Greensand House

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• 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.

This is the first assessment for this newly registered service. This key question has been rated 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.

Care plans showed person-centred detail, showing staff had worked closely with people, their relatives and others important to them to ensure all their wishes and feelings were recorded. We have fed back to the manager that some care plans contained out of date information which they told us they would address.

Staff knew people well. We observed positive interactions between staff and people with them throughout our visit. Staff told us they understood how best to support people. Any changes in people’s needs were responded to and reflected in relevant electronic recording systems. People and their relatives confirmed they were actively involved with decisions about the care and support which they received.

People and relatives told us they liked the warm and friendly atmosphere of the service. Rooms were individualised with pictures, personal items and memory boxes outside to help orientate people to their room.

Relatives described staff knowing personal preferences and routines, and said their family members felt at home in the service.

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 received care from familiar staff who knew their needs well and supported them consistently. Relatives described staff as competent and attentive. Staff demonstrated a clear understanding of people’s health conditions and worked effectively with professionals, who said communication with the home was excellent and they escalate appropriately when needed. This ensured continuity and timely responses to changes in health. One relative said, “I continually see the same staff. They are brilliant with her.” A member of staff told us, “The manager pushes us to communicate with all residents, so they recognise us, and we try and stay in our designated floors so that residents see familiar faces.”

The manager told us, “When I started, we divided staff members to each floor to have some continuity and consistency. We have a structure where staff are allocated to a floor so residents can get to see familiar faces.”

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

People and relatives told us they were routinely informed about changes in care, health needs or incidents. The manager described using written notes, boards and pictures to support people who needed information in accessible formats. We observed the weekly activity planner was displayed in several areas around the floor. There was also a separate notice for activities in slightly larger print. One relative told us, “I love their social media page. I live [away] so only visit once every 12 weeks or so. I find myself scouring the page to see Mum in one of the photos. They should be commended for that because it means so much to me. But they are also very good at keeping us informed.”

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 relatives said staff listened to them and took their views seriously. One relative told us, “I would know how to make a complaint, but never had to.” The manager and staff told us they encouraged people and relatives to raise issues, and that concerns were shared with the whole team so improvements could be made. Relatives said they were involved in care plan updates and consulted on any proposed changes.

There were also resident and relatives’ meetings where they were given opportunities to provide feedback and hear about any changes taking place at the service. A person told us, “(Meetings) are once a month. It’s nice to talk over what’s done to the rooms or the food. Feedback is listened to.”

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

People were supported to access external services whenever they needed them. When someone was unable to attend appointments, arrangements were made for the support to be provided within the service. For example, when people could no longer attend church services, a clergyperson would visit them at the service.

People were consulted regarding various activities available at the service. This supported them to overcome any accessibility barriers, ensuring everyone had equal opportunities to participate. One member of staff told us, “The idea with the layout of the dining rooms is mine and I just want the residents to feel like they are coming out to eat in a posh restaurant. I don’t want any resident to feel left out so came up with ideas for a diabetic menu for anyone who needs it.” The manager told us, “Where residents are on modified diets, they will be offered two options on the menu regardless, not just one.”

Staff and leaders 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.

People reported being treated fairly and respectfully, with no concerns about discrimination. Staff demonstrated an understanding of equality and human rights and told us they felt confident advocating for people if needed. Relatives consistently described positive experiences and said their family members were safe, comfortable and well cared for regardless of their abilities or health conditions. Staff talked about adapting communication methods to ensure everyone was included.

The manager told us, “There is a big barrier at the moment in the home where residents that cannot actually go out for an appointment to have their ears checked so we then contact [audiologist name] or any other professional to make an appointment for them to come in-house. Residents in a care home, they kind of are left sometimes because they can't go out to a dentist and have their teeth checked. We make sure that we actually will be sat working with ‘at home’ dental. So, they will arrange to come here often and do regular visits where they check the residents’ teeth.”

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 and relatives were supported to discuss future needs, and staff demonstrated an understanding of good end‑of‑life care. People felt staff treated them with compassion when discussing future wishes. The manager told us, “We have conversations when we do an initial assessment, we have a discussion with family of residents to say, we understand it's quite a difficult conversation. We give them the opportunity if they would like to discuss at the time or they would like to be given a bit more time. It's always a very difficult topic to approach, but we try to be sensitive and give options, so the family don't feel pressurised.”