We inspected this service on 19 October 2017 and this was an unannounced inspection. We previously inspected this service on 24 September 2015 and rated this service as Good. At this inspection, the service remained rated as Good.

Green Gables is a care home registered to provide accommodation and personal care to 28 adults with physical and learning disabilities. At the time of our inspection 26 people lived there. It is situated on the outskirts of the market town of Alfreton, Derbyshire.

There was a registered manager in the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service remained safe as people’s care was planned to meet their needs and minimise risks to their safety. Recruitment practices ensured staff were suitable to work within people. Staff understood their role in protecting people from harm and people received their medicine as required.

The service remained effective and staff were trained to have the skills they needed to support people. People chose the food and drink they liked and where people needed a specialist diet, they received nutrition to keep well. People had access to healthcare services and necessary referrals were made to ensure new health concerns were reviewed. People had choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained caring because staff knew people well and were interested in knowing what was important to them. People were asked how they wanted to be supported. Staff supported people to retain their independence and when support was required it was provided in a kind and reassuring manner which protected people’s dignity.

The service remained responsive because people’s care was reviewed with them to ensure it continued to meet their expectations. People were able to engage in activities that interested them and if they were unhappy, they could talk to staff about their concerns.

The service remained well led. The manager was approachable and people and relatives were given opportunities to comment on the care they received. There were quality assurance systems in place to monitor the quality of the service to drive improvements in care.

This inspection took place on 24 September 2015 and was unannounced.

Green Gables is a care home registered to provide accommodation and personal care to 28 adults with physical and learning disabilities. They are not registered to provide nursing care. At the time of our inspection 25 people lived there. The service is set over two-stories and has an internal lift. It is situated on the outskirts of the market town of Alfreton, Derbyshire.

At our last inspection in February 2014 we found that the essential standards of quality and safety were being met at this service.

The was a registered manager in post, although they were on annual leave on the day of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt happy and safe living at the service. Staff had received training to safeguard people from abuse and knew how to report any concerns they may have. There was effective recruitment procedures in place and these were followed to ensure staff were suitable to work with vulnerable people. There were arrangements in place to ensure staff numbers were suitable to meet the needs of the people.

There were plans and guidance in place to ensure people were safe if an unforeseen event, such as a fire occurred. Specialist equipment and the environment was well maintained to ensure people were kept safe.

Staff attended training to ensure people’s medicines were stored, administered and disposed of safely. Potential risks to people’s health were monitored and reviewed.

Staff respected and promoted people’s dignity and privacy. Staff had developed caring and compassionate relationships with people and their relatives. Staff were knowledgeable about people, their background, histories, likes and dislikes and understood their needs well.

Staff were able to explain to us how they maintained people’s safety and protected their rights. Staff had been provided with training such as the Mental Capacity Act (2005), Deprivation of Liberty Safeguards (DoLS) and safeguarding.

People received care that was personalised and took into account personal preferences and choice. People and relatives felt able to raise concerns and had confidence it would be dealt with promptly.

Staff understood their roles and responsibilities. There were effective systems in place to audit and monitor the quality of the service being provided.

This inspection was unannounced which meant the provider and the staff did not know we were coming. Green Gables supported older people who had a physical condition and/ or a learning disability. There were 25 people in residence when we undertook our inspection. We spoke with six people living in the home, one volunteer, four staff and the registered manager.

People told us they were happy with the care they received and staff were responsive to their needs. One person told us, “It is good here and it’s nice to have company. I feel safe.”

We saw the home could demonstrate how arrangements to seek people’s consent to care or treatment had been agreed in the person’s best interests.

The home was clean, warm and offered suitable fixtures and fittings.

We saw the staff were appropriately recruited to ensure vulnerable people were protected and staff were suitable to work in the home.

Records were stored safely and correctly. This ensured people’s confidential information was stored appropriately.

At our last inspection on 7 December 2012 we made two compliance actions. This meant the provider had to make improvements to demonstrate they were fully protecting people using their service in these areas.

We found that suitable and sufficient improvements had been made where we had identified concerns. We saw the provider had put right what was required. This meant the provider could demonstrate outcomes for people using the service had improved.

There were 26 people using the service at the time of our inspection visit. We spoke with four people, one relative, four members of staff, the manager and two visiting professionals during the visit. We spoke with one relative and three visiting professionals by telephone following the visit. We were accompanied by an expert by experience who spoke with people, toured the premises and observed the lunchtime period.

Most people and their relatives praised the service and told us staff were respectful and one person said staff were “ever so good”. We observed that people enjoyed warm relationships with staff and that interactions were polite and friendly. They were always happy and responsive to people. One person said “Staff are very polite” and a relative said “The home is friendly”.

One person using the service told us that the “Staff are very good” and another said “I’m quite happy here”. Another person told us “They look after me pretty well”. People told us all their health and medical needs were well met. One person told us the service was “First class”.

We saw that there was input from a physiotherapist and the service had access to specialist community health staff but we found that apart from the manager, there were no qualified nursing staff available.

There were some access issues with the building that needed addressing to ensure people using wheelchairs could move freely round the premises.