Green Care Services

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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. People’s needs and choices were assessed and care was planned to reflect these assessments. People were involved in making decisions about their care and had consented to their care and treatment. The provider ensured staff were well trained and able to provide care in line with best practice. For example, the staff had undertaken training about people with a learning disability and had a good awareness of how to provide personalised support which empowered people. The provider had systems for monitoring and improving care to make sure people received good outcomes. We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

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.

People’s needs and choices were assessed before they started using the service, following changes in their needs and during regular reviews. Assessments and care plans were personalised, detailed and included evidence of consultation with the person and their relatives. People using the service and their relatives confirmed they had discussed care plans. They told us the service had altered care plans to reflect their wishes when they requested this.

People received evidence-based care which reflected best practice. The staff had undertaken training about learning disabilities, dementia and other needs people presented with. The service had a clear management structure, and managers supported staff to follow best practice and keep up to date with this. People using the service and their relatives told us staff were well trained and demonstrated good care practices. Their comments included, “The carers are skilled’’, “The staff are well trained as they cope when [person] is angry and they show good practice to keep [them] calm’’ and “They are very well trained and seem interested in [person], they pick up on and tell me if there are any changes.’’ Staff told us the training was helpful and had supported them to understand their roles and responsibilities. Their comments included, “Training has given me greater insight into learning disabilities and autism which has helped me to put this into practice’’, “The training has made me more aware that everyone communicates differently’’ and “The training has helped improve my ability to provide person-centred care and create a supportive environment that promotes independence and wellbeing.’’

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.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider had systems for monitoring outcomes so that care could be reviewed and adapted. People’s care plans included objectives and desired outcomes. The provider reviewed these to make sure they were being worked towards and met. The staff kept logs of the care they provided, and the management team reviewed these to make sure care plans were being followed. The staff also kept additional monitoring charts, when needed, for example when they were monitoring a particular health condition, food and fluid intake, elimination or someone’s mood and behaviour. People using the service and their relatives confirmed the provider regularly reviewed outcomes to make sure care was appropriate. Comments from relatives included, “They constantly monitor my [relative] to assess the care’’ and “The carers keep an eye on [person’s] skin. The carer spotted a wound and told me so we could act.’’ The provider carried out regular reviews of people’s care and asked people and their representatives for feedback. Through their monitoring they had adjusted and improved outcomes for people. For example, supporting people to access the community and a range of social events, reducing anxiety and helping to reduce restrictive practices and barriers, all of which helped people to live a fulfilling life. There were examples of this which showed how people’s wellbeing had improved since they started using the service.

People consented to their care and treatment when they were able and had the mental capacity to do so. People using the service and their relatives explained they were offered choices and given information to make decisions. For people who lacked the mental capacity to make decisions about their care, the provider had consulted others to help make decisions in their best interests. The provider ensured communication was personalised so that people had opportunities to understand choices. For example, the staff used pictorial guides, sign language, spoke in people’s first languages and offered objects of reference to help people understand what was happening and give them time to consent. Staff had undertaken training about the Mental Capacity Act 2005 and understood the principles of this.