Greenways

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Care records were not detailed around the physical care people required, there were also gaps in the provision of supporting those with communication needs to have their opinions and choices heard. This therefore did not maximise the choices for people with a learning disability in line with RSRCRC guidance. Staff demonstrated poor understanding of how to deliver person centred care. During our assessment of this key question, we found concerns around people not receiving person centred, evidence-based care, specific to their needs which resulted in a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were mixed responses from relatives about how staff supported people with day-to-day activities. Some comments from relatives included, “[Person] goes out every day, [person] does swimming and trampolining, and [person] goes out for a lot of walks” and “From what they [staff] have said, horse riding and trampolining. Arts and Crafts to the house. [Person] goes for long walks.” Whilst one relative told us, “I would like [staff] to find things for [person], is capable if they found something, more initiative for [person].” Another told us they would like to see their loved one try new things and to go out more.

During both days of the visits, people that remained in the home had very little to occupy them. We found were either just sat in their rooms or sat in the lounge. Although people were supported to go out, this was limited to walks, drives and a couple of regular pre booked activities including trampolining and horse riding.

Staff told us they try and ensure people have access to activities. The deputy manager told us, “We have known them for a while and take them to activities we think they might enjoy.” However, the registered manager told us of 1 person and their activities, “The funding limits how frequently [person] can go out.” They said walks around the local area are due to them not requiring a second member of staff for this and if they drove to another area, they would need a second member of staff which they said the person was not funded enough for. They said, “I have been requesting extra funding. “We fund a lot. We utilise activities for [person].”

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People did not always have information provided in a format that they would understand despite the registered manager stating on their local authority assessment for January 2024 that, “Information is accessible to our customers by using our “Home Communication Board” which is located in the main communal area as well as staff sharing this information with our customers.” However, we did not see this was being utilised in this way.

Staff were able to tell us how people communicated however as stated, we did not see staff use any alternative methods during the inspection.

Although people had alternative communication aids, we did not see these being used by staff. There was 1 person that was visually impaired, we did not observe any audio communication aids for the person aside from the person’s ‘Alexa’. The person used this to find out what the weather was like each day.

Relatives were not routinely involved in reviews of care. The deputy manager told us, “Their parents are informed of any updates.” They said in relation to how people are involved, “Get their views by allowing the key worker to talk to them.” However, we found this was not effective in ensuring people’s views were sought.

There were relatives who felt very involved in their loved one’s care. One told us, “I feel absolutely listened to. I speak on behalf of [loved one]. Communication on point.” Whilst others felt the communication and involvement was lacking with one telling us, “I just find communication is a struggle.” The majority of the relatives told us it had not been communicated to them the changes in the management structure of the service.

People were not always encouraged to feedback any areas for improvements. We saw people had monthly key worker meetings and a template was completed to prompt discussion. However, there was no prompt to ask them about things they would like to change or see improved. The key worker meetings involved discussions about people’s goals and aspirations however there was no evidence these were being looked into to see if what could be done to achieve these. Where it was recorded people were unable to verbally communicate, there was no record of how staff were communicating their discussions with the person.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Through conversations with the registered manager and staff team, there was a lack of understanding of the principles of Right Care, right support and right culture.

We did not receive any direct feedback in relation to this. Whilst people did not raise concerns with us directly, other evidence showed the service had not always ensured people’s wellbeing and care was being reviewed

We found each person who used the service was not treated as an individual. There was a lack of evidence each person's self-defined strengths, preferences, aspirations and needs as the basis on which to provide care and support to live an independent life was undertaken.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.