Greenfield House is registered to provide accommodation and personal care for up to 10 people with a learning disability. At the time of our visit 10 people were living in the home. Eight people lived in the main section of the home and two people lived in a separate flat with their own kitchen and living room.

The inspection visit took place on 21 September 2016 and was unannounced.

The service had 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 registered manager was also an owner of the company.

There were enough staff to meet people`s needs effectively and to support them to participate in activities outside the home. Staff were trained in safeguarding people from abuse and understood their responsibilities to report any safeguarding concerns they may have. Relatives were confident that people were safe at Greenfield House because staff were skilled and knowledgeable, and knew people well.

Training was provided for staff to help them carry out their roles safely and staff were encouraged to gain nationally recognised qualifications to support their practice. People received their prescribed medicines as prescribed from staff who had received training in how to manage medicines safely.

Staff had received training in the Mental Capacity Act (MCA) 2015 and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests. Where people’s liberty needs to be restricted for their own safety, this must be done in accordance with legal requirements. The provider understood their responsibility to comply with the requirements of the MCA and staff worked within the principles of the Act.

People were supported with their eating and drinking as required and staff helped people to maintain good health by supporting people with their day to day healthcare needs.

Relatives were extremely positive about the caring attitude of staff and the friendly atmosphere within the home. Relatives told us staff knew people well and understood their abilities, support needs, habits, preferred routines and social preferences. Staff were caring, treated people with respect and made sure their dignity was maintained. People were supported to continue relationships with those who were important to them.

Care plans were centred on the needs of individuals so staff had the information they needed to provide person centred care. Care was subject to on-going review and the views of relatives were encouraged and valued. Staff were responsive to people's social needs and supported them to attend clubs and groups to follow their interests.

Staff understood their roles and were well supported by the management team through one to one supervision meetings and appraisals. People and staff told us the registered manager was effective and approachable.

Procedures were in place to monitor the quality of the service provided and to reduce potential risks and drive improvement. The provider monitored the service to ensure people received safe, effective care that was responsive to their needs.

During the inspection we spoke with three members of staff and the registered manager. We also spoke with relatives of people who used the service and carried out observations as people were unable to express their views about the service due to their communication difficulties.

We saw that people were treated with dignity and respect. Care was assessed and planned for to meet the individual needs of people who used the service.

Relatives of people who used the service told us that they were happy with the care that was provided. One relative told us, “I am very happy with the support that X receives. The staff and manager have a genuine understanding of X’s needs and always act in their best interests”. Another relative told us, “I am more than happy. I am always involved in X’s care.”

Staff we spoke with understood the various types and signs of abuse. Staff were able to explain the actions they needed to take if they had concerns that a person who used the service was at risk of harm.

The provider had an effective recruitment system in place. Appropriate checks had been undertaken by the registered manager which ensured that staff were suitable to provide support to vulnerable people.

We found that the provider had systems in place to monitor the quality of the service and gain feedback from representatives of people who used the service. Relatives we spoke with told us that the service was well led by the registered manager.

We saw that eight people used the service at the time of our inspection. Two people who used the service shared an annex to the main building. They enjoyed their own living area, kitchen and household facilities but could move freely between the annex and the other parts of the home and socialise with the other people who used the service and staff.

All the people who used the service needed one to one personal care to meet their needs.

We met with all the people who used the service and the staff who were on duty and we saw how the staff interacted with and helped people in their care.

We spoke with relatives, staff and with an advocate who ensured decisions were in people’s best interest.

The people living at the service were not able to tell us about the service. However we spoke to professional health and social care staff from the local health trust and from the local authority who worked with people that lived at the service. We also spoke to some relatives who had regular contact with the service. Everyone one we spoke to was very positive about the support people received.

We were told that people had their health care needs met and that staff were good at monitoring people’s health care conditions. Everyone one had a health action plan and had their health checked every year.

Professionals told us that people had communication plans in place and that they were supported to make decisions about their lives. The staff were aware of people’s likes and dislikes and knew how people communicated these.

Where people needed support with their behaviour, plans were in place and staff were trained in how to respond appropriately.

We were also told that people’s personal care needs were met and that people were always dressed appropriately.

We observed that people were supported to be as independent as possible. Some people helped to lay and clear the table, and helped to keep their room tidy. People took part in a number of social activities including going out for meals, swimming, playing games, listening to music and going for walks.

Relatives of people that lived there were very happy about the care provided. They felt that the staff were excellent and that they knew their relatives well understanding them and knowing how to provide the care they needed. We observed that staff spoke with people in a kind and respectful way.