Greenhurst Care

On this page

• Overview
• 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
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional in assessing people’s needs, ensuring assessments directly improved people’s safety, independence and quality of life. Assessments were not static documents but were continuously reviewed and adapted in response to changes such as hospital discharge, infection or fluctuating capacity, enabling people to receive the right care at the right time.

Assessments were highly personalised and explored people’s health, preferences, communication needs and life histories in detail. One person described how the registered manager “asked lots of questions about what I like and dislike, about my health… mobility and sensory disabilities”. This approach ensured care reflected what mattered to people and supported them to remain in control of their care. As a result, people experienced care that was tailored to their needs and preferences, with one person confirming, “I am supported how I would like to be supported.”

The impact of this was evident in improved outcomes for people. Assessments enabled timely and safe hospital discharge and continuity of care at home, with relatives confirming the provider “came to the hospital… so that she could get out of hospital at the earliest opportunity”. Ongoing review of needs meant changes in health were identified early and care was adjusted promptly, reducing risks such as pressure damage or infection. For example, relatives told us staff were able to identify early signs of pressure sores and take action quickly, preventing deterioration.

Assessments also supported people to remain living independently for longer. By regularly reviewing needs and adapting care packages, people were able to stay safely in their own homes, with one relative stating this proactive approach enabled their family member to continue living independently and happily at home.

The provider embedded the Accessible Information Standard within assessments, adapting communication and using prompts and assistive technology to ensure people could understand information and make decisions. This meant people were actively involved in their care, even when their needs fluctuated, and were not excluded from decision making.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Care plans and risk assessments reflected people’s individual needs, preferences and wishes and provided staff with clear guidance to deliver safe, effective care. Staff followed safe moving and handling procedures, infection prevention and control practices, and monitored people’s nutrition, hydration and overall wellbeing. Records showed concerns were identified promptly, escalated appropriately and acted on without delay. Medicines were managed safely through robust systems and regular audits completed by the registered manager. Where minor errors were identified, lessons were learned, and improvements were made to reduce the risk of recurrence.

Staff used evidence-based approaches to achieve positive outcomes for people. Regular moving and handling assessments ensured people’s transfer needs were reviewed as their mobility changed, helping to reduce falls and avoidable hospital admissions. For example, support arrangements were adapted when required, including the introduction of full-body hoists to maintain people’s safety and independence. Staff used recognised assessment tools, including Waterlow assessments, to identify and monitor risks associated with pressure damage. One person assessed as being at very high risk of pressure ulcers had remained free from pressure damage because staff provided proactive monitoring and timely interventions.

People’s health and wellbeing were promoted through innovative and person-centred practice. Staff introduced additional wellbeing visits to encourage hydration and used Jelly Drops to support people living with dementia or those who found it difficult to drink enough fluids. This improved hydration while maintaining people’s independence and choice. Staff respected people’s rights and embedded consent into everyday practice. They received training in person-centred care, informed consent and the Mental Capacity Act 2005 and understood the importance of supporting people to make decisions about their care. Staff also delivered compassionate, evidence-based end-of-life care. They worked closely with healthcare professionals to ensure one person’s wishes, documented in their ReSPECT form, were respected. Anticipatory medicines were obtained promptly, care plans were updated, and staff were kept informed of changes in the person’s condition, enabling consistent care to be delivered in accordance with their wish to remain at home.

The provider worked exceptionally well with staff, teams and partner services to deliver coordinated, proactive care that consistently improved outcomes for people.
Staff built strong, effective relationships with a wide range of professionals, including GPs, district nurses, occupational therapists and specialist services. They did not wait for people’s needs to deteriorate before seeking support. Instead, they worked proactively to anticipate changes and respond early. This approach directly reduced avoidable deterioration and supported people to remain safely and independently in their own homes.

This coordinated way of working had a clear and positive impact on people’s lives. People experienced smoother transitions between services, including safe and timely hospital discharge, with care and equipment in place when they returned home. Relatives told us staff made practical suggestions to improve care and independence. One relative explained their family member “was able to live independently in their own home, entirely due to Greenhurst’s proactive approach.”

Communication between staff and professionals was consistent, purposeful and focused on achieving good outcomes for people. Professionals confirmed their advice was listened to, acted upon and reviewed, ensuring care remained effective and responsive. This meant people received the right support at the right time, with minimal disruption to their daily lives.

The service also worked closely with community resources, including dementia services and local hubs, to promote engagement and wellbeing alongside personal care. Staff recognised the importance of maintaining social connections and meaningful activity, which improved people’s quality of life.

Relatives were treated as partners in care and were regularly involved in decisions, particularly where people’s capacity fluctuated. This ensured care remained person-centred and aligned with people’s preferences. Collaborative working was embedded across the service, rather than dependent on individual staff, providing people with consistent, reliable and well-coordinated care.
 

People were supported to maintain their health through encouragement with mobility, nutrition and hydration, and by promoting healthier daily routines where appropriate. Staff used assistive technology and practical prompts creatively to support independence, including reminders to take medicines and maintain adequate fluid intake. Care plans reflected people's strengths and focused on supporting them to achieve the best possible outcomes.

The provider worked with people, their relatives and healthcare professionals to promote recovery and improve wellbeing. For example, one person was supported following a stroke to complete exercises recommended by healthcare professionals during daily care visits. Staff encouraged the person to engage in the physical activity to increase activity in a way that was enjoyable and motivating. This supported the person's rehabilitation and helped them work towards greater independence.

People were also supported to remain connected with their communities and participate in activities that were important to them. Another example included a person attending a local dementia hub ensuring they were part of their community and remained in good health. Staff supported the person to prepare for the day, ensuring they were appropriately dressed, had taken any required medicines and were ready for transport. Staff supported them safely into their taxi and helped them settle comfortably at home following their return. This helped reduce social isolation and promoted emotional wellbeing.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and, where possible, reduce their future needs for care and support. Care was personalised and regularly reviewed to reflect people's health needs, rehabilitation goals and changing circumstances. Staff worked closely with people following hospital discharge or periods of illness to help them regain confidence and independence within their own homes.

Reviews were used effectively to identify opportunities to improve people's health outcomes. For example, staff identified one person was relying mainly on toast and snacks because they found preparing nutritious meals difficult. Following discussions with the person and their family, staff supported them to access Wiltshire Farm Foods, providing a wider range of balanced, nutritionally complete meals that could be prepared safely and independently at home. This helped improve the person's access to healthy eating and supported their overall wellbeing.

The provider demonstrated a strong approach to monitoring outcomes, where audit findings and incident reviews consistently led to measurable improvements in people’s experiences and safety.

Audits were regular and meaningful, covering care plans, medication records, incidents and staff practice. Findings were analysed to identify themes and used to target supervision and training. Importantly, this resulted in improved practice. For example, where a missing medication signature was identified through audit, the staff member received follow-up supervision and observation. Records showed this led to improved recording and no further omissions, reducing the risk of medicine errors.

Incident and accident records clearly demonstrated how learning was used to improve outcomes for people. For example, following a fall, the person’s care package was reviewed and their evening call was increased to provide additional support with mobility and getting into bed. This reduced the risk of further falls and supported the person to remain safely at home.

Staff consistently used monitoring information to identify early signs of deterioration, such as urinary tract infections. Prompt testing and liaison with health professionals meant treatment was provided early, helping to prevent avoidable hospital admissions and maintaining people’s health and independence.

The provider also used feedback to improve outcomes for people. For example, following survey and feedback responses, changes were made to the timing of care calls and staff practices, resulting in care being better aligned with people’s routines and preferences.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff worked in line with the Mental Capacity Act 2005 (MCA) and obtained, recorded and reviewed consent as part of people’s care. Records covered key areas including care delivery, medicines support and information sharing. People told us staff asked for their consent before providing support and respected their wishes and choices at every visit. Where people were living with dementia or experienced fluctuating capacity, staff completed and reviewed decision-specific mental capacity assessments and sought consent at every opportunity. When people could not make specific decisions, staff followed best interest principles and involved relatives and relevant professionals to ensure decisions were made in the person’s best interests and in the least restrictive way. Staff clearly documented and respected end of life wishes, including ReSPECT plans and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions.

The provider embedded consent within its culture. Staff received training during induction and throughout their employment on person-centred care, informed consent and the MCA. This helped them uphold people’s rights and promote choice and independence. The provider allocated regular care professionals to support continuity of care. This enabled staff to develop a detailed understanding of people’s life histories, routines, preferences and communication needs, helping them build trusting relationships and deliver care in line with people’s wishes.

One example involved a person receiving end of life care whose ReSPECT plan recorded their wish to remain at home. When their condition deteriorated, staff worked closely with healthcare professionals and obtained anticipatory medicines promptly to manage pain or distress. The care manager updated all care professionals due to support the person and explained changes to their condition and care plan. This ensured staff delivered consistent and compassionate care that respected the person’s wishes and enabled them to remain at home.