Archived: Greenview Residential Care Home

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 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were effectively assessed prior to admission to the service. Their care plans and risk assessments were regularly reviewed and updated and contained person specific information. For example, they included information about people’s lives, such as, their hobbies, interests and where they used to work. Care plans considered people’s health, care, wellbeing and communication needs, meaning staff had the information they required to be able to support people effectively.

Evidence was provided of the service working effectively with other professionals to arrange and follow up on appointment.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The service did not always use clinical assessment tools to assess and monitor people’s health needs. For example, there was no evidence provided of clinical tools being used to monitor people who are at risk of malnutrition, such as where 1 person’s care plan identified them as being underweight and at risk of malnutrition. However, people had clinical assessments in place to identify their risk of developing pressure injuries, and they had mitigation in place, reducing the risk of a pressure injury occurring.

Although staff were observed to pay particular attention to people’s hydration needs on a hot day, for example by providing regular fluids and ice lollies, records showed people were not always offered and did not always receive their recommended daily fluid intake as identified in their care plans. For example, records showed 2 people did not receive their recommended daily fluid intake on any days over a 6-day period, including for 1 person who’s care plan stated they were at increased risk of dehydration in summer, which is when the inspection took place.

However, people and their relatives told us they felt confident staff knew how to support them and they did so with compassion. Staff had the information they needed in people’s care plans to support them to manage their specific health care needs. For example, 1 person’s care plan detailed a monthly health check needed to monitor their health condition.

Most people told us they enjoyed the food, there was a suitable variety, and their nutrition needs were met. Staff told us they were aware of people’s specific dietary needs, and these were also recorded in people’s care plans.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked effectively with each other and communicated well. We observed them sharing information with each other throughout their shift, as well as formally at handover to ensure people’s needs were met. For example, during handover staff shared information about each person’s wellbeing and highlighted any action needed.

Records showed a range of healthcare partners visited the service and were communicated with, for example the district nurse, GP, and optician. Healthcare partners told us they had positive relationships with the service, and staff were responsive and communicated effectively with them. This coordinated approach ensured people had their health care needs met.

People had emergency admission care plans in place, which detailed important essential information if, for example, they needed to go to hospital at short notice. People’s care plans, risk assessments and care records were clear and up to date meaning staff, partners, or other services would have an accurate understanding of a person’s needs from the information in them.

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.

People’s care plans reflected national legislation and evidence-based good practice. For example, 1 person had a specific health-care need, for which their care plan detailed how staff should respond to the need, in line with best practice.

People were supported to live healthy lives, for example fresh fruit and vegetables were grown in the garden and used by the chef in food preparation. Healthcare partners told us the service made timely referrals and provided relevant information when people needed healthcare support.

Staff regularly recorded people’s weight, blood pressure and temperature. However, people’s care plans did not always identify the normal ranges for people, or what to do if they are outside of the normal range. This meant that any recordings outside of the normal ranges for people may not have been identified, or support sought, in a timely manner.

Staff had completed training which helped people stay healthy, for example, most staff had completed first aid training.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

People and their relatives told us how the service helped to maintain and improve people’s emotional wellbeing. They told us the service helped them to feel “happy”, “relaxed” and it had a “lovely family atmosphere”.

People’s care plans identified individual outcomes, how people could achieve these and what support they needed to achieve these, although there was no written evidence of how these outcomes are monitored for progress and achievement. However, we saw how 1 person had learned a new skill, as identified in their care plan, and was enjoying using this.

Staff had completed training in relation to some health conditions, such as diabetes, which meant they had the skills and knowledge to support people to maintain and improve their health.

The provider did not always tell people about their rights around consent.

Records showed people who had capacity to consent had consented to their care. However, where people lacked capacity to consent, there was not always evidence consent had been provided by people legally allowed to do so. For example, 1 person’s family member had signed for consent regarding health and welfare when they did not have the legal authority to do this.

Only 4 staff had completed training regarding the mental capacity act. We found a lack of evidence of mental capacity assessments and best interest decisions being completed. For example, there was no mental capacity assessment recorded prior to applying for a Deprivation of Liberty Safeguards (DoLS) for 1 person. However, most staff had completed training around DoLS.

Staff were observed asking people for consent before supporting them, for example, before administering medication or supporting them to move.