Greenhill Park 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 71 (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.
A relative told us, “There is good open communication. I feel involved in my relative’s care. They always respond and say when something has been acted on. They are safe here”.
We reviewed people’s care plans and found them to be comprehensive, containing key information about each person. This included a detailed history of the person and their life story, their communication preferences, personal care needs, health and wellbeing requirements, hobbies and interests, eating and drinking guidelines, and any medication support needs.
Staff demonstrated good knowledge of people and their support needs.
The registered manager had an audit plan in place to ensure people’s care plans were reviewed on a regular basis or when people’s needs changed. However, the audit plan failed to identify issues we found with PRN protocols not being followed, particularly for supporting people with their bowel movements.
 

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 we reviewed were comprehensive and reflected current evidence‑based practice. They covered all key areas relevant to people’s needs, including communication, continence, oral health, daily living, manual handling, mobility and personal hygiene.
Records we reviewed showed effective use of the International Dysphagia Diet Standardisation Initiative (IDDSI), enabling staff to safely adapt and manage people’s diets to minimise the risk of choking. During our assessment, kitchen staff clearly identified individuals who required modified diets and showed good knowledge and understanding of dysphagia.
Risk assessments were personalised and clearly identified risks specific to the relevant person, such as manual handling requirements, falls risks and nutritional needs. These assessments provided staff with clear, practical guidance on how to manage and minimise risks, supporting people to receive safe and consistent care.
 

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.
People told us staff worked effectively with other professionals to ensure they received consistent care and treatment. One person told us, “They help me when the nurses come and see me, I sometimes struggle to say how I’m feeling but they help me.”
Visiting healthcare professionals also reported communication between teams had improved, and there had been progress in recognising when people required urgent care.
Professionals told us support staff work well with them. One professional said,, “(Staff member) is very good and very supportive when on shift.”
 

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.
During our assessment, we observed people taking part in food preparation for the home. This was a regular activity and supported people to maintain independence and daily living skills.
The home’s menu was reviewed quarterly with people’s involvement. Kitchen staff sought regular feedback about the meals provided, but we received mixed feedback regarding the food on offer. One person told us, “Food is erratic. Mostly quite alright, but dull. I’ve tried suggesting things such as putting ice cubes in the jugs of tap water. They’ve accommodated my breakfast needs.” Another person told us, “The food is nice and if you don’t like what’s on the menu, they listen and they don’t give it you.”
Records showed people had access to appropriate healthcare services, and information from appointments was documented and used to inform care planning.
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.
We observed people taking part in a range of onsite activities, including sessions in the garden area, the dining space and an exercise and movement class. These activities supported people to remain active, stimulated and engaged, contributing positively to their wellbeing.
People and their relatives told us they were regularly involved in reviews of care, ensuring support remained appropriate and reflective of people’s changing needs. One relative told us, “Yes I am involved, I know the annual review is due and there is also one with social services.”
Care plans we reviewed were mostly up to date and accurately reflected people’s current needs. However, improvements were needed to support staff to monitor progress, identify changes promptly and adjust care to support improved outcomes for people living in the home. This was mainly linked to people’s PRN protocols not being followed in the event people required additional support with their health needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.
The home was not always working within the principles of the Mental Capacity Act 2005 (MCA). Care records we reviewed showed mental capacity assessments had been completed, and there was evidence of involvement from the person and, where appropriate, those important to them.
However, where people were assessed as lacking capacity, documentation relating to best‑interests decision‑making was inconsistent or incomplete. In several cases, it was not clear how decisions had been reached, who had been consulted, or how the person’s wishes, feelings, values and beliefs had been considered.
We provided feedback to the registered manager the mental capacity assessments we reviewed could be more decision‑specific, in line with MCA requirements. Strengthening this documentation will help ensure the service continues to work fully in accordance with the Mental Capacity Act.
The provider was working within the principles of the Deprivation of Liberty Safeguards (DoLS). There was evidence appropriate referrals had been made to the local authority, and where authorisations had been granted, any conditions were clearly documented within people’s care plans.
The provider monitored when people’s mental capacity assessments and DoLS authorisations required review.