About the service: Greenacres is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Greenacres provides accommodation, care and support for up to five people with a learning disability.

People’s experience of using this service:

¿ People were positive about Greenacres and liked living there. Comments included, “I have my own apartment and I have time to myself or time with staff if I want this,” and, “I like my flat.”

¿ People were protected from avoidable harm and abuse.

¿ Risk assessments were in place to ensure people and the environment they lived in was safe.

¿ People received their medicines when they needed them.

¿ Staff were recruited safely and staffing levels were sufficient to meet people’s needs.

¿ Staff were knowledgeable and were kind, caring and patient.

¿ The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

¿ People's health was well managed and there were links with other services to ensure that their individual health needs were met.

¿ People were treated with dignity and respect.

¿ Staff knew people well and had developed meaningful relationships with them. Support was provided in a person-centred way based on people’s preferences.

¿ People were supported to have choice in their daily lives and staff supported them in the least restrictive way.

¿ People could take part in a range of activities which promoted their wellbeing.

¿ Quality assurance processes were in place and actions were taken to address any issues identified.

¿ The service was run well by a registered manager who was held in high regard by people, their relatives and staff.

¿ The registered manager had good oversight of the service.

Rating at last inspection: Good (report published 19 September 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on the 9 August 2016 and was announced.

Greenacres provides care for up to 3 people. The home supported people who had a range of learning disabilities. People lived in self-contained flats within the service.

There is another home next door called Pinetops. This is owned by the same provider and has the same registered manager. As a result there are similarities with both homes in terms of the management and the administration of the services. We inspected these services during the same week.

There was a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. During this report we will refer to the registered manager as the manager.

People benefited from being supported by staff who were safely recruited, well trained and who felt supported in their work by their colleagues and by the manager. There was consistently enough staff to safely meet people’s individual needs.

Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Medicines were administered safely and adherence to best practice was consistently applied. People received their medicines on time, safely and in the manner the prescriber intended. The service regularly audited the administration of medicines. Medicines were stored securely.

Staff knew and understood the needs of people living at Greenacres.

Staff received yearly appraisals. Staff also had regular supervisions. The manager observed practice and was involved in the daily running of the service.

Staff told us they were happy working at Greenacres. They assisted people with kindness and compassion. People’s dignity and privacy was maintained and respected. People were treated as individuals.

The Care Quality Commission (CQC) is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service was depriving some people of their liberty in order to provide necessary care and to keep them safe. The service had made applications for authorisation to the local authority DoLS team. The service was working within the principles of the MCA.

The manager and the staff’s knowledge and understanding about mental capacity and DoLS was variable. When we raised this with the manager, they put a plan in place to address this.

People’s care plans contained important, relevant and detailed information to assist staff in meeting people’s individual needs. People had been involved in making decisions around the care they received. People’s needs had been reviewed. People’s care was person centred.

People were supported to maintain good health and wellbeing. The service reacted proactively to changes in people’s health and social care needs.

The service had links with the local community and the manager planned to develop this in the future

The service encouraged people to maintain relationships with people who were important to them. There were planned activities on a daily basis to support people to maintain their interests and fulfil their goals.

There was a positive, open culture and a welcoming and friendly atmosphere at Greenacres. There were systems in place to monitor the quality of the service. Although there appeared to be delays at the provider level (New Boundaries) for some of the improvements to the building and garden, the manager and staff wanted to make.

During our visit on 08 July 2011, we were not able to speak with people directly about what they felt about the care and support offered to them at Greenacres. People were either unable to speak with us or did not want to.

Because of this we made sure that we looked at how staff interacted with people, understood their needs and made efforts to communicate to find out what people wanted.