Greenways 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 inspection we rated this key question good. At this inspection 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.

Care plans were developed from people’s assessed and ongoing needs. Care plans were regularly reviewed to ensure they remained reflective of the care people required to keep them well and any risks associated with their health were identified and managed.

Whilst most people could not recall seeing their care plans, they were positive about the care and support they received. One person told us, “They treat me exceptionally well, it is great care.” A relative described the registered manager as being, “Very proactive in her communication” through the assessment process and their family member’s transition into the home.

The provider did not always follow current evidence-based good practice and standards.

Information about people’s individual dietary requirements was not available in the main kitchen. The member of staff cooking on the day of our inspection usually worked as a member of the care team and was covering these duties. They told us they were given information about people’s dietary requirements through handovers, WhatsApp messages and care plans. However, some days the cooking was covered by agency staff and there was no formal process to evidence how information was shared with them.

One person was at risk of choking, and their health care plan stated their drinks should be thickened with 1 scoop of thickening agent to 200mls of fluid. Staff described ‘one scoop of thickener in drinks’ and told us all the person’s drinks were served in 200ml cups. However, we found entries in the person’s care records reflected some drinks provided had been 300mls and the consistency they had been thickened to had not been recorded. This meant it was difficult to ensure the person was receiving drinks thickened to the correct consistency. The registered manager told us they would take action in response to our feedback.

The provider did not use the International Dysphagia Diet Standardisation Initiative (IDDSI). IDDSI describes food textures and drink thicknesses for people with swallowing difficulties and aims to improve people’s nutritional safety by providing a common language for everyone to use.

However, people told us they enjoyed their meals and had a choice every day. One person told us, “The food is good and you have a choice.” Another person told us they had put weight on since moving to the home. A relative told us, “[Name] gets plenty to eat and drink.”

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 told us they worked well together because communication was good. One staff member told us, “Everyone works well as a team. We really care about the residents. We are organised and try to stick to a nice routine. I think the residents appreciate that.”

Staff described effective working relationships with external health and social care professionals. A GP and a frailty nurse visited the home on separate days each week and reviewed people’s health. People’s medications were regularly reviewed by a clinical pharmacist who worked with the GP practice. One healthcare professional told us, “Staff are very responsive. They try to be proactive.”

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.

Staff understood the importance of supporting people to enjoy the best health possible to improve their physical, emotional and social wellbeing. People were supported to attend regular screening appointments with the optician and audiologist, and a chiropodist visited the home regularly.

Where appropriate, staff sought specialist advice from other health and social care professionals, so people would remain as well as possible. One healthcare professional told us, “They (staff) have a checklist from us to think about what might be happening for a person, including the signs/symptoms to look out for. If we give them instructions, or ask for additional measures, they follow this through.”

People were offered opportunities for gentle exercise to support their independence and mobility. One person told us they had participated in an exercise activity on the morning of our inspection and a relative commented, “[Name] does sitting down aerobics to help their mobility.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

Records did not contain sufficient detail to demonstrate that people’s needs were being effectively monitored. The electronic care system was difficult to navigate, which meant staff could not easily identify when people required additional support, such as repositioning, fluid intake, or nutritional monitoring. There were no dedicated charts in place, and senior staff were required to use daily notes to locate key information. Reliable documentation is essential to ensure people’s planned outcomes are being met and to support clinical decision‑making by other health professionals.

However, staff understood the importance of monitoring people through their observations and reporting any concerns to ensure positive outcomes for them. One staff member told us, “I always document it if I feel someone isn’t quite right and let the seniors know.”

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

Staff understood the importance of involving people in decisions about their care and sought people’s consent before providing them with assistance. For example, we observed staff asking people if they were happy for their room to be cleaned and whether they would like to be assisted to the communal lounge.

Staff told us they respected people’s right to decline support but encouraged them to accept assistance when it was in the person’s best interests. One staff member told us, "We will document their refusal, and we will go back in 20 minutes or half an hour and offer it again. If they refuse again then we report it to the senior who will have a chat with them. Sometimes we try a different staff member and that will work."

The provider had systems in place to work in line with the principles of the Mental Capacity Act 2005 (MCA). Where it was identified people may not have capacity to make a specific decision, mental capacity assessments had been completed and best interest decisions recorded. However, we found capacity assessments would benefit from more information about any adjustments or aids that had been introduced to ensure people had been provided every assistance to make their own decisions.