Greenacre Park

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 Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People could not always be directly involved in planning their care and support needs due to their communication needs. This required more emphasis on staff, relatives and other professionals to support care planning. One relative said, “They [staff] asked me if I’d like to be involved in [name] reviews. I have been and feel I am kept ‘in the loop’ with staff being transparent with me when reviews take place.” Another relative said, “We did have a best interest meeting recently with the social worker, the manager and everyone else involved to decide on the best way forward for [name].”

People’s needs were routinely assessed and reviewed monthly or when there was a sudden change. Records we reviewed confirmed this. We highlighted to the provider best practice when undertaking care reviews should reflect people’s progress not just amended when people’s needs change. Managers accepted this feedback and assured us forthcoming reviews would include reflection of people’s progress and positive outcomes.

Staff had ready access to information on people’s care needs which enabled them to support people safely and effectively.

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.

Recognised clinical assessment tools were used to assess and review people’s care and support needs, such as skin care, dietary and hydration needs.

Most people and their relatives told us they enjoyed the food and menus on offer. A person told us, “The food is good here and I get choices.” A relative said, “Yes, [name] does eat very well and gets a lot to drink. I have seen the food, and they do cater for their preferred cultural food as they often ask for this.”

We observed how people were supported at lunch time in the dining areas and their bedrooms. Daily menus, showing photographs of meals were in each dining room. One person told us they usually choose their food the day before, using these photographs but could have alternatives on the day if they had changed their mind.

People who required support from staff to eat their meals safely, were supported appropriately and with dignity. The chef and kitchen staff were knowledgeable about people’s dietary needs and daily menus offered choice. This meant people received food choices that were safe and appropriate for them and followed national guidance.

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.

Good communication by staff with other services and professionals was in place. Where required this included the local authority, GP and healthcare professionals for treatment for conditions such as diabetes and SALT (speech and language therapists) for risks associated with choking. Recommendations from these professionals were incorporated into care plans.

Relatives told us they were kept updated and provided with outcomes from the services interactions with other health professionals following appointments. One relative said, “The communication from that point of view is good. If there are appointments to attend, the family are told before if they want to attend.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

People’s health conditions were assessed and monitored using recognised clinical tools. Care plans were detailed, person centred and provided staff with guidance on effective care and support. Health needs were monitored. For example, people who were at risk of pressure injury to their skin received regular care interventions including repositioning, and food and fluid charts were in place to people’s monitor nutrition and hydration.

A further training requirement for some staff was identified so they knew how to fully interrogate the electronic system for recordings over time as opposed to daily recordings. Again, managers were responsive to this finding and implemented refresher training for those staff. We were satisfied these recordings were undertaken when we reviewed the system.

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 and relatives themselves.

People’s care and health was monitored by the staff who knew when to escalate concerns. The provider’s electronic records system supported staff to undertake the requisite care interventions at the appropriate times and if any were missed, for instance, in relation to nutrition and hydration and repositioning needs, the system alerted staff to these.

The system was monitored by the management team so they were also aware of any care interventions missed so appropriate and prompt action could be taken so any delays to care provision were minimal.

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

The principles of the Mental Capacity Act 2005 (MCA) were followed. Systems were in place to ensure mental capacity assessments were completed when necessary. If people could not make decisions or consent to their care, processes were in place to ensure decisions were made in their best interests, involving all relevant persons.

Documentation relating to and recording people’s capacity was in place. For example, one person’s care records detailed how their preferences and cultural needs in relation to food types were considered. A mental capacity assessment was undertaken by a multi-disciplinary team in relation to the risk of consuming such food which posed a risk of choking as their physical presentation was deemed not to be able to tolerate it with a best interest decision made and recorded.

Staff were trained on MCA and knowledgeable about people’s rights regarding consent to care and treatment.One staff member told us, “We understand people’s rights and always obtain consent prior to delivering care. If a person does not consent, we by no means force any care upon them. We try and encourage them in the most sensitive way.”