Galanos House

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 outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (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 always 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 assessed face to face and care plans were developed. Relatives told us the service had worked with them and their loved ones to gain as much information about people before they moved to Galanos House. This meant people’s preferences, likes, dislikes and communication needs were known and used to provide care in the way people wished. It also ensured people were given the opportunity to share any specific needs in relation to their protected characteristics under the Equality Act 2010. One relative told us, “They were excellent in getting to know [Name] and what she needed, and they did all the forms with her, and she chose how she wanted to be cared for. She said she wanted to choose and was fully involved as they arranged her care. The home got to know her very well and knew what she needed before day 1.” People were invited to spend time in the home prior to admission which helped them to know they had made the right choice. People and relatives felt supported when moving in and because of this approach, pre-admission assessments were robust, detailed, and person cantered.

Long-term care plans, risk assessments, and management plans were developed from the assessments and clearly reflected each person’s needs and wishes. The registered manager explained the importance of involving people and those important to them when developing care plans and commented, “Years ago it was ‘we know best’ but now it is about partnership working and choice. The expectation has changed, and we have to move with that. People need to be empowered to say ‘this is my home, and this is how I want it to be’." This approach provided staff with the information they needed to provide individualised care based on people’s life histories and preferences. One staff member told us information gathered, “Opens conversations.” Another staff member commented, “We get a lot of background information before [people] move here.”

Regular reviews of people’s care were holistic and looked at their medical, physical, emotional and social needs. People, relatives, staff and other healthcare professionals were involved in care plan reviews to ensure they remained appropriate and reflective of people’s changing needs and preferences.

The provider always 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. They worked to develop evidence-based good practice and standards.

The provider and management team were proactive in ensuring they kept up to date with national standards and best practice guidance. The registered manager held positions in several organisations that promoted collaborative working between healthcare professionals and the sharing best practice. This ensured they were up to date with developments in standards and could consider introducing them into the practice of the home. Individual staff attended external events and conferences in their specialist areas to develop their skills and maximise outcomes for people. Best practice guidance was accessible and available to staff including information on diabetes management and good prescribing practice for adults receiving end-of-life care.

Staff training was refreshed at regular intervals to maintain their knowledge and skills. Staff responsible for training reviewed training content to ensure it was up to date and in line with current best practice guidance.

People were supported to understand best practice in their care and treatment and how it could improve their care outcomes. For example, people had recently been invited to attend fire awareness and falls awareness courses. One staff member told us, “Last week we did a course on falls awareness with an understanding of what the risk factors are. One person said she struggled with her shoes, so I addressed that, and another person said the lighting levels were not good for him, so we have addressed that too." Some people were on modified diets due to risks around their eating and drinking. Relatives had participated in sessions to taste modified diets and understand why their family members needed to be on a specific texture of food. This increased knowledge provided assurance people would continuously be supported in the safest way when eating with their families.

There was a strong emphasis on people eating and drinking well to maintain their health and wellbeing. Each person was reviewed using a recognised risk assessment tool to identify any concerns around malnutrition. Where a need was identified, people were referred to external healthcare professionals such as dieticians and speech and language therapists for advice and support. Catering staff told us they were kept up to date with nutritional risks such as allergies, weight loss and when people needed a modified diet. Modified diets were described using the International Dysphagia Diet Standardisation Initiative (IDDSI) Framework to ensure consistency when describing food textures and drink thicknesses for people with dysphagia (swallowing difficulties).Staff demonstrated a good knowledge of IDDSI and how these applied to people’s needs.

People and their relatives considered there was plenty to eat and told us drinks were readily available. Relatives told us staff encouraged people to eat and drink and would tempt them with something else if they did not like the choices on offer. Comments included: “[Name] gets lots and they are very accommodating to him. He lost his appetite, and they tried to tempt him. They will always cook him something he fancies” and “[Name] gets loads to eat, she says too much. There is a big selection at breakfast, and they make her something else if she doesn't like it.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Managers and staff were fully committed to working collaboratively with other health and social care professionals, so information was effectively shared to ensure positive outcomes for people. External healthcare professionals described excellent communication which supported their clinical decision making. One healthcare professional told us, “Care plans are up to date, we are always clear on escalation plans for residents, and staff consistently have a good knowledge of their residents which supports good decision making.” Another healthcare professional said, “Staff are excellent in communicating with my team to provide best supportive care for patients.” A third healthcare professional commented, “Our multidisciplinary approach, especially enhanced with the contributions of the resident's family, is an exemplary way of working in my opinion. We keep patients at the centre of our interventions in a way that is respectful to them and never undermines their autonomy in their care.”

Staff described robust systems to ensure good communication between the staff team and continuity of care for people. These included daily handovers between shifts, weekly clinical meetings, “Resident of the Day” reviews, nursing office diaries, and reviews following GP visits. The handover on the day of our inspection was observed to be interactive and well-structured, with clear communication between the nursing and care teams. Discussions included updates on new admissions and people’s care needs. Clinical staff supported each other when addressing complex cases, demonstrating a positive team culture with mutual respect and effective collaboration. These systems provided a structured framework for monitoring, communication, and continuous improvement.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. People experienced positive outcomes because staff encouraged them to be active and motivated them to engage with others to support their physical and emotional health and social wellbeing.

There was a strong recognition within the service that physical activity could benefit people’s physical and emotional wellbeing and provide opportunities for social connection. Many activities were designed to promote exercise including a daily walking group and yoga. Thirty-one people in Galanos House had recently entered the ‘Road Worlds for Seniors’ challenge which is a global indoor cycling championship for seniors and people with dementia. The home had achieved first place in the UK overall and as the miles clocked up, people had enjoyed reminiscing about places they had lived, worked and visited. The registered manager commented, “The sense of wellbeing and healthy competition was palpable, and the physical benefits were seen with a reduction in falls and increased strength and balance.”

Relatives told us staff supported people to remain well with guidance and support. One relative told us their family member had regained their mobility at Galanos House because staff had encouraged them to walk using their walking frame. Another relative told us, “They will walk with [Name] to keep her mobile and safe and they encourage her healthy eating.” A third relative commented, “They have encouraged [Name] to eat and found things he really likes. It is important that he does not gain weight, and they bring him colourful and lovely fruit in a nice bowl.”

Staff worked collaboratively with the local GP surgery to ensure people received preventative healthcare from clinicians who knew people well. GPs, the pharmacist and the frailty nurse visited the home every week and in urgent cases, GPs were available 24 hours a day for advice via telephone or email. Staff also had access to the NHS Patient Access website so were able to promptly check any medical test results and the dates of other healthcare professional interventions. One healthcare professional told us, “Requests (by me) are quickly actioned by staff, and they are proactive in requesting results where patients have had tests and investigations.”

People were supported to attend routine appointments with healthcare professionals such as dentists, opticians and chiropodists. Regular check-ups helped the detection of any early deterioration in people’s health so proactive steps could be taken to help people remain well. One healthcare professional commented, “Yesterday [Name] said his glasses had broken and he has already got an opticians appointment sorted."

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

Relatives told us staff were confident and competent in monitoring people’s health to promote positive outcomes. One relative told us, “They know that [Name] has regular chest infections and they keep an eye on her and act if they see she is under the weather. They listen to me too.”

One healthcare professional told us staff completed any monitoring checks requested by them and commented, “They are very efficient in this regard. I have had no recent incidents where actions were not completed, and when actions are completed, they are done so to a high standard.” Another healthcare professional told us, “When I recommend adjustments to medications, for example, when deprescribing medications, they promptly update their care plans, and we discuss how to monitor outcomes which they action.”

However, we found some inconsistency in monitoring records, for example food and fluid monitoring charts. Managers accepted new systems recently introduced to support people to eat and drink well had impacted on the accuracy of record keeping. They assured us action would be taken to address the inconsistencies identified. Some records were well maintained, for example in relation to monitoring people who had experienced a seizure.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us they had full choice and control about how they lived their daily lives. For example, what time they got up and went to bed, the clothes they wore, what time and where they ate their meals and whether to participate in activities. One person told us, “The staff here are great. They are kind but they make sure we are still in charge.” A relative told us their family member could sometimes decline support and commented, “Staff listen to [Name] and know to come back a little while later. They comply with his wishes and do what he asks of them.”

Where people had capacity, staff respected their right to make decisions with risk. One staff member gave an example of how they worked with 1 person to understand and mitigate risks whilst respecting the person’s views and opinions. This staff member told us, “People come here to live, and I am a big believer in promoting independence but keeping people safe. We don’t stop anybody doing anything. We will advise if we don't think things are safe, but if they have capacity, why not?" One person confirmed, “They never say we can't do that; they just make it happen.” Care plans had been agreed with people to minimise identified risks.

Our observations demonstrated staff sought people’s consent before providing care and clearly worked with people in the least restrictive way possible. However, we found the documentation to support the good practice evidenced during our inspection required improvement. People had global mental capacity assessments that were not always decision specific or that clearly evidenced the actions taken to ensure people had the best chance of understanding the decision to be made.