The inspection took place on 14 and 15 September 2016 and was unannounced. At the previous inspection on 23 July 2013 there were no breaches of regulation.

Greenbanks provides accommodation with personal care for up to 20 adults with a learning disability or autistic spectrum disorder. Greenbanks is a limited company and the shareholders and directors are family members or guardians of the people who live there. The directors hold regular meetings to discuss all aspects of the service any surplus monies go back into improvements. There were 19 people living at the service at the time of the inspection. There were two communal lounges, a conservatory, dining room and a garden to the front of the home.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 safe systems in place for the storage and disposal of medicines. Staff received training in how to administer medicines and had their competency in this area assessed. However, not all staff had ensured that when a medicines error occurred, immediate action was always taken to minimise any potential risks to the person’s health and well-being. We have made a recommendation about medicines.

Staff knew how to identify and report any safeguarding concerns in order to help people keep safe. Checks were carried out on all staff before they supported people, to ensure that they were suitable for their role.

There were enough staff who were sufficiently qualified and competent to support the people at the service. A core team of staff had worked at the service for a number of years and so helped ensure consistency of care.

A schedule of cleaning was in place to ensure the service was clean and practices were in place to minimise the spread of any infection.

Staff felt well supported. They received informal support from the staff team and formal supervision with a senior member of staff. There was a rolling programme of essential training to ensure staff had the skills and knowledge to care for people effectively.

People had their health needs assessed and clear guidance was in place to ensure they were effectively monitored. People had been effectively and appropriately supported when they suffered from periods of ill health and specialist advice had been sought and acted on.

People were offered a choice of food based on their preferences and mealtimes were informal and seen as a social occasion where people and staff chatted to one another.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The consulted the local authority with regards to making DoLS applications, to ensure that people were only deprived of their liberty, when it had been assessed as lawful to do so.

Staff were kind, caring and compassionate, and treated people with dignity and respect. Staff had positive relationships with people based on equality and understood people’s individual and emotional needs. People were actively involved in important making decisions that affected their daily lives such as recruiting new staff and the service’s policies.

People’s care, treatment and support needs were clearly identified in their plans of care and people had been involved in writing their own care plan which included what was important to them and how they wanted to live their life. Guidance was in place for staff to follow to meet people’s needs which included information about people’s choices and preferences. Staff knew people well which enabled them to support people in a personalised way.

The service prioritised ensuring people had active fulfilling lives. People undertook a variety of educational, creative and work base

There were 20 people using the service. We met and spoke with some of them and everyone we spoke with said or indicated that they were happy living at Greenbanks.

People told us that they felt safe and well looked after. People told us that they could express any problems to the staff who would listen and act to sort things out.

People said that they thought the staff were kind and caring. Staff were supported and supervised and given the training they needed to provide a good quality service.

Staffing was planned around individual needs and activities. This meant that people had the support they needed when they needed it. Everyone was fully involved and included in the running of the service. Personal hobbies, interests and individual holiday choices were supported.

People looked relaxed in the company of each other and staff. We saw that people took part in a range of community based activities that they enjoyed and were involved in the local and wider community. There was an on-site workshop where people attended various courses. People had opportunities for supported employment and lifelong learning. One person said “I am independent here, we all work together.”

People’s health and personal care needs were supported and the service worked closely with health and social care professionals to maintain and improve people’s health and well being.

We spoke with most of the people living in the home. People talked to us about their lifestyle and interests and how they were supported to pursue them. People said they went to work in the vineyard and the pottery and woodwork shops. One person worked in the Cancer Research charity shop. People said they had plenty to do. They said they went out to different places each week and went on holiday every year. One person said, "I like doing the arts and crafts in the workshop". One person said "I'm going to Gillingham to watch the football tomorrow." Another person returned later having been on a Christmas shopping trip with lunch out and said they had enjoyed it. People said the staff helped them and listened to them. People were given the support they needed to make decisions about their care and support. We saw that staff gave person centred support that varied depending on each person's level of ability and needs. Staff said they enjoyed working in the home. One of the staff commented, "It is like being in a big family". They were able to attend training and said they were well supported by the manager.