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Inspection carried out on 28 November 2017

During a routine inspection

Greenacres is registered to provide accommodation and personal care for up to 60 older people who may be living with dementia and/ or a physical disability.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service has 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.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm. There was sufficient numbers of staff to support people safely. Staff took appropriate precautions to ensure that people were protected from the risk of acquired infections. People’s medicines were managed safely, and there was evidence of learning from incidents.

People’s needs had been assessed regularly and they had care plans in place that took account of their individual needs, preferences, and choices. Staff had regular supervisions and they had been trained to meet people’s individual needs effectively.

The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people’s consent prior to care and support being provided. Where required, people had been supported to have enough to eat and drink to maintain their health and wellbeing.

People were supported by caring, friendly and respectful staff. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.

Staff regularly reviewed the care provided and were guided through regular input by the person receiving care to ensure the care provided continued to meet their individual needs, in a person centred way.

The provider had an effective system to handle complaints and concerns.

People on end of life care were supported by the home and staff to remain comfortable and have a dignified and pain-free end to their lives.

The service was well managed and the provider’s quality monitoring processes had been used effectively to drive continuous improvements. The registered manager provided stable leadership and effective support to the staff. They worked well with staff to promote a caring and inclusive culture within the service. Collaborative working with people, their relatives and other professionals resulted in positive care outcomes for people using the service.

Further information is in the detailed findings below.

Inspection carried out on 8 March 2016

During a routine inspection

This inspection took place on 8 March 2016 and was unannounced. The home provides accommodation and personal care for up to 60 older people, some of whom may be living with dementia. On the day of the inspection, there were 57 people living in the home.

The service has 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.

People were safe and there were systems in place to safeguard them from the possible risk of harm. Risks to each person had been assessed and managed appropriately, and there were risk assessments that gave guidance to staff on how risks to people could be minimised.

The service followed safe recruitment procedures and there were sufficient numbers of suitable staff to keep people safe and meet their needs. There were safe systems for the management of people’s medicines and they received their medicines regularly and on time.

People were supported by staff who were trained, skilled and knowledgeable on how to meet their individual needs. Staff received supervision and support, and were competent in their roles.

Staff were aware of how to support people who lacked mental capacity to make decisions for themselves and had received training in Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. People’s nutritional needs were met and they were supported to have enough to eat and drink. They were also supported to access other health and social care services when required.

People were treated with respect, and their privacy and dignity was promoted. People were involved in decisions about their care and support they received.

People had their care needs assessed, reviewed and delivered in a way that mattered to them. They were supported to pursue their social interests and hobbies and to participate in activities provided at the home. There was an effective complaints procedure in place.

There were systems in place to seek the views of people, their relatives and other stakeholders. Regular checks and audits relating to the quality of service delivery were carried out. There were effective systems in place to monitor the quality of the service.

Inspection carried out on 10 May 2013

During a routine inspection

During our visit, the people we spoke with said that they were being well looked after and cared for. One person said, "I have moved from another care home. I like it here. The staff are quite nice. The food is good. I have no concerns. Everything is fine." Another person said, "I came two days ago. The staff are looking after me. The food is good. I am not aware of any activities taking place though. I like to read my papers."

We found that people's needs were being met appropriately. They were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. Staff had been provided with training relevant to their work, and there were systems in place to assess and monitor the quality of service.

Inspection carried out on 15 August 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 14 people using the service and nine visitors including relatives and friends of people using the service.

Relatives of people living in the home praised the staff for the way they supported people. One person told us, "It's wonderful here, you couldn't beat it, the food is good and the staff are excellent - This is a place I would like to come and live in."

People we spoke with felt that their personal care was carried out in a manner that promoted their privacy and dignity. We saw that staff were polite and courteous to people and offered them choices about their day to day routines.

The people living in the home said they were satisfied with the food provided. One person told us, “The food here is very nice indeed, they always manage to find something I like.”

Every person living in Greenacres with whom we spoke said they felt safe in the home and that if they had any concerns they could discuss it in confidence with either a member of staff or the management.

The people living in Greenacres with whom we spoke said the staff team were kind and caring.

Visitors to the home told us they were confident that the staff cared for people well and had their best interests at heart.

Inspection carried out on 9 June 2011

During a routine inspection

In conversations with people who live in Greenacres on the 9 June 2011, they told us that they well-looked after and that they did not have any concerns about the safety and suitability of the premises. One person told us that their room was ‘very comfortable and clean’.

When we talked with some people living in Greenacres who were having breakfast they told us they could choose what they had for all of their meals, including breakfast where they had a choice of cereals, porridge, toast and scrambled egg or other cooked item.

Reports under our old system of regulation (including those from before CQC was created)