We inspected Greenacres Care Home on 1 November 2016. The inspection was unannounced. Our last inspection of the service was in October 2013 when we found that the service was compliant in all areas we looked at. The service is registered to provide accommodation with personal care for up to 41 people.

The home is required to have a registered manager. 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 home had a registered manager who had been in post for a number of years.

During our visit we saw that there were enough staff to support people and meet their needs. People we spoke with considered there were enough staff and they described the staff as kind and caring. We observed positive and respectful interactions between staff and people who lived at the home.

Robust employment procedures had been followed when new staff were recruited. Staff received regular training and supervision and most staff had a national vocational qualification.

The home was clean and well maintained. Medicines were stored and managed safely and records showed that people received their medication as prescribed by their doctor.

Deprivation of Liberty Safeguards (DoLS) had been applied for with respect to some people living at the home. We saw evidence that people's capacity to make decisions was assessed before they moved into the home, however we did not see a system in place to keep this under review in order to identify any changes in people's mental capacity.

We found that the lunchtime experience was busy and poorly organised. People had a choice of meals, however the menus we looked at did not offer healthy choices and lacked variety.

People's needs were assessed before they moved into the home and referrals were made to medical professionals as needed. Care plans recorded the care and support people received and were reviewed monthly.

People who lived at the home had choices in daily living. Some people chose to spend their time in their own bedroom while other people enjoyed participating in the social activities provided.

People spoke highly of the home manager and the staff members we spoke with considered that they were well supported and worked well together as a team.

There was a good standard of record keeping across the service.

During our inspection at Greenacres Care Home, we observed people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Two people we spoke to said, "the staff make this place" and "the staff are brilliant here". We observed people receiving attentive and respectful caring, always being asked for consent before any care or treatment was carried out. People using services were given choices around meals and activities without any pressure. Appropriate arrangements were in place in relation to obtaining, recording and handling of medication by qualified staff members which ensured the safety of people using services.

The provider had an effective recruitment process which ensured people using services were cared for by staff who had appropriate skills, experience and qualifications. We observed staff rotas which confirmed people were always cared for by appropriate numbers of staff members. Although the complaints policy was not observed displayed around the care home, the provider, staff members and people using services were aware of the process which they explained to us. From what we were told and observed we are confident a robust complaints process is in place at Greenacres Care Home.

People who lived at the home and their relatives told us they were happy with the care and support they received. One relative said, “They look after my relative well. I can go home and feel better knowing that he is ok.”

People who lived at the home told us they were involved in planning and reviewing their care and said they felt confident they would be listened to. Up to date care plans were in place. People were cared for in ways that met their needs. A relative said, “I was very impressed when I read in the care plan that the staff were aware of my relative’s disorientation. I felt reassured that they understood his needs.”

A community matron said, “I have been coming here for two years and I have never had any concerns. I give care directions to the staff and they follow them properly.”

Staff told us they were trained to do their job properly and said they felt supported by their manager.

There were systems in place to monitor the quality and safety of the service.

The home was clean and comfortable throughout.