This inspection took place on 23 October 2018 and was unannounced. A second day of inspection took place on 25 October 2018 and was announced.

Greenways Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Greenways Court provides personal care for up to 51 people. At the time of our inspection there were 48 people living at the home who received personal care, some of whom were living with a dementia.

A registered manager was in place at the time of our inspection. 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.

At our last inspection in February 2016 we awarded an overall rating of outstanding. At this inspection we found the service was good overall and we have rated the key question responsive as outstanding.

During this inspection we found staff provided extremely compassionate end of life care. A relative told us how staff had gone the extra mile and been instrumental in ensuring their loved one had a dignified death. They told us how staff had provided enormous support to the whole family and had been able to anticipate the family’s needs at such a sad time. Relatives described staff as outstanding in meeting people’s care and emotional needs.

Staff were highly effective at providing and engaging people with access to a wide range of activities. People were actively encouraged to bring their hobbies and interests with them when they moved in, which meant people's lives had continuity and individuality. People and relatives told us how activities and events had improved people's quality of life.

Staff training in key areas was up to date. Staff received regular supervisions and appraisals and told us they felt supported.

Staff had received training in safeguarding and knew how to respond to any concerns. Safeguarding referrals had been made to the local authority appropriately, in line with set protocols.

A thorough recruitment and selection process was in place which ensured staff had the right skills and experience to support people who used the service.

People were supported to have enough to eat and drink and attend appointments with healthcare professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Risks to people were assessed and they were supported to do the things they chose in as safe a way as possible.

The home was clean and in a good state of repair. There was a warm, welcoming atmosphere.

Staff were trained in infection control and during our inspection we observed staff following good infection control practices.

People's privacy and dignity were respected. Staff spoke to people kindly and calmly.

Care plans were detailed and person-centred and contained important information about people’s life stories so staff could get to know people well.

People and relatives knew how to make a complaint and were happy approaching staff or the registered manager if they had any concerns.

People were supported to engage in meaningful activities and access the local community.

Systems and audits were in place to regularly check standards and to support improvements within the home.

People, relatives and staff spoke positively about the registered manager being an effective leader. Staff said they felt supported and able to raise issues at any time.

The home had good links with the local community and people told us how much they enjoyed this.

The inspection took place on 22 and 24 February 2016 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Greenways Court on 16 September 2013, at which time the service was compliant with all regulatory standards.

Greenways Court is a residential care home in Consett providing accommodation and personal care for up to 51 older people. The service does not provide nursing care. There were 48 people who used the service at the time of our inspection.

The service had a registered manager in place. 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.

We received outstanding feedback from people who used the service regarding their choice of nutritious meals. We saw meals were varied with a range of menu options made available to people. Kitchen staff were knowledgeable about people’s needs and passionate about delivering high quality, enjoyable meals. We saw the registered provider had successfully introduced a new method of preparing and serving pureed food so that people with a specialised diet could benefit from a more pleasurable dining experience. We found people’s tastes and preferences were extremely well catered for and their feedback was valued and acted on.

We found the design of the building to be tailored to the needs of people who used the service, including people who lived with dementia. We found people used facilities such as wi-fi and telephone lines in their rooms to stay in touch with relatives and to retain their independence.

Training was comprehensive and regularly refreshed, with staff receiving a range of core training as well as training specific to the needs of people who used the service, for example dementia awareness and diabetes training. Staff displayed a sound understanding of all aspects of care we asked them about during the inspection and we found care to be delivered extremely effectively.

The service was extremely caring. We observed a range of warm and affectionate interactions during our inspection, with people who used the service and staff sharing jokes with staff. People we spoke with and their relatives were unanimous in their praise of the caring attitudes of staff. We found the atmosphere to be extremely relaxed, calm and welcoming and all relatives we spoke with told us this was the case whenever they visited. We saw people were treated in a dignified manner with regard to personal interactions with staff, as well as having their rights upheld, such as the right to a particular religious belief, or the right to vote.

We found staff to be particularly knowledgeable with regard to end of life care and how they could support people compassionately in a place they had chosen as home when that time came. Nursing professionals confirmed the registered manager liaised well with external nursing support to ensure people could choose their place of death and for this to be a thoroughly planned part of their care.

We found that there were sufficient numbers of staff on duty in order to meet the needs of people who used the service. We observed call bells being responded to promptly and people told us they never had to wait if they required help.

We found the service had robust systems in place for ordering, receiving, storing and disposing of medicines, including controlled medicines. We found the registered provider had regard to guidelines set out by the National Institute of Health and Clinical Excellence (NICE) when administering medicines.

We saw that risks were well managed through regular assessments and associated care plans, which were kept in each person’s care file and reviewed monthly. We found staff had

We spent time observing staff supporting people who lived in the home. We found that staff were respectful in their approach and treated people with dignity and courtesy.We observed staff knocking on doors before entering ensuring that people's privacy was respected.

We spent time talking with people and observed how staff provided support and care. Staff explained what they were doing, for example when they were taking people to the dining room for lunch and tea.

During our visit, we looked at care plans held on behalf of people who lived there.We saw that people who used the service and their relatives were asked for their views about the care provided in regular meetings.This ensured that the support and care provided for people was undertaken with their consent and met changing needs.

We observed that people looked clean,well presented and cared for. People we spoke with said that the staff were kind and one person said "They would do anything for you, nothing is too much trouble". Another said "It's like a hotel here".

We saw evidence that staff employed had been through recruitment checks prior to commencing employment. Staff had received training in safeguarding and understood the process for identifying and reporting any concerns. We saw that the provider had acted on comments received about services provided.

We talked to relatives and one said "It's home from home here and I can talk with the manager if I am unhappy with anything".

People told us they were treated with respect and were given lots of choices. One person told us about the range of choices available to them, including a variety of food “we get two choices for dinner every night”, “you can have a cooked breakfast if you want or cereal or porridge” and a range of activities for them to take part in.

All the people we spoke to said they were very happy with the care they received at Greenways Court. One person said “It’s the best home I’ve been in”, while another told us “It’s great I couldn’t ask for better.”

People told us that the staff were good and responded quickly if you needed them, one person said “I was ill one night and pressed my buzzer, the staff came straight away and they were really good.” During our inspection we observed staff responding quickly to peoples requests for help. Another person told us “The staff are absolutely marvellous – they would breathe for you if they could.”

Relatives we spoke to during our inspection were also very happy with the care provided by Greenways Court, telling us that they were kept very involved. One relative told us that the home was “like an extended family.”

A relative told us they were encouraged to be involved in their relatives care and that the provider organised a family day every year to allow everyone to get together and enjoy themselves.