Greenway House Residential Home is a care home. 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. The care home accommodates up to 12 people in one adapted building, arranged over two floors. At the time of our inspection, there were 11 people living there, some of whom were living with dementia. There is a communal lounge and a separate dining room on the ground floor. There is also a conservatory and garden area that people can access.

There is a registered manager in post. 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 systems the provider had in place were not always effective in identifying concerns or driving improvements within the home. The provider had sought feedback from people and relatives however had not used this information to make changes. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice. We have made a recommendation about identifying concerns and driving improvements.

People were happy with the staff that supported them and the provider had ensured they were suitably recruited. There were enough staff available for people. People were encouraged to be independent and make choices about their day. Their privacy and dignity was also considered. People were happy with the food and drink that was available. They were given the opportunity to participate in activities they enjoyed.

Risk to people were considered and reviewed and medicines were managed in a safe way. Staff received an induction and training that helped then support people. Staff understood safeguarding and how to protect people from potential harm. The home was decorated in accordance with people’s needs and preferences.

Staff offered consistent care and knew people well. There was a complaints procedure in place and they knew how to complain. People were supported to access health services when needed. Staff felt listened to and knew who the registered manager was. Relatives and friends could freely visit the home. The provider worked jointly with health professionals who came into the home. The provider was displaying their rating in line with their requirements. There was a system in place to ensure lessons were learnt when things went wrong.

Greenway House is a care home. 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. Greenway House is registered to accommodate 12 people in one building. Some of the people living in the home are living with dementia. At the time of our inspection 11 people were using the service. Greenway House accommodates people in one building and support is provided on two floors. There is a communal lounge and dining area, a conservatory and a garden area that people can access.

This inspection visit took place on the 5 December 2017 and was unannounced. The inspection visit was carried out by one inspector. The home was previously rated as good in all domains.

The service had a registered manager in post. 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 could not be sure people were protected from harm as incidents and accidents were not always investigated or reported to the local authority safeguarding team when needed. As these incidents were not fully considered we did not see how the provider was using this information to learn lessons or make improvements within the home. Some quality audits were completed by the provider however this was not used to drive improvements and make changes to the service as required.

As the provider had not fully considered the mental capacity act, people are not supported to have maximum choice and control of their lives and staff do not support them in the least restrictive way possible; the policies and systems in the service do not support this practice.

Individual risks to people had been considered and for these people risk assessments were in place. Staff had the information available to support people in a safe way. Staff received training and an induction and the provider ensured staff suitability to work within the home. Medicines were managed in a safe way to ensure people were protected from the risks associated to them. There were enough staff available for people and they did not have to wait for support.

We found people were happy with the staff and the care they received, this was considered in a personalised way. People’s cultural needs had also been considered by the provider. People were encouraged to remain independent and make choices for themselves, including the activities they participated in and the food they ate. People’s privacy and dignity was also considered. When people needed support from health professionals this was provided for them.

There were infection control procedures in place and these were followed by staff. The provider had received no complaints however people knew how to complain and felt they would be listened to. Staff felt supported be the management team and were happy to raise concerns. The provider was not currently delivering end of life care.

This is the first time the service has been rated Requires Improvement. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We inspected this service on 7 December 2015. This was an unannounced inspection. The service had not been inspected since re- registering in April 2013. Prior to this the service had been inspected and was compliant in all the areas we looked at.

The service was registered to provide accommodation for up to 12 older people who may have dementia. At the time of our inspection 9 people were using the service.

The service had a registered manager in post. 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. There were two registered managers in post. The registered managers had a job share arrangement in place.

People told us they felt safe and staff demonstrated they knew how to recognise and report potential abuse. Risks to people were managed in a positive way to keep people safe and promote independence. There were effective systems in place to administer store and record medicines to ensure people were protected from the risks associated to them. We saw there were enough staff to meet people’s needs. Staff who worked at the service had checks to ensure they were suitable to work there.

When people were unable to consent mental capacity assessment and best interest decisions were completed. The provider had considered when people were being restricted unlawfully and Deprivation of Liberty Safeguards (DoLS) authorisations were in place. Staff knew their role within this and how to protect people.

People told us there was enough food and drink and they were offered a choice. When needed people were referred to healthcare professionals for support. Staff completed training that supported them to have the skills to meet people’s needs. People and families told us they were involved with reviewing their care.

People were treated in a kind and caring way and their privacy and dignity was promoted by staff. They were able to remain independent and make choices about how they spent their day. People were offered the opportunity to participate in activity’s they enjoyed. Friend and family told us they could visit the service when they liked and the registered manager was always available.

The provider sought feedback from people and families who used the service and used this information to make improvements. Quality checks were completed to bring about changes. Staff felt listened to and were given the opportunity to raise concerns.