Greenacres Grange

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 have identified breaches in regulation in relation to person-centred care, dignity and respect, and person-centred care. Peoples needs and rights were not always effectively supported. Peoples’ care, treatment, and communication needs were assessed with them when they started care at Greenacres Grange, but peoples care plans were not kept up to date and any assessments needed were not always completed in a timely manner. Staff did not have a good understanding of people’s individual needs and preferences due to staff changes and a lack of current detailed information about people. People who had capacity to make decisions about their care were aware of their rights around care and treatment however the home had a number of people who would not be able to understand this and would require support with decision making. We have asked the provider for an action plan in response to our concerns.

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.

People and relatives did not feel they were involved in care planning and the assessment of people’s needs. One relative told us, “I did some basic admission paperwork when [relative] came in but haven’t been involved in anything else to do with [name] care. Another relative said, “We have occasional meetings so I can ask how [relative] is at night - it’s the only time I get to know. I feel I could go down to the office and ask if I had any concerns.” A relative contacted us regarding their loved one’s end of life care. The staff supporting the person had not had sufficient knowledge about the person and their wishes which meant the persons family were not contacted to be with them at the end of their life. People were not confident that their needs were understood by the staff team.

Staff told the inspection team that an assessment of people’s needs was completed before people received care. Staff told us they had not had time to review care planning documents or received an effective handover, so they could keep up to date with people’s changing needs.

The assessment process, and ongoing assessment of people’s needs, is a process that should support with effective care planning and monitoring of peoples’ health and wellbeing. Care plans were not all completed in full or reviewed and updated to reflect people’s needs and key information was missing. Other tools used to assess people including risk to people regarding fluid and nutrition was not recorded consistently. The provider had started the process of reviewing and updating all care plans and carrying out an audit of people’s needs including malnutrition and dehydration during our assessment.

People did not always feel what was important for them and mattered to them was delivered. People told us fluid and nutritional needs were not always met including support for people with eating their meals. One relative said, “Now there’s only one carer on at lunch to feed people that can’t - three of us relatives had to help him out”. Another relative told us, “[Relative] seems to eat ok - they know [relative] likes jacket potatoes, so they’ll make them one if they’re not eating well.” Regarding support with drinks a relative said, “I bought three juice drinking bottles which I fill for [relative], so he’s always got plenty in the little room fridge. I’ll go in and find [relative] sat with an empty bottle in front of them, yet no one thinks to give [name] one from the fridge.

We received whistleblowing concerns regarding availability of food for people and staff and family members having to bring in food for people. Staff we spoke with said they had also raised concerns regarding previous food shortages. One staff member told us, “I’ve seen delayed deliveries such as cheese and milk, and we’ve raised concerns, we were told if we need anything we can get at the shop.”

Weights, fluid and nutritional intake were not monitored effectively putting people at risk of health deterioration. We noted staff did not always check if people were eating meals or if they had fluids available and in reach. The provider implemented a daily managers walkaround which supported with identifying if people had adequate fluid and nutrition and replaced the digital recording form with a paper version so that it was accessible for all staff to complete, and supported oversight of people’s fluid and food intake so that appropriate action could be taken to address any concerns.

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.

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.