Greenwood Court Care and Nursing Home

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

We reviewed all 6 quality statements under this key question: 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 and consent to care and treatment. People were involved in planning their care and staff sought their consent before supporting them. Where people could not consent to care, a representative was provided to be the agreed decision maker for more complex affairs. People were supported to have their nutrition and hydration needs met where required. There were effective approaches to monitor people’s care and treatment and their outcomes.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed prior to admission to the service. Care plans were regularly reviewed and updated to ensure they reflected their current needs.

The manager told us, “We receive referrals online, people walking in enquiring, and the local authority. We aim to complete a pre-assessment within 24 hours and these are mostly face to face assessments . We take at least one member of the team with us for possible admissions, so at least the person would have another familiar face when they arrive. We also invite and offer people lunch, do a tour of the home so they can get a feel of what it would be like to live here.”

Prior to admission to the service people’s needs were assessed by the manager and deputy managers. Care plans included risk assessments, care reviews and updates. This ensured staff had access to up-to-date information to enable them to meet a person’s needs.

People were satisfied with the care and support they received. Their only criticism was the length of time it took for staff to respond to them when they required assistance. People raised no concerns regarding their personal care and were complimentary about the food and drink on offer. People told us they looked forward to mealtimes which enabled them to socialise and talk to others. Comments included, “The food is very good here and you can always get something different if you want it,” “I love lunchtimes, there is always someone to chat to, we have our regular table to sit at.” And “My food gets served hot; it is all pretty good.” During our mealtime observation we saw the chef engaged with people and staff, talking about how the dessert was made and checking how people’s meals were.

The chef told us, “We have residents’ meetings which I attend, the residents tell me their preferences. My team and I serve residents on both floors so we can see how the food is presented and if people are eating. I have the support of 2 sous chefs. My support comes from the catering manager which I find good. I have had training for IDDSI, and the catering manager is very passionate about this, so he organises this for the team. We cook fresh vegetables every day. All my staff are qualified to at least level 2 and all updated with allergy training.”

Care plans contained evidence of involvement of a range of external professionals. We saw referrals were made to dietitians when people had lost weight and the speech and language team when people required modified diets. Any advice or guidance given was recorded in the person’s care plan for staff to follow. There was guidance around people’s nutritional and dietary needs. A system was in place to monitor and review daily care records.

People told us they had access to other health services to support their health and well being. Relatives we spoke with told us, “We are here so much, we do pick up a lot of the health concerns, but [name of staff member] is very good at getting [person’s] medicines,” and “They [staff] are very quick to let me know things, if [person] has been in bed for 3 days as they do not want to get up. They [staff] are straight on the phone to let me know.”

Staff had developed effective working relationships with health and social care professionals to ensure people received effective care and support. Staff told us they have access to the information they need to appropriately assess, plan, and deliver people’s care.

Visiting professionals on the day of our assessment visit were complimentary regarding collaborative working with the service.

The manager and senior team kept records of any visiting health and social care professionals. Documenting any changes to people’s healthcare needs and updating care plans with any actions or advice to be followed.

People and relatives, we spoke with told us they were involved in reviewing their health and well being needs where appropriate. A relative told us, “In April [person] had to go into hospital, we were notified straight away, we are kept up to date with changes.”

Staff understood the importance of people’s care and support being regularly reviewed and how effective communication helped people to achieve good outcomes. Some staff we spoke to told us about ‘Resident of the day’ where a review of the person would take place, including their relative/representative if required.

Records identified where people were at risk, for example, poor nutrition and hydration. The service monitored people’s weights, and risks associated with nutrition and hydration were assessed and referrals made to the dietitian and speech and language therapists (SALT) as required.

People we spoke with told us their needs were being met and they enjoyed living at the service. Comments included, “I love living here, I have made a lot of friends. I can have my hair cut when I want to, and they [staff] do your nails as well,” and “I can sum it up. I am happy living here, if I do not have a shower, they [staff] give me a good wash every day, I have no complaints.” However, we received mixed feedback from relatives in relation to their involvement in planning and reviewing their loved one’s care and support. Some told us they were involved and kept updated with any changes whilst another relative told us despite asking for a copy of their loved one’s care plan they had not yet seen it.

The manager told us, “We have a well-being team who carry out ‘resident of the day’ and a discussion is had to involve people in their care and support needs. If a person lacks capacity, we will link with their power of attorney and their next of kin will be notified. We use a multi-disciplinary team approach, so everybody is involved.”

Regular care plan reviews were undertaken to ensure improvements were made to people’s care and treatment when required. However, the providers processes for monitoring and improving people’s outcomes was not always robust. The service did not sufficiently monitor or manage the risks associated with people’s skin integrity.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We observed on the day staff offering choice to people whether it be their food and drink. One person told us, “I have the choice to go to bed and get up when I want to.”

Staff had received training around the Mental Capacity Act (MCA) and were able to describe how they apply this in their day-to-day practice.

There were processes in place to assess people’s capacity to make decisions and where appropriate Deprivation of Liberty Safeguards (DoLS) were applied for in their best interests with involvement from their representative lawfully acting on their behalf as the decision maker. However, on the day of our assessment visit the DoLS overview which tells us who lacks capacity and for whom a DoLS has been applied for was not accurate. The area manager immediately updated it to ensure it reflected the current number of DoLS applications and their status.