Greenways is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Greenways does not provide nursing care.

Greenways accommodates up to six people with a learning disability and/or autism. At the time of inspection there were six people using the service. These were the same six people who were using the service at our previous inspection on 7 January 2016. At that inspection we rated the service ‘good’ overall and for each key question. At this inspection we found the provider retained their rating of good for the key questions ‘effective’, ‘caring’ and ‘responsive’. However, we found areas requiring improvement for the key questions ‘safe’ and ‘well-led’ and therefore the service’s rating has deteriorated to ‘requires improvement’ overall.

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.

We found a safe environment was not consistently provided in line with best practice guidance. At the inspection we found one window on the first floor was not adequately restricted putting people at risk of falling from height. We also saw radiators were uncovered and there were not sufficient practices to ensure people were protected from burns or scalds from touching hot surfaces. The registered manager submitted evidence promptly after the inspection to show these risks had been addressed. Records relating to fire alarm tests and water temperature testing needing improving to ensure robust details records were maintained so any concerns could be identified and actioned. The registered manager assured us the necessary action would be taken to ensure detailed records were maintained and we will check this at our next comprehensive inspection. Nevertheless, we recommend the provider implements quality assurance checks in line with best practice guidance outlined by the Health and Safety Executive in their document ‘Health and safety in care homes’.

At the time of the inspection the registered manager had not adhered to all of the requirements of their CQC registration and had not submitted statutory notifications about the outcome of Deprivation of Liberty Safeguards assessments. Promptly after the inspection the registered manager submitted the required notifications.

Staff adhered to safeguarding adult’s procedures and protected people from discrimination. Safe medicines management processes were adhered to. A clean, hygienic environment was provided and staff adhered to procedures to protect people from the spread of infections.

Safe staff recruitment practices were adhered to and there were sufficient numbers of staff to keep people safe and meet their needs. Staff received regular training and were encouraged to develop their knowledge and skills. Staff received regular supervision and an annual appraisal.

Detailed care records were maintained about people’s needs and the care they received. Staff worked with people’s social care teams to review their needs and to reflect on the progress people had made. Staff were supporting people to learn new skills and develop their independence. People had busy active lives and participated in a wide range of activities.

People were involved in their care and received person-centred care. People’s choices and decisions were respected. Staff adhered to the Mental Capacity Act 2005 and best interests’ meetings were held when people did not have the capacity to consent to certain decisions. Staff applied to deprive people of their liberty when they felt this was required in order to main

Greenways provides personal care and support for a maximum of six adults with a learning disability or complex emotional and behavioural needs. On the day of our inspection six people were living in the home.

This was an unannounced inspection that took place on 7 January 2016.

The home had 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff were knowledgeable in the procedures for people who did not have capacity to make decisions for themselves and had worked closely with the local authority to ensure they were submitting DoLS applications appropriately.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were cared for in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible.

Care was provided to people by staff who were trained and received relevant support from the registered manager. This included regular appraisals and supervisions and undertaking training specific to their role. Staff felt supported by the registered manager and told us he was approachable and had an open-door policy.

Information in care plans included detail around people’s personal care needs, likes and dislikes and preferred activities. Care plans were individualised and contained information to guide staff on how someone wished to be cared for. Relatives told us they had been involved in developing their family member’s care plan.

People were able to make their own decisions about their care and we saw staff respected this. People, relatives and staff were involved in the running of the home and suggestions and ideas were listened to and acted upon. We saw evidence of quality assurance checks carried out by staff to help ensure the environment was a safe place for people to live and people received a good quality of care.

It was evident staff knew people well and there was a feeling of companionship within the home. People treated the home as their own and staff were discreet and unobtrusive in the way they provided care. People were treated with respect and dignity by staff. Relatives were very happy with the care provided and they were made to feel welcome when they visited.

There were a sufficient number of staff deployed to care for people and to enable people to go out to external activities. Staff supported people to take part in various activities and arranged activities that were individualised.

The provider had safe recruitment practices, which meant they tried to ensure they only employed staff suitable to work in the home. Staff knew the procedures to follow should they have any concerns about abuse or someone being harmed. Complaints information was available. Relatives told us they would have no hesitation in speaking with the registered manager if they were unhappy about anything.

People were provided with home cooked meals each day and were involved in choosing what they ate. No one living in the home had any dietary requirements, but guidance was available to staff in the event it was needed.

Staff maintained people’s health by providing them with a healthy balanced diet and enabling good access to healthcare professionals when needed. For example, the doctor or community psychiatric team.

There was a contingency plan in place should the home have to be evacuated. Regular fire drills were carried out by staff to ensure they would know what to do in the event of a fire.

There was an upbeat and

Greenways is a care home for up to six people. This service provides care and support to people with complex emotional and behavioural needs. Four people lived there at the time of our visit. We were able to see and talk with all four people.

The service had a registered manager in place and he provided good leadership and support to the staff. He was also involved in day to day monitoring of the standards of care and support that were provided to the people that lived at Greenways. This ensured that people received care and support that met their needs and enabled them to do the things that they were interested in.

All the people we spoke with said, or indicated through sign language, that they were happy living at the home. When we spoke with them they used words such as "Good" and "I like it here." One person told us "I see my relative every week. I like it here because I get to go out when I want." A relative said the staff understood their family member’s needs and they were "Happy that they were living here." Another relative told us they thought the staff were caring and compassionate. They said "They help to create a loving and caring environment which makes the home feel relaxed and welcoming."

A health care professional told us "My overall opinion of the service is that they have done a very good job considering the complexities that the individuals placed at Greenways present. I feel that the staff work in a person centred way and ensure the individuals living at Greenways are happy, content and settled in their home."

The service had good systems in place to keep people safe. Assessments of the risk to people from a number of foreseeable hazards had been developed and reviewed. We saw that staff followed these guidelines when they supported people who used the service, for example where people became agitated and displayed behaviour that could cause them or others harm.

People’s needs and choices had been clearly documented in their care plans. We saw that people took part in regular activities that they had an interest in.

During our observations over the course of the day we saw that people were treated with kindness and compassion. Family members and a health care professional that we contacted all told us that the people were supported by kind and caring staff. Staff were able to tell us about the people they supported, for example their personal histories and their interests.

We saw that people were encouraged to make decisions for themselves. Where people were unable to do this the service considered the person’s capacity under the Mental Capacity Act 2005. We saw records that showed a person’s relatives and health care professionals had been involved in a best interest decision process for that person.

Greenways opened in February 2013 and since that time five people had moved into the service. We met with each of these people and spent time talking with them and observing the support they received. Greenways provided residential care to people with highly complex emotional and behavioural needs. It was evident that a lot of work had been undertaken to ensure that people's needs were met both individually and collectively.

We found that the home had undertaken comprehensive assessments of people's needs and four of the five people who lived there had experienced a planned transition with key staff being recruited, trained and supported to work closely with them. One person moved to the service in an emergency situation and there was evidence that this admission had been handled competently and professionally.

One person talked to us at length about their experience of moving to Greenways and said the move for them had been a positive one. They described the manager as "Really Lovely" and went on to say that both the manager and staff "Help me to make informed choices about my life." We saw that the home had excellent links with other professionals and ensured that through collaborative working, people received support that met their range of very complex needs.

The new staff team had been recruited specifically to work with the individuals who lived at Greenways and the rota had been developed to ensure that people were supported by small teams of staff who knew their needs well. This meant that people received consistent and appropriate support by staff who felt confident in their roles.