Greenhill

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 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 and their relatives where appropriate, were involved and supported to plan and review their care. Assessments and care plans were comprehensive, individualised, and contained details about people’s needs, wishes, cultural needs and what was important to them. Reviews of people’s care were carried out on a regular basis to ensure care plans remained up to date, especially when there were changes in people’s conditions or circumstances.

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.

People received their care and support in line with good practice. Clinical review meetings took place to ensure issues or clinical concerns were identified and addressed, and best practice was followed. Monitoring health tools were used within the care planning system to help guide staff in delivering safe and effective care. Health and social care professionals visited the service to provide support to people, including GP’s and speech and language therapists (SALT).

People's nutrition, hydration, dietary and cultural needs were met. People had mixed views about the food served and choice of menus on offer. The majority of people we spoke with told us they enjoyed the food; however, some said the food was not always good or cooked to their liking. We drew this to the registered managers attention who told us they would raise this with people at residents’ meetings and discuss this further with the chef. We observed how people were supported at lunch time in dining rooms, communal areas and in their rooms. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. People were offered choices from set menus and were offered a wide range of drinks. There were enough staff to support people, and we saw positive interactions between people and staff.

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 health and social care professionals, to ensure people’s care needs were met. Referrals were made in a timely way to services such as dietician and speech and language therapists. Care records documented people’s care and treatment and any guidance received following consultations or visits.

Staff communicated effectively through staff meetings, daily handover meetings and regular contact with external health and social care services.

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.

People were supported to access a range of health and social care professionals when required to support their physical and emotional wellbeing. Care plans and records documented how best people should be supported and staff monitored people’s conditions and health needs on a regular basis taking action when people became unwell. Care records confirmed that people were visited by professionals such as GPs, speech and language therapists and dieticians when needed.

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.

There were systems in place to monitor outcomes and review people’s needs and progress. A range of monitoring tools were completed where required, such as repositioning, personal hygiene, oral care and food and fluid intake. Monitoring tools were maintained and completed consistently where required. Nursing staff were knowledgeable and were able to provide examples of how they used clinical tools and practice to detect and recognise deterioration in people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People’s care records contained consent forms, covering a range of areas including consent to care and treatment. People told us staff were respectful and always sought their consent.

We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. Staff promoted people's rights and worked within the principles of the Mental Capacity Act 2005 (MCA).