We last carried out a comprehensive inspection of Greenways in June 2016 where we found the registered provider was rated ‘Good’ in each of the five key questions that we ask.

This inspection took place on 14 November 2018 and was unannounced.

Greenways is a 'care home'. People in care homes receive accommodation and nursing or personal care as a 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 service has 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 with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Greenways is registered to provide accommodation and personal care for up to five adults who have a learning disability. At the time of our inspection four people live here. The service is delivered from a two-story house in a residential area.

It is a requirement of the provider's registration that they have 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 registered manager was present during this inspection.

Greenways continues to provide a good level of care and support to people.

The registered manager and staff team at Greenways ensured people were safe. Risk s to people’s health and safety were well managed without restricting people’s choice to take part in ‘risky’ activities such as horse riding. Staff understood their responsibilities about protecting people from abuse, and knew who they must contact if they suspected it was taking place. Where accidents took place, these were reviewed to prevent a re-occurrence.

Staffing levels were based on the needs of the people who live here. The provider’s recruitment process ensured staff were safe to work with the people living at Greenways.

People lived in a clean home, and the risk of the spreading of infections was well managed through use of protective equipment such as gloves and aprons.

People received their medicines when they needed them. The storage and disposal of medicines was carried out in accordance with national best practice guidance.

Procedures were in place to ensure that before someone new came to stay at the home, the staff and home would be able to meet their needs. The registered manager said that people from the lesbian, gay, bisexual or transgender communities would be made to feel safe and welcome if they came to live here. Staff received effective training and supervision to ensure they had the skills necessary to meet people’s needs.

People were supported to have enough to eat and drink. Dietary preferences and support needs were accommodated. People had a good level of access to health care professionals for routine appointments, or if they felt unwell. Staff worked well as a team to ensure that information was passed from one shift to the next so that people had care and support that met their changing needs.

The house where people live had a homely feel, and some adaptations had been made to meet people’s needs, for example smooth flooring to reduce the risk of trips and falls. Some areas of the homes decoration looked tired, such as the bathroom and carpets. The registered manger was in the process of applying for improvements to the environment so that people’s future needs (for example if their mobility decreased) could be accommodated.

Peoples rights under the mental capacity act where understood by staff. The requirements of the act were followed to ensure people’s consent was sought befor

Greenways provides accommodation and personal care for up to five adults with a learning disability and/ or autistic spectrum disorder. At the time of our inspection five people were living at the home. The inspection took place on 20 May 2016 and was unannounced.

The home is presented across two floors with access to the first floor via stairs. People had single rooms. Communal space consists of a lounge area and dining room. There is a private garden with a patio at the rear of the property.

There was a registered manager in post, and they were at the home 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.

The home was well decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid people’s mobility needs. The home had a homely feel and reflected the interests and lives of the people who lived there, with photos of people and pictures they had made.

There was positive feedback about the home and caring nature of staff from people who live here. One person said, “I can sum it up by saying it is A1 here. Home is the right word, I feel like part of the family.” A relative said, “This is a first class, quality home form home for my family member.”

Another relative said, “I wouldn’t mind living there myself.”

People were safe at Greenways. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. People were involved in these decisions because staff took the time to explain to them in a way they could understand.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. People were supported to manage their own medicines where possible. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. These procedures were regularly discussed with people to ensure they knew how to respond in an emergency. An alternative location for people to stay was also identified in case the home could not be used for a time.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty may have been restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People were complimentary about the food, One person said, “I enjoy the food.” A relative said, “When I drop my family member back at the home there is a smell of the most wonderful cooked meals.” Staff had a good understanding of specialist diets that people were on to ensure people could eat and drink safely, and still enjoy their meals.

People were supported to maintai

We visited Greenways to look at the care and welfare of people who used the service. We were not able to speak to most people using the service because they had gone out on activities for the day. We spoke briefly with three people before they left, and spent time with the one person who chose not to go out that day.

All the people we spoke with said they liked living at the home. Staff were seen to interact well with people as they were preparing to go out. People appeared relaxed and happy.

We saw that systems were in place to ensure staff worked with the consent of people using the service.

People who used the service, relatives and advocates had been involved in the planning of care. We saw that risks had been identified to protect the welfare and safety of people.

We saw that there were systems in place to protect people from abuse. Staff had received training. Information about what to do if abuse was suspected was available.

We looked around the house and saw that it was clean and tidy. A cleaning schedule was in place and was followed by staff.

We saw that the provider carried out appropriate checks when employing staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

The provider had systems in place for monitoring the quality of the service and sought the views of people who used the service.

During our visit we met everyone that lived in the home. Some people were not able to verbally tell us about their experience of living at the home. However, we saw that they joined in with activities and their body language and facial expressions seemed positive and happy. We spoke to three people who used the service who told us that they liked living at the home.

We saw that staff treated people with dignity and respect. People told us that they chose what they wanted to do every day. One person told us “I go to London on the train for beer and lunch”. Other people went to a day centre where they stayed for lunch and returned home in the afternoon.

We looked at care records and saw that each person had an up to date care plan that informed staff of how to support them. People also had a person centred plan called “All about me” that described their life, hobbies, likes and dislikes in photographs.

We spoke with staff who told us that they had received training in safeguarding vulnerable adults and knew what to do if the saw or suspected abuse.

Staff told us that they felt well trained and supported to do their jobs. We saw staff records that confirmed staff training took place regularly and that staff received regular supervision and guidance.

We spoke with staff who told us that they knew what to do if someone raised a complaint. We saw that the provider had a complaints policy and a complaint file although there were no complaints logged.

All the people we spoke to appeared relaxed and involved in preparations for going shopping with staff, watching television and sitting chatting to staff.

We saw people choosing where to sit and relax in the home, and choosing which activities they wanted to be involved in.

We observed good interactions between staff and people who use the service. We observed that staff were attentive to those at home and they demonstrated a good understanding of their communication styles or body language. Staff were seen to offer

support and guidance in a sensitive, knowledgeable and caring manner.