Greenways

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.

There had been no new people move into the service since our last assessment. However, people who already lived at the service had their care plans reviewed regularly. The deputy manager told us, “Care plans are reviewed every 3 months. Relatives are invited once a year to take part in a review. I usually print it and send a copy of them to go through, and then when we meet, we can discuss it further.” This allowed people’s relatives to feel informed and included in their family member’s care and allowed them to share important information about that person’s life history which may have an impact on their care. Relatives confirmed this, with one telling us, “I get the chance to give my contributions.”

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.

The provider was meeting the principles of Right Support, Right Care, Right Culture. The registered manager told us, “We try to provide the best possible care for individuals, make any adaptations we can and we’re transparent with families. As a care home, I think we deliver as much as we can.” People were supported to live an enriching and empowering life, take part in opportunities available to them and maintain important relationships. The deputy manager told us, “[One person’s relative] has ill health so can’t come up here often, so we will drive them down to him for the day.” The registered manager added, “Their funding is only 2:1 for 3 hours a day, so when we do that trip, we step in and give the extra time as [the relative] lives 3 hours away in travel time alone.” People were supported to go on holiday once a year and were provided with extra staff to fulfil this at the expense of the provider rather than seeking funding. The quality manager told us of further opportunities they were exploring for people. They said, “There’s more opportunities and enrichment than before. There’s empowerment too. We’re considering getting them involved in interviews of staff or getting them involved in our eco green meetings.”

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 worked well as a team to provide good quality care to people. The deputy manager told us, “Without staff you can’t be a good manager. They are open with me about personal issues. If you call a staff member and they turn down work, then there is a problem. [The registered manager] told me this and I believe it.” We observed good working relationships between staff and management, including humour as well as professionalism.

Handovers of people’s needs between staffing shifts was in depth. Staff met at the end and start of their shift to share information about people’s wellbeing, health needs, and what activities they had done throughout the day. Handover notes were also written in people’s daily notes so these could be reviewed if needed.

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 worked in conjunction with health care professionals to encourage people to live healthier lives. The deputy manager told us, “The occupational therapy and speech and language team came in and that was positive for [person]. They came in and gave some suggestions around behaviours and triggers and we’ve worked on those.”

Relatives felt the nutrition provided at the service was healthy and varied. One relative told us they felt the food available was healthy and that staff offered healthy alternatives to biscuits, as their family member would typically over indulge in these if the opportunity arose.

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.

Staff had worked hard since our last inspection to improve people’s wellbeing. One staff member told us they noticed one person had a lot of energy and was not always sleeping well at night because of this. They told us, “I asked his [relative] if I could take him to the gym, and ever since we’ve been going he’s sleeping better. He really enjoys going too.” Another person had previously not enjoyed being in the kitchen at the service. However, staff had spent time encouraging them and they were now enjoying being involved in cooking their meals.

External providers were involved in monitoring and improving lives alongside staff. One relative informed us their family member had a psychiatry review coming up soon and that they were reviewing one of their medications to determine if it was no longer needed.

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

Records showed that where a person lacked mental capacity to make an informed decision, or give consent, staff acted in accordance with the requirements of the Mental Capacity Act (MCA) 2005 and associated code of practice. We found the MCA assessment had not considered recent national guidance in response to case law about the order of the test for capacity. However, there was no impact upon the person’s rights in this case.

Staff we spoke with described how they supported people to make everyday decisions for themselves, such as choosing their preferred meals and snacks. People were supported to access the locked kitchen with staff supervision and support.The registered manager told us, “Staff are up to date, they’re fully aware of the 5 principles [of MCA]. They know things just can’t happen overnight as we need to speak to family members, professionals etc.”