We carried out a review of the data available to us about Greenmantle Care Home Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Greenmantle Care Home Limited, you can give feedback on this service.
Greenmantle Care Home Limited is a residential care home providing personal care to 15 people aged 65 and over at the time of the inspection. The service can support up to 15 people.
People’s experience of using this service and what we found
People told us they felt safe using the service. Systems were in place to help protect people from the risk of abuse. Risk assessments were in place which included information about how to mitigate risks people faced. Steps had been taken to ensure the premises were safe. Infection control measures had been put in place. There were enough staff working at the service to support people in a safe way, and pre employment checks were carried out on staff to check their suitability.
Quality assurance and monitoring systems were in place to help drive improvements at the service. Some of these included seeking the views of people who used the service and others. The service had links with other agencies to help develop best practice. There was a clear management structure in place and staff spoke positively about the support they received.
Rating at last inspection
The last rating for this service was requires improvement (published 9 August 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 26 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led, which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Greenmantle Care Home Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Greenmantle Care Home Limited is a residential care home providing personal care to 14 people aged 65 and over at the time of the inspection. The service can support up to 15 people. Bedrooms were located on the ground and first floors with the communal areas situated on the ground floor.
People’s experience of using this service and what we found
We found that fire safety records were not always up to date and medicines were not always disposed of appropriately. We also found that quality assurance systems had not always identified areas for improvement. In addition we have made a recommendation related to supporting people to have better dental care dental care.
Systems had been established to safeguard people from the risk of abuse. Risk assessments were in place setting out how to support people safely. Measures were in place to protect people from the risk of infection. There were enough staff working at the service and pre-employment checks were carried out on prospective staff.
Assessments were undertaken to determine people’s needs before they moved into the service. Staff received training and supervision to support them in their roles. People’s nutritional needs were met, and they told us they enjoyed the food. People were supported to access relevant healthcare professionals.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People told us they were treated in a caring manner by staff. Staff understood how to support people in a way that respected their dignity, privacy and independence.
Care plans were in place which set out how to support people. These were subject to review. People were supported to take part in various activities. Systems had been set up for dealing with complaints and people and their relatives told us they knew how to make a complaint.
The service had a registered manager in place and there were clear lines of accountability for staff. People’s views about the service were sought through surveys, while team meetings enabled staff to express their views.
Rating at last inspection
The last rating for this service was requires improvement (report published 8 June 2018). We did not find any breaches of regulations at the last inspection. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment and quality assurance systems at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Greenmantle is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.
Greenmantle is a 15-bed care home providing accommodation and care for older people, including people living with dementia. When we visited 12 people were using the service.
The service had a registered manager. 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.
The registered provider of the service recently changed from an individual provider to Greenmantle Care Home Ltd. Whilst this change is technically a new registration it is however just a change in legal entity for a continuing service.
At the last inspection on 23 and 29 August 2017, we found three breaches of regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Medicines were not safely managed and there were not enough staff deployed to safely meet people’s needs. The registered person had not adequately monitored, assessed and improved the quality of the services provided. Following the last inspection, the provider completed an action plan to show what they would do to improve the service and meet the requirements.
At this inspection, we found that action had been taken. Staffing levels had been changed and were sufficient to meet people's needs. An additional member of staff was on duty in the afternoons and an extra staff was on duty for an hour at the beginning and end of the day.
Systems to monitor the service provided had been changed and strengthened. External consultants had provided guidance and support and an action plan was in place to address issues found. The registered manager had increased the audits and checks they carried out and had taken action when issues had arisen. Staff felt the registered manager was supportive and gave them clear guidance.
Systems in place supported people to receive their prescribed medicines when they needed them. The registered manager monitored and audited medicines to ensure they were safely managed. The completion of outstanding staff competency checks will make the process more robust.
The provider’s relationship with staff and some relatives was not positive and was not conducive with an open or supportive culture. We have recommended that the provider works with staff and relatives to address any issues and to foster positive professional relationships.
Planned improvements to the environment were still pending and the bathroom and kitchen continued to need refurbishment.
There was a stable staff team who knew people's needs. Further changes had been made to care plans but some more work was needed to ensure they were detailed and person centred.
Systems were in place to minimise risk and to ensure that people were supported as safely as possible. Accidents and incidents were recorded but not reviewed or analysed to determine if there were any trends or issues that needed to be addressed.
People were supported to receive the healthcare that they needed. They told us they felt safe at Greenmantle and were supported by kind and caring staff.
Staff supported people to make choices about their care and systems were in place to ensure they were not unlawfully deprived of their liberty. Systems were in place to ensure that decisions made in people’s best interest protected their human and legal rights.
Information about complaints and activities was available for people and pictures and larger print formats were used to help those who might find it difficult to read or understand. Complaints and concerns were investigated and information on complaints was clearly displayed. People were comfortable to raise concerns with the registered manager.
Discussions and reviews about people's care were held in private. Personal care was provided in private and changes to the storage of incontinence products meant that people’s dignity was no longer comprised.
Systems were in place to safeguard people from abuse and staff were aware of how to identify and report any concerns about people's safety and welfare. Safeguarding incidents had been reported to the local authority safeguarding team.
Staff received up to date training and support to enable them to carry out their duties.
We saw that staff supported people patiently and encouraged them to do things for themselves.
The provider's recruitment process ensured staff were suitable to work with people who need support.
Systems were in place to ensure that equipment was safe to use and fit for purpose.
People's nutritional needs were met and they were appropriately and patiently supported with their meals.
Activities were provided and had improved but some people and their relatives felt this was still not adequate. They told us they would like to use the garden and also to go out. The provider told us that there were plans to improve the garden and to buy garden furniture.
People’s cultural and religious needs were identified and respected.