Elliott House provides accommodation and personal care to a maximum of nine people who live with a learning disability, autism and/or associated health needs, who may experience behaviours that challenge staff.

At the time of the inspection eight people were living at the home. The service is a residential home that has been developed and adapted in line with the values that underpin the Care Quality Commission's 'Registering the Right Support' and other best guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can lead as ordinary life as any citizen.

The home had a registered manager. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

This comprehensive inspection took place on 27 and 28 November 2018. The inspection was unannounced, which meant the staff and provider did not know we would be visiting.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection in March 2016 we found the provider was required to improve the recording of the administration of people’s prescribed medicines and staff recruitment processes. At this inspection we found the provider had made the required improvements to accurately record medicine administration and staff recruitment procedures.

People were protected from avoidable harm, neglect, abuse and discrimination by staff who understood their responsibilities to safeguard people. Risks to people had been assessed and plans minimised potential risks, whilst promoting people’s independence. There were sufficient suitable staff deployed to support people safely who been enabled to develop and maintain the necessary skills to meet people’s needs. There was a positive attitude to learning from incidents and near misses.

People's care and support were delivered in accordance with detailed assessments and care plans, which were reviewed regularly. People were supported to eat a healthy balanced diet. 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. The registered manager had developed effective partnerships with relevant professionals and quickly referred people to external services such as GPs, neurologists, dieticians, opticians and dentists, when required to maintain their health.

Staff supported people to maintain high standards of cleanliness and hygiene in the home, which reduced the risk of infection. Staff followed required standards of food safety and hygiene, when preparing or handling food.

There were positive, caring relationships between people and the staff who supported them. The provider supported people to be actively involved in decisions about their care and support. The service people received had a very positive impact on their dignity, independence, self-esteem and confidence.

People were supported by regular staff who were kind and caring, which had a positive impact on their mental wellbeing. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.

People were supported to take part in activities that they enjoyed and to maintain relationships with their families and those that mattered to them. This helped to protect them from the r

We carried out an unannounced comprehensive inspection of Elliot House on 10 March 2016.

The service provides accommodation and support for up to nine people who have learning disabilities or autism. Elliott House aims to support people to lead a full and active life within their local community and continue with life-long learning and personal development. The service is a converted house, within a residential area, which has been furnished to meet individual needs. At the time of our inspection nine people were using the service.

The service had a registered manager in place. 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 service is required by a condition of its registration to have a registered manager.

There were enough staff to keep people safe and support people to do the things they liked. The provider had recruitment process in place to identify applicants’ who were suitable to work with people. However, the registered manager had not always followed this process through to completion to ensure a full employment history would be available for all staff. They took action following our inspection to rectify this and we will be looking at this again at our next inspection to ensure these improvements have been sustained.

Staff understood how to keep people safe from abuse. People’s safety risks were identified, managed and reviewed and staff understood how to keep people safe at home and in the community. Systems were in place to protect people from the risks associated with medicines. We found three medicine recording errors. The service had identified this as an area of improvement prior to our inspection and was taking action to ensure medicine records would always be accurate.

People living at Elliott House received care and support from knowledgeable and experienced staff. Many of the staff had supported people living at the service for some years and demonstrated an in-depth knowledge of people’s needs and aspirations. Staff were supported to undertake training to support them in their role, including nationally recognised qualifications. They received regular supervision and appraisal to support them to develop their understanding of good practice and to fulfil their roles effectively.

Staff sought people’s consent before they provided their care and support. Where some people were unable to make certain decisions about their care the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them to keep them safe, the staff continued to ensure people’s care preferences were respected and met in the least restrictive way.

People were supported to have their health needs met by health and social care professionals including their GP and dentist. People were offered a healthy balanced diet and when people required support to eat and drink this was provided in line with professional’s guidance. People received the support they needed to manage their epilepsy.

For those people who needed support to manage their behaviour, behaviour support plans had been drawn up by the provider’s assistant psychologist. Staff had received training in positive behaviour support, understood the triggers for people’s behaviours and ensured people were sufficiently occupied during the day. When restraint was used to keep people safe in line with their behaviour support plans, these incidents were recorded and reviewed by the registered manager to ensure they were appropriate and proportionate.

Staff supported people to identify their individual wishes and needs by using their individual methods of communication. People were encouraged to make

People were not able to tell us about their experiences of living at Elliott House because of communication difficulties. However we spoke with relatives and observed care and support provided to people. We also reviewed people’s records in depth.

Relatives told us the home “exceeded their expectations” and they were “delighted” with the care people received. They told us the staff were skilled and they knew the best ways to provide care and support for their relative. We saw evidence that people were engaged in many activities of their choosing.

Staff told us they felt well trained and supported to provide a good service for people. Their records evidenced an extensive training programme. Staff received regular supervision and annual appraisals which meant the provider had ensured they were well trained and supported to provide safe and appropriate care and support.

People at this service told us they like living there and told us they enjoyed going out with the support of staff.

Before people moved in to the service, the provider worked with them to make sure they were happy to live there. The staff checked that people were happy to receive support they offered to them, as far as people were able to communicate this. Where restrictions were in place, this was assessed as being necessary to protect people.

People’s support plans reflected their needs and the provider made sure that plans were up to date. Staff followed people’s support plans to provide appropriate care and support to people.

Where people’s behaviours were challenging and potentially harmful for others, the provider worked with other professionals to minimise the impact this had on people using the service.

The provider regularly reviewed the quality of the service to ensure that enough well trained staff were available to meet people’s needs and so that improvements could be made to the service provided.