Elm House provides personal care and accommodation for up to six people who have a learning disability. Four people were living at the service on the day of our inspection.

This unannounced inspection was undertaken on 18 July 2017 by one inspector. At the last inspection on 19 May 2015 the service was rated as 'Good'. At this inspection we found the service remained 'Good'.

A registered manager was in post at the time of the 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.

Systems were in place to manage risks to people using the service and to keep them safe. This included assisting people safely in the service and whilst out in the community.

There were enough staff on duty to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited to work with people using the service.

The deputy manager who was in charge at the service during this inspection understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as far as they were able to. Staff supported people in the least restrictive way possible.

People's needs continued to be assessed and regularly reviewed, so that their care was planned and delivered in a consistent way. The management staff and care staff were knowledgeable about the people they supported and knew their care needs well. Staff offered people choices such as how they spent their day. These choices were respected and actioned by staff.

People experienced a good quality of life because staff received training that gave them the right skills and knowledge to meet their needs. People were supported and assisted with their daily routines, shopping and accessing places of their choice in the community.

People had access to a range of health care professionals, when they needed them.

Staff were clear about the values of the service in relation to providing people with compassionate care in a dignified and respectful manner.

The provider had processes in place to assess, monitor and improve the service. People had been consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were provided with the opportunity to give their feedback about the quality of the service provided.

Further information is in the detailed findings below.

Elm House is registered to provide accommodation and personal care for up to 12 people. The home does not provide nursing care. The home mainly provides support for people who have a learning disability or autistic spectrum disorder and who may also have mental health needs. Accommodation is provided over two floors and there are 12 single bedrooms. There were six people living at the home at the time of our inspection.

This inspection was undertaken on 19 May 2015 and was unannounced. We last inspected Elm House in October 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

There was a registered manager in post at the time of this inspection. 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.

People had mental capacity assessments completed and information about their best interest decisions were well documented. Deprivation of Liberty Safeguards guidance had been followed and completed applications sent to the appropriate agencies so that people were not deprived of their liberty unlawfully.

People’s health and care needs were assessed and reviewed so that staff knew how to care for and support people in the home. People had access to a wide variety of health professionals who were requested appropriately and who provided information to maintain people’s health and wellbeing.

The risk of abuse for people was reduced because staff knew how to recognise and report abuse. People were supported to be as safe as possible and risk assessments had been written to give staff the information they needed to reduce risks.

Staff received an induction and were supported in their roles through regular supervision, annual appraisals and training to ensure they understood their roles and responsibilities.

People were involved in the planning and choice of the meals, snacks and drinks, which they told us they enjoyed.

People were able, with support, to contact their friends and families when they wanted. Staff supported and encouraged people with activities that they enjoyed.

People were able to raise any concerns or complaints with the staff and were confident that action would be taken. Independent advocates were available so that people could be provided with independent support.

People in the home were happy with the staff and management. People were involved in meetings, and action was taken where requests or comments had been raised regarding suggested improvements.

People’s rights to give consent to their support and care were respected. Where a person was not able to give this consent, there were legal systems in place to ensure that the person received essential support and care that they needed.

People were supported and encouraged to improve their level of independence, confidence and self-esteem. They were provided with structured therapeutic and recreational activity programmes which reflected their on-going personal aspirations; agreed goals for achievement and their personal choices. People were supported in a consistent way so that their agreed programmes were adhered to.

Systems were in place to make sure people were protected from the unsafe management of medication. One person told us that they were satisfied with how they were supported to take their prescribed medication. People who used the service were supported to manage their own medication and when this was safe to do so.

Staff recruitment systems were in place to ensure that vulnerable people were safe from unsuitable staff. Members of staff were experienced and trained to safely do their job.

A complaints procedure was in place which enabled people who used the service to make a concern or complaint, if they needed to. People were supported to make a complaint if they had a need to do so.

During our inspection on 30 August 2012 we spoke with two people who lived in the home. They both said that they were involved in the planning of their care and the reviews of their care plans. They also told us about the service user forum that took place and the availability of an external advocate if they wished to speak to them. Both told us that the staff encouraged and supported them to become more independent. One person told us, "Its all good here, nothing bad".

We observed staff supporting people in a kind and calm manner. Communication was positive and staff spoke respectfully with people. Staff were provided with appropriate training and support to enable them to meet the needs of the people who lived in the home. There were additional staff on duty to ensure that people were able to access the local community.

The organisation had good systems in place to monitor the quality of the service provided and action was taken to address any issues that were highlighted as needing improvement.

We spoke with four people who use the service and they were all generally positive about

the care and support they received. One person was particularly appreciative about the

support he had received in planning a forthcoming holiday and said that the staff were very always very kind and helpful in meeting his needs. People spoken with said that they were involved in their care plan and regularly discussed their care and support needs with their key worker.

We spoke with two people and they were satisfied with their bedrooms. They stated they

were encouraged to bring possessions with them to personalise their bedrooms.