Greenacres Grange

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• 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

We assessed 2 quality statements in the effective key question and found areas of good practice and concerns. Peoples needs and rights were not always effectively supported. Peoples’ care, treatment, and communication needs were assessed with them when they started care, but peoples care plans were not always kept up to date and any assessments needed were not always completed in a timely manner. People were aware of their rights around care and treatment. Staff did not all have good knowledge of the mental capacity act, including capacity and consent or how to support someone with fluctuating capacity.

This service scored 21 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

One relative told us that they had spoken with staff about their loved one’s care. However, other people we spoke with told us they had not been involved in their care planning. One person told us, “Nobody talks about my care.” Another relative told us “I’ve not been involved in any planned meetings about [relative] care.” Not involving people or their relatives in planning their care meant that their care plan may not contain information about what is important to them, and what matters to them.

Feedback from staff and leaders: The registered manager described the initial assessment process they carried out with people, relatives, and professionals to collect information about what was important for the person and what matters to them. They said, "We try to involve residents that can be involved or family. Families are heavily involved in care planning and are asked to give any feedback and if they want to review the care plan.”

The provider had processes in place before people started care at the home, the assessment, to collect information about what was important to the person and what mattered to them. There were processes in place to review care plan documents to ensure that they were current and reflected people’s needs and wishes. These processes had not always identified when care plans were not current or there was information missing. We saw that care plans were of poor quality which put people at risk of not having appropriate care. Through feedback as part of our assessment, the registered manager recognised that care plans required updating and updated the additional care plans sent to the inspection team.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People did not always feel they were supported to live healthier lives. One person told us, “I feel abandoned about my physio.” However, we were able to review a report that indicated that the person had received an assessment by the physiotherapist. People were supported to access services to support with their health and wellbeing, People’s mental well-being was considered, and people could access in-house activities to support them to socialise with others and engage in activities which included art, cooking and a mother and baby group for people to spend time with younger family members. However, although activities were available, we only saw small numbers of people engaged in activities at the time of our assessment.

Staff told us there was a weekly ward round completed by a GP at the home and that staff and the nurses at the home supported people to manage their health and well-being. One staff member told us about what they would do if they had concerns about someone’s health. They said, "I would report it to the nurse or management and document it on the resident’s notes.”

The provider had a variety of processes in place to support people to live healthier lives, some of these processes were effective and others were not. We saw areas set up for activities for people, although we did not see anyone using them, which included an indoor garden area and a laundry area. People's food and fluid intake was recorded and monitored as well as people's weights to identify any concerns regarding weight loss/gain, or people not having enough to eat or drink. We reviewed one person’s care plan that required a referral to the physiotherapist which had not been made. We also noted that the system in place to support the safe management of medicines was not reviewed so issues with people receiving medicines late had not been identified.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.