Greenacres care home is situated in the market town of Caistor, in Lincolnshire. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Greenacres provides accommodation for up to sixteen older people with care needs. On the day of our inspection 14 people were living at the home.

At our last inspection we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring, that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We found systems and processes were in place to keep people safe. Staff understood their responsibilities for safeguarding people they cared for and assessed risks to their health and safety. Measures were in place to reduce these risks and people were supported to stay safe, whilst not unnecessarily restricting their freedom. Incidents and accidents were reported and the provider completed an analysis of the events and identified actions, to reduce the risk of similar incidents happening again.

Medicines were generally managed effectively and safely. The premises and environment was well maintained and the required safety checks were completed. Infection prevention and control was effectively managed.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills. People’s needs were assessed and care was delivered in line with national guidance. Care was responsive to people’s needs and wishes. People felt they had a voice and staff listened to them to identify their wishes. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

Staff had developed caring relationships with people and treated them with kindness and compassion. Staff treated people in a respectful and inclusive manner and their opinions and views on their care were recognised and acted upon.

People continued to receive care that was responsive to their individual needs. Staff had a detailed knowledge of the people they cared for and they responded effectively to their needs and wishes. People were treated equally, without discrimination and information was accessible. People were encouraged to maintain their relationships and contacts outside the home. Activities were based on people’s interests and wishes.

The registered manager and provider provided good leadership and support to staff. The provider had put processes in place to support the manager and staff. The views of staff, people using the service and relatives were actively sought and listened to. Quality audits were in place to enable continuous improvement in the quality of the service provided.

Further information is in the detailed findings below.

Greenacres Care Home is situated in the market town of Caistor in Lincolnshire. The home provides residential care and support for up to 16 older people, some of whom experience memory loss associated with conditions such as dementia.

We inspected the home on 9 February 2016. The inspection was unannounced. There were 15 people living in the home at the time of this inspection.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the home. 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 home is run.

The registered provider had safe recruitment processes in place and background checks had been completed before new staff were appointed to ensure they were safe to work at the home.

Staff were well supported by the provider and registered manager. They had been provided with the training and development they needed, which ensured people’s individual needs were met.

Staff knew how to manage any identified risks and people’s individual health and nutritional needs were managed effectively and in ways that met with their wishes and preferences. Staff also knew how to recognise and report any concerns they had regarding people’s safety so that people were kept safe from harm. The registered manager and staff had developed good working relationships with other professionals involved in people’s care which ensured they had the full range of support they needed.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. The registered manager demonstrated their understanding of how to identify restrictions to people’s freedom and apply for DoLS authorisations if this was required. At the time of the inspection no-one who lived in the home had their freedom restricted.

Staff provided the care described in each person’s care record and had access to a range of visiting health and social care professionals when they required both routine and more specialist support. Arrangements were also in place for supporting people to take their medicines when they were needed. These included ordering, storing, administering and disposing of medicines in the right way.

Staff understood what was important to people and worked closely with them and their relatives. The development of these relationships ensured each person had access to a range of meaningful activities and could maintain their individual interests toward sustaining an enjoyable life. People were provided with a good choice of nutritious meals and when necessary, people were given any extra help they needed to make sure that they eat and drank enough to stay healthy.

We found the culture developed by the provider and registered manager was based on openness and inclusion. People, their relatives and staff members were encouraged to express their views and the provider and registered manager listened and took action to resolve any concerns identified. Formal systems were in place for handling and resolving complaints.

The provider and registered manager had systems in place to regularly assess and monitor care practices and the overall running of the home. The systems in place meant that any shortfalls in quality would be identified quickly and improvements made.

When we visited Greenacres Care Home we used a number of different methods to help us understand people’s experiences. We spoke with two people who lived at the service, two relatives, two staff members, and the Home Owner.

We also looked at records. These included care records and information about how the service operated.

One person told us, “I have not been here long but the care is first class. I plan to go home at some point and the home is supporting me with all my plans and decisions.”

A visiting relative said, “Visitors come and go throughout the day. There is always something going on here and I think the care is given in a way that makes it feel like my home as well as my relatives.”

People were supported sensitively and their dignity maintained when staff provided physical care. Staff also encouraged people to take part in meaningful activities.

We found that the Home Owner had managed and monitored the service regularly and gained views on the service from people who used the service and their relatives.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

One relative told us, “I have absolutely no concerns. XX is very happy here and I would not want them to by anywhere else.”

We found people were cared for in a clean, well presented home. People’s care was based about their individual needs. The staff provided care in a pleasant and professional manner and had time to interact with people. One person living at the home said, “The staff and owner are wonderful, they cannot do enough for you.”

We saw the cook provided a choice of hot and cold foods at each mealtime and snacks throughout the day. One relative told us, “The food is absolutely wonderful.”

We looked at the premises and saw it was in a good state of repair. Equipment had been serviced at regular intervals and the home possessed valid gas and electrical safety certificates. We saw the kitchen had been awarded 5 stars following an environmental health inspection in May 2012.

People who live at the home, and the visitors we spoke with, told us they were happy with the service provided and confirmed they were involved in every aspect of planning their own care. They said they thought the home was clean and tidy and said they were encouraged to personalise their rooms. A relative told us that the owner was “very good and really cares about people.” During our visit no one raised any concerns or complaints with us.

People told us that although there were no planned social activities staff did ask them if they wanted to play dominoes and cards, do some knitting or have a manicure. They said they were happy chatting, reading and watching television. They said they enjoyed the entertainers who visited the home regularly and local school children coming to sing for them.

People were complimentary about the food provided by the home. They told us they were offered choices and if they did not like what was on the set menu they could select something else. One person said, “This fish pie is lovely.”

The people we spoke with confirmed their needs were being met and staff were supportive and helpful. They told us staff were good at their job and we received only positive comments about how they provided care. One person said, “They are all just wonderful.”