What life is like for people using this service:

• People enjoyed living at Greenhill Park Residential Home and felt safe and comfortable around staff who understood their needs. Staff knew how to recognise and report abuse.

• Staff recognised the risks to people's health, safety and well-being and how to support them safely. Where relevant, specialist equipment was used by staff who understood how to use this safely..

• People had access to support from sufficient staff when needed.

• Staff recruitment processes included a check of their background to review staff suitability to work at the home.

• People received support with the medicines. Regular checks were undertaken to ensure people received the correct support by staff who were competent to help them.

• The home was clean and odour free and staff understood and practised infection control techniques to promote people’s continued health.

• The registered manager ensured people's care was based on best practice standards and staff had the correct training to meet people's needs.

• Guidance on people's needs was also shared through supervision and staff meetings.

• People were offered choices at mealtimes and encouraged to decide what menu options they would like.

• People were supported to attend healthcare appointments and advice from healthcare professionals was incorporated into people's care.

• People were treated with dignity and respect and their independence was promoted.

• People and their families were involved in planning their care with support from staff.

• Staff supported people to enjoy a range of activities which reflected people's individual interests.

• People and their families understood how to complain if they wanted to. Systems were in place to take any learning from any complaints made.

• Staff felt supported by the registered manager and felt part of a newly established team that were keen to develop people's care further.

• Staff worked together with the registered manager and families to ensure people's care was continually monitored, reviewed and reflected people's needs.

• The registered manager and staff worked with stakeholders such as the local authority and hospice to improve people's experience of care.

We found the service met the characteristics of a "Good" rating in all areas; More information is available in the full report

Rating at last inspection: Good (04 February 2016)

About the service: Greenhill Park Residential Home was providing personal and nursing care to 34 people aged 65 and over at the time of the inspection.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

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

This inspection took place on 31 December 2015 and was unannounced.

The home provides accommodation and personal care for a maximum of 34 people. At the time of our inspection 29 people lived at the home.

There was a registered manger in post at the time 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.

We carried out an unannounced comprehensive inspection of this service on 25 February and 3 March 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponded with two breaches of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014. These breaches were due to shortfalls in how consent to care was obtained and how people were lawfully restricted.

At this inspection we found action had been taken to ensure people who lacked capacity were safeguarded in line with the Mental Capacity Act 2005. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. In addition the provider had taken appropriate steps to ensure people who lacked capacity gave their consent to their care. We found where necessary assessments were undertaken regarding people’s ability to make specific decisions. Best interest decisions had taken place which had involved suitable people. Where people were restricted applications had been made to the local authority to legally support people in the least restrictive way.

Staff knew how to protect people from risks. People and their relatives told us they felt safe. Staff were aware of the signs of abuse and knew how to report these as well as of other agencies who may be involved. Risk assessments were in place to ensure people were kept safe. Staff were aware of these and how they could be minimised.

People who lived at the home knew the staff well and believed there were sufficient numbers on duty to meet care needs. We saw staff were kind and caring towards people at the home. Care and support was provided in a way to meet people’s individual needs. People confirmed staff ensured their privacy and dignity was maintained. People’s medicines were administered and managed in a safe way and as prescribed.

People were encouraged to eat and drink in order to maintain their wellbeing. Staff were aware of people’s likes and dislikes as well as any specific dietary needs. People told us they liked the food and had a choice available to them.

We found people had access to healthcare professionals when they needed them as well as specialists. Arrangements were made to ensure people were able to attend appointments outside of the home.

We saw people were involved in planning care around their needs. People felt they were listened to and their views taken into account. People as well as their relatives knew how to raise concerns about the care provided.

The registered manager was well liked by people who used the service as well as their relatives and members of staff. Checks were in place to ensure quality care was provided. People and their relatives were able to participate in this to improve the service.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions

During our inspection of Greenhill Park Residential Care Home we set out to answer our five questions.

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We saw that people who used the service felt safe at Greenhill Park Residential Care home. We saw that staff were kind and friendly towards them and provided the care and support they needed.

We found that risk assessments were in place and that these made sure that people were not placed at risk of inappropriate care and support.

Risks to people who used the service and staff had been identified and managed in a way that made sure people were not placed at risk of inappropriate care. We found that equipment had been checked and serviced at regular intervals to ensure it was safe to use.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted the registered provider and staff understood when an application should be made and how to submit one.

Is the service effective?

People's health and care needs were assessed and care and treatment was planned and delivered in line with their individual needs. We found that relatives had been involved.

People were involved in day to day decisions and could make choices about what support they needed.

We found from our observations and from speaking with staff that they had a good understanding of people's care and support needs. We found that people’s mobility and mental health care needs had been taken into account in relation to the environment.

Is the service caring?

We saw that staff treated people kindly. We saw staff interactions were often supportive and respectful. Staff assisted people sensitively, whilst at the same time promoting their independence as much as possible. We saw that staff supported people and provided comfort and reassurance and gave people time to respond.

We saw that staff respected people’s choices and they helped people to promote their own independence. We found that people were able to make choices about their food and drink and where they spent the day.

Is the service responsive?

We found that people were confident that any issues they had would be responded to in a timely way.

People received help and support from health care professionals when required such as doctors, dentist and chiropodists.

Is the service well led?

People who used the service as well as relatives spoke highly of the management. People felt that they could approach the registered manager and felt assured that any worries or concerns would be listened to and addressed.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to systems to regularly assess and monitor the quality of the service provided.

Greenhill Park provided care for older people. During this inspection we spoke with nine people who used the service, one relative, the provider, registered manager and three staff. People we spoke with were complimentary about the care and support that they received. One person said the home was: “Very clean, cosy and warm”.

People told us that they felt involved in any decisions that needed to be made about their care and these were made in their best interests. We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We found that medicines were prescribed and given to people appropriately that ensured they were managed safely.

Staff had been recruited in an appropriate way and checks had been undertaken that ensured they were suitable to care for vulnerable people.

We found that any comments and complaints people made had been responded to appropriately and ensured that people were listened to.

When we visited Greenhill Park we spoke with several people who used the service. We found that people were able to express their views and had been involved in making decisions about their care and treatment. We found that people's privacy, dignity and independence were respected.

We found that care and treatment had been planned and delivered in a way that met with the essential standards. We talked with several people about their experience of the care and service they had received from the service. They were complimentary about the care and support that they received from the service. People told us the service was “very good”. The home was “lovely”. They “could not have anywhere better”.

We found that people who used the service were protected from the risk of abuse. People who used the service told us they felt safe and they were aware of how to complain.

People told us that they received a good standard of care from the staff who worked for the service. They told us that staff were “very nice kind people” and they were “very good”.

We found that staff received appropriate induction and training. Staff told us that they liked working at Greenhill Park as it was a “very friendly place” and it was “like a home, I like it”. Staff told us they were “always doing training here”. People were cared for by staff that were supported to deliver care and treatment safely and to an appropriate standard. However, the supervision of staff had not been formalised and recorded to show that all staff had been appropriately supported. There were no records to show that the potential risks of people not receiving care to an appropriate standard had been considered.

People who used the service were asked for their views about the care and treatment provided. We found that overall, the provider had an effective system in place to regularly assess and monitor the quality of service that people received.

We found that there were some gaps in records at the service. This meant that people may not have been fully protected from the potential risk of inappropriate care and treatment.

This inspection took place on 25 February and 3 March 2015 and it was unannounced.

The home provides accommodation and personal care for a maximum of thirty four people. At the time of our inspection thirty people lived at the home. The provider had no vacancies as one person was in hospital and double bedrooms were been used as single rooms. People who lived at the home may have a physical disability or a dementia related illness.

We previously inspected the service in May 2014 and found that the provider had breached Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in that they were not able to assess the quality of the service provided. At this inspection we found that improvement had taken place and that arrangements were in place such as the carrying out of audits.

One of the providers is also the 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 Care Quality Commission is required to monitor the implementation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). We found that the provider had not followed these requirements as equipment was in place and used without people’s consent or a best interest decision. In addition people would not be able to leave the home without staff supervision. We found that no applications to the local authority for these to be assessed had been made. You can see what action we told the provider to take at the back of the full version of the report.

People were relaxed when they spoke with staff. There was a calm atmosphere within the home. We saw that staff responded appropriately to people who lived at the home and their relatives.

People told us that they were well cared for and that they felt safe. Staff were able to tell us how they kept people safe and the action they were take if people were at risk. We found that incidents which had occurred at the home had not always been reported to external agencies such as the local authority and the Care Quality Commission.

We were told that there was enough staff on duty to care for people and ensure their individual needs were met. People received their medicines as prescribed and at the right time although practices needed to be improved regarding the application of creams.

People had access to healthcare professionals who felt part of care provided at the home. Healthcare professionals were confident that staff responded appropriately to the advice they had given.

People were supported to eat and drink sufficient amounts to maintain their wellbeing. People had access to drinks and were offered a choice of menu. People had access to a range of social events and activities within the home in order to maintain hobbies and interests. People and their relatives told us that staff were caring and attentive. We saw people engage in friendly conversation with staff. Staff supported people with dignity and encouraged independence where possible.

Staff knew about people’s needs and had undertaken training to ensure that they had the skills and knowledge needed to care for people.

The registered manager was open to managing people’s comments and complaints and people were confident that these would be resolved. The registered manager was approachable and had sought the views of people, their relatives, healthcare professionals and staff in relation to the care and support provided.