Elmsdene Care Home is registered to provide personal care for a maximum of thirty three people. The home specialises in providing care for people who live with dementia. The accommodation, which is on the ground and first floor, consists of twenty-five single bedrooms, nine of which have en-suite facilities and four double bedrooms, two of which have en-suite facilities. The communal space consists of a large dining room, lounge area and a separate television lounge. There is a small parking area for visitors at the front of the building. At the time of our inspection visit there were 29 people who lived at the home.

At the last inspection carried out on 05 April 2016 the service was rated 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 ongoing 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.

There was 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.

Although a number of people had limited verbal communication and were unable to converse with us, we were able to speak with two people who lived at the home. They told us they were happy and supported by staff who cared for them and treated them well. We also spoke with three visiting relative’s who told us they were happy with the care provided and knew their relatives were safe. One person said, “Really nice friendly staff and I know [relative] is safe. I am highly satisfied with the care.”

Throughout the inspection visit we observed staff being kind and attentive to people in their care. We saw they were caring, patient and engaged people in conversation whilst providing their support. We saw staff were always in attendance in communal areas and available when people needed their help.

Procedures were in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. We saw safe staffing levels in place and people received care and support when they needed it. People had support to enable them to pursue activities of their choice including going for walks.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People received their medicines as prescribed and when needed and appropriate records had been completed.

Care plans were organised and had identified care and support people required. We found they were informative about care people had received. We saw people had consented to their care and treatment and where appropriate family members who had the legal authority to do so.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required. The design of the building and facilities provided were appropriate for the care and support provided.

We saw there was an emphasis on promoting dignity, respect and independence for people supported by the service. They told us they were treated

This inspection visit took place on 05 April 2016 and was unannounced.

At the last inspection on 05 June 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Elmsdene Care Home is registered for the regulated activity providing accommodation for persons who require nursing or personal care. The service provides support for people who live with dementia and can accommodate a maximum of thirty three people. The accommodation, which is on the ground and first floor, consists of twenty-five single bedrooms, nine of which have en-suite facilities and four double bedrooms, two of which have en-suite facilities. The communal space consists of a large dining room, lounge area and a separate lounge. At the time of our inspection visit there were 31 people who lived at the home.

There was 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.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People told us when they requested assistance this was responded to in a timely manner. One person visiting the home said, “Always plenty of staff on duty when I visit which is daily. What I like is the girls sit with the residents and spend time with them.”

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed they had received induction training when they commenced working at the home.

Staff had received training and were knowledgeable about their roles and responsibilities. They had skills, knowledge and experience required to support people with their care and social needs.

We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The environment was well maintained, clean and hygienic when we visited. No offensive odours were observed by any members of the inspection team. Hand sanitiser dispensers were prominently placed around the home for the use of staff involved in the delivery of personal care.

The service had a redecoration and refurbishment programme in place. Bathrooms and ensuite facilities were being updated when we visited. People who lived at the home told us they were happy with the improvements being made.

We found equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.

People visiting the home told us they were happy with their relatives care. One person said, “I find the staff are kind and caring. I have never seen anything that has caused me concern during my visits. I know [relative] i

During this inspection the Inspector gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. We also spoke with Blackpool council’s contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required.

The service was safe, clean and hygienic. One person visiting the home said they chose the home for their relative because it was spotless when they looked around the home. The person said, “I was very impressed how clean and fresh the place smelt. No unpleasant smells anywhere. It’s always clean when I visit”. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after. Systems were in place to make sure the manager and her staff learnt from events such as accidents and incidents, complaints and concerns raised about the service.

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support. People’s health and care needs had been assessed with them or their relative, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found the care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were very happy with the care being provided. One person said, “I am very happy. The staff look after me really well. I enjoy the activities they arrange they keep me entertained”. One person visiting the home said they were very happy with their relatives care. The person said, “Mum is always clean and tidy when I visit. She is well looked after and I have no concerns about her care”.

We saw the deployment of staff at lunch time was organised. People who had been identified as being at risk from poor nutrition had a care worker allocated to assist them to eat their meals. We observed staff members were attentive to the needs of people who required assistance. Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

Records showed admissions to the home were well planned. Information about people’s care and dietary needs had been recorded. We also saw potential risks to people’s health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care. We saw staff engaging people in a range of activities. We observed people enjoying themselves and interacting with the staff. We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

During our inspection we looked at care, staff training records and staff supervision arrangements. We checked maintenance records, the homes duty rota and undertook a tour of the building. We also spoke with a number of people visiting the home and staff throughout the inspection. We observed the quality of care and support provided by staff during the inspection. We did this to confirm people were having their care needs met. We also wanted to identify that staff had been trained and appropriate support arrangements were in place for them.

We found staffing levels were adequate with an appropriate skill mix to meet the needs of people using the service. Staff had been trained and appropriate support arrangements were in place for them. The home had been well maintained when we visited.

The people we spoke with said their relatives were receiving safe and appropriate care which was meeting their needs. One person said, “This home is great for mum. She is getting excellent care and I find the staff are all very friendly and helpful. They are always organising activities to keep the residents happy. I never leave the home with any concerns about her care”.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We also spoke with Lancashire Fire & Rescue Service. They told us they had no issues when they last visited the home.

We carried out an unannounced visit and found the home to be warm, clean and comfortable. We noted that people were provided with a homely environment which was nicely furnished and decorated with pictures and flower displays.

During our visit residents were taking part in a gentle exercise session. We chatted with one resident who showed us the exercises she had been doing. She said, ‘’I enjoy it. I do it every week!’’

We saw that residents appeared comfortable and relaxed, chatting with each other and the staff. Residents were nicely dressed and well groomed, demonstrating that they had good support with their personal care.

We noted that the staff at the home went about their duties in a pleasant, cheerful manner. We saw staff supporting residents in a kind and gentle way. They appeared to have plenty of time to spend with individual residents just chatting or providing reassurance where needed.

We spoke with a number of residents and relatives during the inspection and received very positive feedback. Comments included;

‘’My mother has blossomed since she came here. She is like a different person, eating better, more alert and more content.’’

‘’I visit regularly and I have never seen anything but patience, kindness and caring.’’

We looked at a number of standards including how the service promoted the welfare of people who lived at the home and how they safeguarded people from abuse. We found the home was compliant in all the areas we assessed.

People told us they can express their views and are involved in decision making about their relatives care. They told us the provider and her manager were very supportive towards them and they felt listened to when discussing the care needs of their relative.

We spoke to people about their relatives experiences living in the home and were told the staff team provided sensitive and flexible personal care support. They told us routines were flexible and they could visit whenever they wished. They said the standard of food was very good and the activities organised kept people entertained.

People visiting the home told us they had no concerns about the care being provided and felt the people living in the home were safe and protected from potential harm. They told us they were happy with the care provided and the staff were responsive to their relative’s needs. They told us they were consulted about the service being provided and felt their views were listened to and acted upon.

“I visit my mum every day and I am fully involved in her care. I assist the staff with her personal care needs because I want to be involved. I attend meetings when we review her care and I am consulted about any changes they feel need to be made. They are very supportive towards me and my family and we are very happy with care provided”.

“They are very good about keeping you informed about your relative’s welfare. If I phone the home I am always passed on to someone who has been dealing with mum and knows what they are talking about”.

“I am highly satisfied with the care provided. They cater to my mum’s needs excellently. I have no issues or concerns”.

“My mum is in very good hands. The staff are brilliant, the food is excellent and there are always plenty of activities to keep people occupied. We were very lucky to find this place”.

“My Mum is receiving the best care possible. The staff are all pleasant, kind and friendly. They cope really well which can’t be easy looking after people with dementia. They manage people who become agitated really well. They are well trained and very knowledgeable in my opinion”.

“So glad this home was recommended to us. We looked around a number of homes and fell lucky with this one. My mum is always well presented whenever I visit and seems very happy. She joins in all the activities and always enjoys her meals”.

“I cannot praise the home high enough. The care they provide is exceptional. The support they provide to assist you in coping with your relatives illness is well beyond any expectations I had. I am so grateful and cannot thank them enough”.