This inspection took place on the 18 July 2018 and was unannounced. Greville 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. Greville House is registered to provide accommodation for up to 25 people. At the time of inspection there were 24 people living at the home.

There was 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.’

At the previous inspection in November 2015, the service was rated as ‘good’ in all key questions. At this inspection we found there were areas for improvement and development. This was because at times people’s choices and wishes were restricted and limited and improvement was required in relation to the recording and documentation of some people’s care records and some of the quality assurance processes.

Staff were kind and caring in their approach and knew people well. However, people told us that there were not enough staff to have time to talk to them. There was a bath and shower rota in place and people told us they could not have a bath or shower as and when they chose. People were unable to have hot meals at breakfast and felt their breakfast options were limited.

There were times throughout the inspection when the registered manager informed us of conversations that had taken place and actions completed that we would not corroborate. This meant the recording of information and documentation required improvement.

People told us they felt safe at Greville House and we found there were enough staff to meet people’s needs. People were safeguarded from harm. Staff demonstrated they knew how to spot signs of abuse and how to report concerns. Accidents and incidents were analysed to look for trends and reduce reoccurrence. Risks to people were minimised because staff knew people well and knew what to do to reduce the risks. People received their medicines as prescribed. The provider had safe recruitment procedures in place.

People were supported by staff who had the skills and knowledge to meet people’s needs. Staff had regular training and found this useful. They had regular training via a workbook. People told us they enjoyed the food and we saw that meal times were an enjoyable experience. People were involved in the development of the menu. People had access to professionals where required. At the time of inspection, there was nobody living at the service that was being deprived of their liberty. Staff demonstrated an understanding of the Mental Capacity Act 2005 but required further training on this.

People’s needs were assessed and reviewed regularly with their involvement and input. Relatives were updated when things changed. People had a range of activities which they told us they enjoyed. People knew how to complain and we saw people and relatives approach the registered manager throughout the day. People’s independence was encouraged and their privacy and dignity was maintained.

People and relatives told us they felt the registered manager was approachable. Feedback was sought from people and their relatives and this information was used to drive improvement. Processes and systems in place had not identified issues we identified.

This inspection took place on 9 November 2015 and was unannounced. At the last inspection on 12 November 2013, the provider was meeting the regulations we inspected.

Greville House is a residential care home providing care and support for up to 25 older adults with low dependency care and support needs. At the time of our inspection 22 people lived at the home.

There was 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.

People who lived at the home felt safe and secure. Relatives believed their family members were kept safe. Staff felt people were kept safe. The provider had processes and systems in place to keep people safe and protected them from the risk of harm.

People received their medicines as prescribed and appropriate records were kept when medicines were administered by staff who were trained to do so.

Risks to people had been assessed appropriately and equipment was maintained and available for staff to use.

There was sufficient staff on duty to meet the support needs of people. The provider ensured staff were recruited and trained to meet the individual needs of people.

People were supported to have choices and received food and drink at regular times throughout the day.

People were supported to access health care professionals to ensure that their health care needs were met. People’s health care needs were assessed and regularly reviewed.

People, relatives and health care professionals, felt staff were caring, friendly and treated people with kindness and respect.

People were involved in group or individual social activities to prevent them from being isolated.

People and relatives were confident that if they had any concerns or complaints, they would be listened to and the matters addressed quickly.

The provider had management systems in place to assess and monitor the quality of the service provided. This included gathering feedback from people who used the service and their relatives.

We visited Greville house on the 12 November 2013, at the time of our inspection there were 18 people living at the home, which was undergoing extensive building work to improve facilities and increase the number of beds available for the people using the service. To find out about people's experiences and what it was like to receive care from this provider we spoke with five members of staff and five people using the service.

People using the service were supported to be involved and make decisions about their care. One person using the service said; “It’s like one big happy family here”.

People are in receipt of effective and appropriate care that meets their needs. All

staff we spoke with told us they had the information they needed to care for people safely. One member of staff said; “I treat the people how I would treat my mum and dad”.

There were systems and procedures in place so that medicine was administered, stored and disposed of safely. People received their medicines as prescribed by their doctor to ensure their health needs were met.

All staff we spoke with told us they felt supported by the manager, and had regular training opportunities. One member of staff we spoke to said; “They have an open door policy here, I feel I can comment to them about anything”. This meant staff were supported by the provider to carry out their responsibilities.

People received a service that met their expectations and enabled them to make choices and they were involved in developments in the quality of the service they received through regular consultations. One person we spoke with said; “If I have a grievance I am happy to take it straight to the top”.

At the time of our visit there were 18 people living at the home. We spoke to eight people, four staff a visiting relative and health care professional. The registered manager was on holiday.

We saw that people were involved in making choices about what they wanted to do and what they ate and drank. One person told us that staff asked them what help they wanted. People were able to maintain their independence.

People’s health care needs were met by either visiting the doctor or having home visits from the doctor and other health care professionals.

People told us they had choices at all meal times and we saw that staff offered choices at lunchtime. One person told us, “There’s plenty of food”.

Staff knew how to protect people from harm and were confident that action would be taken to protect people if they raised any concerns. All the people we spoke with said they felt safe in the home.

Staff were knowledgeable about people’s needs. One person told us, “Staff are friendly, it’s a very well organised home”. Another person told “Staff come quickly if I buzz”.

The provider ensured that there was adequate monitoring of the service to ensure that people received a good service that met people’s needs.