Green Gates Care Home is a care home service with nursing. The home is situated in the Summertown area of Oxford and is registered to accommodate up to 40 people. On the day of our inspection 31 people were living at the home.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

At our last inspection we identified concerns relating to staffing levels and staff’s response times to people’s needs. At this inspection we found improvements had been made. There were sufficient staff to meet people's needs and staff had time to spend with people. Staff responded promptly when people called for assistance. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.

This inspection took place on 24 September 2015. It was an unannounced inspection. The service had met all of the outcomes we inspected against at our last inspection on 29 October 2013.

Green Gates Nursing Home is a care home service with nursing. The home is situated in the Summertown area of Oxford and is registered to accommodate up to 40 people. On the day of our inspection 32 people were 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.

People told us staff knew how to support them. One person said “No complaints about the staff so far. They

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  are very good and know what to do”. Staff were supported through supervision, appraisal and training to enable them to provide the care we observed during our visit.

There was sufficient staff on duty to support people safely and meet their needs. However, people’s call bells were not always answered promptly.

Staff understood the needs of people and provided care with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people and provide activities such as and arts and crafts, games and religious services.

People were safe. Staff understood how to recognise and report concerns and the service worked with the local authority if there were any concerns. Staff assessed risks associated with people's care and took action to reduce risks. People received their medicines safely as prescribed. However, some nurse’s competency assessments were overdue.

People told us they enjoyed the food and had enough to eat and drink. Comments included; “Food is good, lots of choice and I can get extra. There’s also plenty to drink” and “The food is alright, no fault with it. And I get plenty to drink”

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves. People’s capacity to make decisions was regularly assessed.

People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

All staff spoke positively about the support they received from the registered manager. Staff told us they were approachable and there was a good level of communication within the home. People knew the registered manager and spoke to them openly and with confidence.

On the day of our visit there were 32 people living at the home. There were two nurses and six care workers on duty along with kitchen workers, administration and maintenance staff and an activities co-ordinator.

We spoke with five people who used the service who told us that they enjoyed living at the home. One said "I have a lovely room with my own toilet. I think it is very good". Another said "the staff are busy but they are lovely. I am well looked after". People told us they felt involved in their care and that they were respected. One said "they always knock before coming in my room and I like that".

We spoke with two nurses, three care workers, a kitchen worker, the activities co-ordinator and a maintenance worker. Everyone told us they enjoyed working at the home. One nurse said "I have a really good team who work hard to make a difference". The activities co-ordinator said "I look after their mental and physical wellbeing. Activities are so important for these people so I do my best".

We found that people were protected from the risk of abuse because the provider had taken steps to ensure people were safe. These included appropriate training for all members of staff and robust policies and procedures regarding safeguarding.

We saw that care staff were recruited and selected appropriately and that the provider monitored the quality of the service it provided.

When we visited Green Gates Nursing Home the registered manager was on leave. We saw contact details in the entrance hall for a manager who was covering in their absence. This manager made themselves available to us during our visit. This manager will be referred to as “the manager” throughout this inspection report.

We spoke with six people living in the home, one told us “I think they get a jolly good mark overall”, another told us “I haven’t any grumbles of any sort, it’s very nice.” One person said “I’m very happy here, it is a new way of life and staff have made it easy.”

We also observed staff support, looked at records and spoke with staff who supported the people living at the home. We spoke with four members of staff during our visit. Staff were very motivated and caring and attentive of the people. One member of staff told us “I like it, it can be busy but I like working here”.

We saw that the provider had infection control policies and procedures in place. We also saw cleaning taking place in various parts of the nursing home during our visit.

The home had enough staff on duty to meet the needs of the people. One person said “they are always popping in and out”.

The provider had an effective system in place to record and address any complaints that were made.

People were complimentary about the home. People told us the home was "small and friendly" and had a "warm, welcoming, homely atmosphere". People told us they felt well cared for by the team of "caring and helpful staff". They said that the accommodation was clean, well maintained and comfortable.