About the service: Greengate House is a two storey purpose built care home. The home accommodates up to 13 people with mental health needs. It is close to local amenities and public transport links.

People’s experience of using this service:

People received safe and effective care from staff that were kind, caring and compassionate. People’s needs had been fully assessed prior to them living at the home. Care plans were detailed, reflected people’s individual needs and were regularly reviewed to ensure the most up-to-date information and guidance was available for staff. Staff had a good understanding of the people they supported and had developed positive relationships with them.

Safe recruitment practices were in place and people were supported by staff that had undertaken a thorough induction and training relevant to their roles. Sufficient staff were employed to meet the needs of the people living at the home. Staff were supported through regular supervision and team meetings.

Risks to people had been clearly identified and guidance was in place to ensure that staff could minimise these risks. People were protected from the risk of harm and abuse. Staff felt confident to raise any concerns about abuse and had all undertaken safeguarding training.

Medication was managed safely by trained and competent staff. Staff had access to a selection of medication policies and best practice guidance. Medication administration records (MARs) were fully completed and audits regularly undertaken. An infection control policy and procedure was in place to minimise the risk of infection being spread. Staff had all undergone training and had access to personal protective equipment (PPE).

People’s privacy and dignity was respected and their independence was promoted. People spoke positively about the staff that supported them and the management team. People told us their views were regularly sought regarding their care, meals and activities.

People participated in activities of their choice and were encouraged and supported to maintain contact with friends and relatives.

The registered provider complied with the principles of the Mental Capacity Act (MCA) 2005. Staff understood and respected people’s right to make their own decisions where possible, and encouraged people to make decisions about the care they received. Mental capacity assessments and best interest decisions were completed in line with the MCA.

Rating at last inspection: Good (Report published September 2016).

Why we inspected: This was a planned inspection based on the rating of the last inspection.

Follow up: We will continue to monitor all intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 3 June 2016 and was unannounced.

Greengate House is a two storey purpose built care home. The home accommodates up to 12 people with mental health needs. It is close to local amenities and public transport links.

A registered manager was 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 last inspection of Greengate House took place in June 2014 and we found that the service was meeting all of the regulations we assessed.

People were protected from the risk of abuse. People understood how they should be cared for and who they should speak to if they were not happy about the service they received.

Systems were in place for the management of people’s medicines. A designated storage room was available to ensure that people’s medicines were kept safe. Wherever possible, people managed their own medicines.

Recruitment procedures were in place to help ensure that only suitable staff were employed to support people.

Procedures were in place to help ensure that people could be safely evacuated in the event of an emergency.

People told us that they felt that the staff supporting them were knowledgeable, and understood their needs.

People were happy with the meals available to them. People also, when appropriate had access to kitchen facilities to plan, prepare and cook their own meals.

People told us that staff asked for their opinions and listened to what they had to say and that their decisions were respected.

The atmosphere in the service was calm and relaxed and it was evident that people had formed strong respectful relationships with others.

People were encouraged to freely express their lifestyle choices and individuality in relation to how they spent their day, their religious beliefs and personal presentation.

A service user guide was available to inform people about the service. However, we found that some of the information in the service user guide was in need of updating.

We recommend that a review of the service user guide takes place to ensure that people have access to up to date information.

The registered provider had a complaints procedure that was readily available to people who used the service. People had the opportunity to comment on the service at any time.

People accessed the local community on a regular basis to visit shops, the pub, coffee mornings and places of worship.

Quality assurance systems were in place to ensure that the service was safe and that people received the care and support they needed.

The registered provider regularly asked people for the views on the service they received by way of a survey. Once the people’s views had been sought the finding were sent to the service and any actions needed were taken.

We considered our inspection finding to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found -

Is the service safe?

Systems were in place to assess any risks identified when planning people's care and support. We found that these systems were effective. We found that the risks to people who used the service had been assessed and that the risk were reviewed on a regular basis. People who used the service told us they felt safe.

Is the service effective?

People who used the service told us that they were happy with the care and support they received. Their comments included, “Food very good”, “Excellent” and “Good.”

Is the service caring?

People were supported by pleasant staff. The majority of people told us that they were happy with the staff team that supported them. People’s comments included “They look after me well” and “The staff are nice.”

Is the service responsive?

A system of review was in place to enable care plans to be updated on a regular basis. We saw that a system was in place that enabled people to send their comments / complaints and compliments to the provider.

Is the service well-led?

The newly recruited manager of the service shared with us their action plan which they had developed to make improvements to the service. The manager demonstrated a clear plan which included enabling people who used the service to participate in developing the service further.

This was a follow up inspection, carried out to check on improvements the provider was required to make. At our last inspection in May 2013, we found several policies were out of date and gave incorrect information to people. The provider submitted an action plan detailing how they would correct these policies and make them fully accessible to people who used the service.

During our visit to Greengate House, we spoke with people living in the home, members of staff and a visiting consultant, who was carrying out an infection control audit on behalf of the provider.

We spoke with five people living in the home. Some of their comments included, “It’s rather nice here,” “I am quite happy here, but not much to do,” “I am not afraid to speak my mind, so I will speak up” and “I have no complaints, everybody is great with me”.

The infection control consultant told us, “The staff were very welcoming, friendly and found them to be open and receptive to advice and guidance”.

We observed various members of staff interacting and supporting people in a sensitive, inclusive and encouraging manner throughout the day.

We saw people coming and going during the day, sometimes with support, other times people were unsupported in accessing the community.

People told us that they were happy living at Greengate House. One person told us “I have my room the way that I want it.” Another person told us with excitement “We are going on holiday to Blackpool soon.”

People told us they had good relationships with the staff and that they felt comfortable with the staff. One person told us “The staff are all good to me.” Another person told us “I get on well with the staff.” All of the people we asked told us that they felt safe living at Greengate House.