Greenfields Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good.

This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received care that was personalised, responsive and reflected what mattered most to them. Care plans contained detailed life histories, personal preferences, preferred routines, communication needs and individual goals, helping staff understand people beyond their care needs and support them in ways that were meaningful to them.

Staff demonstrated a good knowledge of people's backgrounds, families, interests and life experiences. We saw examples of care being adapted to reflect people's preferences, including personalised meal choices, preferred routines and support tailored to individual needs. One person's care plan detailed their wish to look smart, choose their own clothes and maintain independence with personal care, whilst another included information about their farming background, family life and preferred daily routines.

Relatives we spoke with consistently spoke positively about staff recognising and responding to people's individual needs. One relative told us, "There is so much in their mind so it's trying to understand what's true," before explaining how staff took time to help relatives understand what had happened when concerns were raised. A further relative told us, "It's more to do with their mood whether they engage or not," showing staff's understanding of how care and support needed to be adapted according to the person's presentation on the day.

We saw examples of people being involved in shaping their environment and maintaining their identity. For example, a relative described how the home planned to incorporate their relative’s wildlife photography into the refurbishment of communal areas, helping celebrate the person's achievements and maintain a sense of belonging.

People and relatives consistently told us staff knew them well. One relative said, "[Registered Manager] also stops and asks how [Person] is," reflecting a culture where people were seen as individuals and not defined by their care needs alone.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People experienced joined-up care that was coordinated across the service and with a range of external healthcare professionals.

Care plans were detailed, regularly reviewed and provided continuity of information across staff teams. Electronic care systems, daily handovers and healthcare reviews helped ensure important information was shared effectively and people received consistent support.

Relatives consistently told us communication was good and they felt involved when changes occurred. One relative told us, "They are very helpful and tell me exactly what happened,"

There were positive examples of care being adapted as people's needs changed. Staff recognised deteriorating health, sought professional advice and adjusted care accordingly. One relative described how staff identified concerns and ensured appropriate support was put in place, telling us, "They dealt with it" when discussing changes to their relative’s care needs.

Staff worked collaboratively across the home, supporting each other during busy periods and sharing information about risks and care needs. One relative recognised this teamwork and said, "The units help each other out which is good."

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People and those important to them were provided with information about their care, health and support in ways that helped them remain involved in decisions. Care plans contained clear, personalised information about people's needs, preferences, risks and desired outcomes, supporting staff to deliver consistent care and enabling people and relatives to understand how care would be provided.

The service sought feedback from people and families through surveys, family meetings and day-to-day conversations. One relative told us, "They come and ask for feedback on care," and confirmed relatives were invited to ‘family and friends’ meetings. This helped ensure people and relatives had opportunities to share views and receive information about the service.

Information was also shared effectively between staff through electronic care systems, handovers, team meetings and multidisciplinary reviews, supporting continuity of care and ensuring staff had access to up-to-date information about people's needs.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and those important to them were encouraged to share their views and be involved in decisions about their care and the development of the service. There were a range of opportunities for feedback, including informal discussions, surveys and meetings with relatives. One relative told us, "My sister has been a number of times" when discussing family meetings, demonstrating ongoing opportunities for involvement.

Relatives consistently spoke positively about being able to approach staff and managers. One relative told us, "They are very good and I would approach the management," reflecting confidence in the home's willingness to engage with families.

We saw evidence people and relatives were involved in decisions beyond their direct care. For example, meetings were held regarding redecoration projects, with people and families consulted on colours, themes and ideas for communal areas.

People told us staff listened to their preferences and wishes. One person told us, "I can put anything I want up in the room," when discussing how they had personalised their living space.

The provider made sure people could access the care, support and treatment they needed when they needed it.

The service worked to ensure people had equitable access to care, treatment and support based on their individual needs, preferences and protected characteristics. Assessments and care plans considered people's communication needs, cultural backgrounds, religious beliefs, health conditions and any adjustments required to support their wellbeing and independence.

The home was split into different units that all had specific areas they specialised in. This meant when people’s needs changed, they did not have to move home. One relative told us, “You don't have to change homes if your needs change.”

People had access to a range of healthcare professionals. Referrals were made when needed and care plans were updated to reflect specialist advice, helping to ensure people received the support they required regardless of their needs or circumstances.

The home supported people to maintain relationships, access healthcare appointments and continue activities which were meaningful to them. Staff training included subjects such as dementia care, learning disability and autism, helping staff understand and respond to different needs.

Staff and management actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service ensured people received care and support based on their individual needs and preferences, rather than a standardised approach. Care plans reflected people's life histories, interests, communication needs, cultural backgrounds and health conditions, helping staff provide personalised support and achieve positive outcomes. Some relatives and people described differences in staff approaches, one person told us, "Some staff are better than others. Some are naturally kind and naturally suited to do this."

There were examples of staff adapting care to meet individual needs. For example, specialist diets, communication approaches and healthcare interventions were put in place in response to people's changing health conditions. One relative told us, "The staff picked up on the choking risk and dealt with it,” showing how people received support tailored to their specific needs.

People told us they were supported to maintain their independence and continue activities that were meaningful to them. One person described continuing to manage aspects of their own healthcare equipment independently. Another person spoke positively about being able to personalise their room and maintain links with relative and personal interests.

Relatives felt people achieved positive outcomes and received equitable support. One relative told us, "They are very understanding. We learn a lot from them." This reflected the positive relationships that helped people receive support in ways that worked for them as individuals.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to plan for their future wishes and preferences, including their end-of-life care, where they wished to do so. Care records contained information about people's future care preferences, resuscitation decisions, healthcare wishes and those important to them. ReSPECT forms and advance care planning documentation were in place where appropriate, helping to ensure people's wishes were known and respected.

The service involved relatives and representatives in future planning and important decisions. There were positive examples of personalised end of life planning. Care plans included information about people's faith, who they would like involved at the end of their life, funeral wishes and preferences for care.

People and relatives spoke positively about the care provided and the confidence they had in staff. One relative told us, "I know he's safe and I know they look after him,"

Although most records contained future wishes and end of life considerations, we identified some opportunities to further develop the detail recorded for a small number of people who had capacity to express their wishes. The registered manager was responsive and took our feedback positively.