Greenacres Grange

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed 2 quality statements in the caring key question and found areas of good practice and concerns. People were not always effectively supported to have choice and control and make decisions about how their support was provided. People were not always encouraged and helped by staff to do as much as they could for themselves, to maintain their independence. People’s friends and families were free to visit them with no restrictions. People were encouraged to take part in a range of activities at the home but there were minimal opportunities for people to engage in activities in the community to support their independence, health, and well-being.

This service scored 25 (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 Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us they were able to make choices, this was mainly around meals. One person told us, “I can make choices, but it is limited.” People were asked if they had access to advocacy services. Advocacy services provide people with support to help them express their views and wishes and to stand up for their rights. The people we spoke with were not aware of any advocacy services available to them.

The registered manager spoke with us about ways in which they promoted people’s independence, so they knew their rights, and supported people's choice and control over their care and treatment. People could receive visits from friends and family when they wished, people had access to support from outside agencies which included social workers and advocacy services and they worked in a way which was as least restrictive as possible. The registered manager told us, "One person has requested bed rails in place as it makes them feel safer. For most people if we can manage a concern about their welfare in another way that is less restrictive we will. For example, instead of using bed rails we will use a low bed with sensor mat in place to ensure the person is safe.”

During the assessment we observed people receiving visits from friends, family and pets and there did not appear to be any restrictions on people visiting. There was an activities coordinator on site who was seen to be supporting some people to engage in a cooking activity although this was only with a small amount of people. During meal service staff were observed to not always promote people’s choice and autonomy.

The providers assessment process was used to capture information about people's choices and wishes to promote and support their independence. However, we found that care plans reviewed whilst at the home were of poor quality and did not reflect this information. We requested and reviewed further care plans remotely, which the registered manager advised they had reviewed and updated, and these did reflect information to support people’s independence, choice, and control. This included recording people with capacity having their choices documented even when this may have been felt to be an unwise decision. Where people had restrictions in place this was carried out under a legal framework and in their best interests.

People did not indicate any concerns regarding their needs and wishes being listened to, but people did tell us they sometimes had to wait for staff. People felt this was because there weren’t enough staff and not because they were not responsive to their needs or caring.

We spoke with staff and leaders about how they understood people's needs and responded to people's immediate needs. One staff member described the actions they would take if someone experienced a fall including carrying out observations afterwards to monitor the person’s health and well-being. The registered manager told us about collecting information at assessment to help to understand people's needs, wishes and views and the importance of listening to people. They told us about a person who didn’t have English as their first language and how they supported this person and found out about their likes, needs, and wishes. "The care plan was completed with family to find out likes and dislikes and to get idea of food liked and things. We used pictures, Google translate and one of the staff translated for us.”

We observed staff practice during the assessment and saw that the response to people's needs was inconsistent. We observed positive communication between a staff member and a nurse regarding a person's pain which the nurse responded to immediately. Staff did not always anticipate people's needs and we observed an incident between 2 people which escalated before staff present intervened. This inconsistent approach meant people did not always receive care and support that responded effectively to their immediate needs.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.