Greystoke Manor

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 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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People said they were involved in an assessment before they moved into Greystoke Manor, but were not routinely involved in reviewing their care plans thereafter. One person said, “They took me round the home and I came with [relative]. He’s very pleased with it.” However, people and their relatives did not recall being asked to review their care or having a look at their care plans. A staff member said that people and their relatives were reminded they could view care plans at any time, they just had to ask. A relative told us, “They frequently write, if you want to see the care plans, then just ask, but it’s not offered on a routine basis. It’s down to me to ask to see it. I’ve not seen it. They’ve never gone through it with me or routinely have a meeting with me. I do feedback on a day-to-day basis, if my mum has a complaint or any problems, we do it on an as and when basis.” The registered manager later sent us a couple of documents explaining what a care plan was, and how people and their relatives could be involved in reviewing their care.

Another person expressed their concern about one of their health conditions and their lack of confidence in staff understanding of this. We asked for a copy of the relevant part of their care plan which staff printed off. The person had not previously been aware of this. We were then able to provide this to the person so they could review what had been written, and provide any feedback or updates to this part of their care plan.

Various assessments and monitoring tools were used to support staff to meet people’s identified needs. For example, the Malnutrition Universal Screening Tool (MUST) identifies people’s risk of malnourishment or issues with their weight. People’s risk of developing pressure areas was assessed. Risks were regularly reviewed and monitored, with staff able to access up-to-date care plans on electronic hand-held devices to support safe and consistent care.

The registered manager said, “We do monitor breakfast, lunch and dinner, food intake and fluid intake, also at night. If someone was beginning to lose weight, we would monitor them more closely and speak with the GP. We have gone to a speech and language therapist too, if someone needed a modified diet.”

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.

The provider worked well with a range of health and social care professionals, including district nurses, the dementia matron, speech and language therapists, GP, and falls team, to support people’s needs. We asked for feedback from 2 health professionals, but had not received this at the time this report was written.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, particularly regarding the food on offer.

People and their relatives were unhappy about the food at Greystoke Manor. We were told that a new chef had recently started and it was hoped there would be an improvement to what was on offer. One person said, “There’s too much emphasis on quantity, not quality. You don’t really do anything to build up an appetite, lots of food is wasted. There’s no imagination, it’s the same thing over and over. There’s a new chef, so we’re hopeful.” Another person commented, “It’s not as good as when I first came here. The quality of the food has gone down. The meals are the main part of the day; you look forward to them. The desserts are top quality and it used to be that the mains were as well.” A relative told us, “Sometimes there was a bit of moaning about one of the cooks. The food is not what it was.” The registered manager told us they had sat and eaten with people over a 2-week period to see what the food was like. They told us, “I think we are improving. The problem is that people are still thinking of the old chef [who left].”

People had access to a range of healthcare professionals. One person confirmed this and added, “Staff take you sometimes. I’ve been to the doctor and when my teeth needed fixing.” The GP surgery was located over the road from Greystoke Manor. Face to face visits with a GP took place every month or contact could be made over the phone.

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.

The home strived to achieve good outcomes through the care and support people received. People and their families were asked for their feedback about the home and results were positive in the main. A relative told us, “We don’t have relatives’ meetings. They have residents’ meetings but my mum doesn’t go to them. I’m not sure what we would gain from a relatives’ meeting. Possibly a meeting once or twice a year and at a weekend when more relatives would be free. We do get surveys to complete.”

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

We observed staff routinely asked people for their consent before any kind of intervention was undertaken.

Staff completed training on the Mental Capacity Act 2005 and demonstrated their understanding of this legislation regarding consent. One staff member said, “We have had training, it’s about choices. I would speak to the manager if I doubted a person’s capacity.”

Records showed capacity assessments were completed for people regarding specific decisions, such as consent to live at Greystoke Manor. Where people were assessed as lacking capacity, for example, agreeing to the use of sensor mats or bed rails, decisions were made appropriately in their best interests.