day of our visit, each of whom had needs associated with forms of dementia. We were therefore only able to get limited information from people about their experience of the service.

Two people told us they were happy living at the home and able to make choices. One person told us their room was regularly cleaned.

We observed that care workers spent time with people when attending to care needs and encouraged conversation. A leisure and social activities assessment had been completed for each person who lived in the home. There was a weekly activities programme, with a definite activity planned for each afternoon.

When we previously visited Greenacre on 18 June 2012 we found that people were not protected from the risk of infection as they were not cared for in a clean, hygienic environment. At this visit we again toured the entire home. We found many environmental improvements had been made or were clearly in progress. Carpets had been replaced by vinyl flooring in some locations to allow for more thorough cleaning and to prevent odours, although we detected odours in two bedrooms. Overall the standard of cleaning was much improved. This had been achieved largely by the addition of a cleaner to the staff team.

The environment was in need of maintenance in many places. Much of the d'cor was old fashioned and worn out. In some places redecoration had been undertaken, but to a very poor standard. In the dining and sitting rooms there were notices on the wall for staff to read. Next to a door from the dining room to kitchen was a coloured notice saying 'kitchen', but also a plain notice saying 'Authorised Personnel Only'. This meant people's need for homeliness was not respected in how parts of the environment were presented to them. Some people's rooms, however, were personalised and homely.

We met and talked with some of the people who were living at Greenacre Care Home, the registered manager and the three staff on duty on the day of our visit. We also met and talked with a relative who visited during the day. There were 10 people living at Greenacre Care Home on the day of our visit and they all had a form of dementia. We were therefore only able to get limited information from people about their care and experience of the support they received.

Of the comments made, one person told us 'they are very good to me in here' and another said 'I like living here'. The relative we met said the staff were 'absolutely brilliant' and 'can't do enough for us'. We were told staff were 'patient' and 'there's nothing to grumble about'.

We observed care and saw staff were kind and patient with people. Staff generally knew about people's likes and dislikes and could explain why people might behave in different ways. Following our last visit, we saw improvements had been made to the menu planning and giving people more choice in what they ate. We observed people being asked what they wanted from the menu for the day. All 10 people living at the home came to the dining room for lunch and were happy to do so. Most people also came to the dining room in the late afternoon for tea.

The home was making progress in building an activity programme for people. We observed some people looking at books and taking part in cake decorating. One member of staff had been made the activity coordinator. The home manager was looking for a suitable training course for this member of staff to attend in relation to meaningful activities for people with dementia.

We found the home had made progress in improving the environment since our last visit. There was, however, some rubbish including an old mattress in the enclosed courtyard area. The manager advised a skip had been ordered to remove this shortly. The lounge and dining room were in reasonable decorative order. The tables were laid with linen for lunch, and the furniture was in good condition.

We saw there were no signs on doors to communal areas, staff areas or the majority of bedrooms. Most signs had been removed to facilitate the decoration of the corridors. The provider may find it useful to note there were no plans at the time of our visit to replace these signs with words and symbols that are meaningful to people with dementia.

We found people we met and observed were given some good care. There was improved stimulation and one-to-one time spent with people. We reviewed care plans and found some work had been done to improve them following our previous visits. The provider may find it useful to note the care plan improvements were not finished and more needed to be done. The daily notes made by care staff for every person at the home contained information that was often repetitive and about meaningless activities. This might mean essential information indicating a person's health was deteriorating was not easily seen or tracked.

We found the improvements we told the home to make around infection control had not been made. A number of rooms in the home did not meet infection control standards. Two rooms had noxious odours and one had no external ventilation. Two rooms had stained carpets and one of these was known to be faeces. The sluice/laundry was in a poor state of repair. We have taken enforcement action against the provider for this essential standard to protect the health, safety and welfare of people using this service.

We found the improvements we told the home to make around how they assess and monitor the quality of the service had not been made. The policy around quality management had not been implemented and did not guide staff to how to implement the requirements of this standard. We have taken enforcement action against the provider for this essential standard to protect the health, safety and welfare of people using this service.

We found the improvements we told the home to make around care and welfare of people who use the service had not been adequately met. Some improvements had been made to care plans and activities, but people were not getting adequate stimulation or attention to meet their needs. The living conditions for two people were failing to meet those persons' basic needs and maintain and support their wellbeing. Some assessments of people's needs and ability to make informed decisions were not being made. We have taken enforcement action against the provider for this essential standard to protect the health, safety and welfare of people using this service.