This was an unannounced comprehensive inspection which took place on 17 and 18 July.

People living at Eltandia Hall Care Centre receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to 83 people across four self-contained units located over two floors, each with their own separate adapted facilities. Three of the units known as Irving, Ivy and Scott support older people. Most people staying on these units are living with dementia. Irving and Ivy units also specialise in providing nursing care, whilst the Scott unit is residential and specifically for older people with personal care needs. The Farish unit supports both younger and older adults who have physical disabilities. Some of the people living on this unit also have a learning disability or autistic spectrum disorder or mental ill health problems. Some people living in the home have a sensory impairment. At the time of our inspection 73 people resided at the Eltandia Hall Care Centre.

The service has had two new registered managers in the last 12 months. The latest manager was registered by CQC in March 2018. A registered manager is a person who has registered with the CQC. Registered managers like registered providers 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.

In August 2017 the home was re-registered by the CQC after the service was taken over as a going concern by a new provider. At the last comprehensive inspection of this home in April 2017 when they were managed by the provider Lifestyle Care Management, we rated them 'Requires Improvement' overall. This was because we found poor management of medicines, risks, complaints and governance, and lack of staff support and understanding of the Mental Capacity Act (2005). We undertook a focused inspection in April 2017 and judged the service had made improvements to address the issues, but continued to rate them 'Requires Improvement' overall because we wanted to be sure they could maintain what they had achieved over a more sustained period.

At this comprehensive inspection we found after 12 months in charge the new provider had improved the service people living in the home received. However, the new providers acknowledged there is a lot more work they need to do to make the home better and ensure it continued to move forward in the right direction of travel. We have therefore rated Eltandia Hall Care Centre ‘Requires Improvement’ overall and for the two key questions ‘Is the service effective and caring?’ For the three key questions, ‘Is the service safe, responsive and well-led? we rated them ‘Good’.

We rated them ‘Requires Improvement’ for effective because staff did not have all the right knowledge and skills to carry out their roles and responsibilities. Although the new provider had a well-established training programme in place, it did not cover the needs of everyone who lived at the home. For example, most care staff had not received any training in learning disability or mental ill health awareness, preventing and appropriately managing behaviours that might challenge the service and understanding equality and diversity. This meant staff might not have the right competencies to effectively carry out all their roles and responsibilities.

We also rated the home ‘Requires Improvement’ for 'caring' because some people did not always feel they were well-cared for or supported by some of the staff who worked at the home. Although we observed positive interactions between people living in the home throughout our two-day inspection, several people and their relatives and community health and social care professionals expressed concerns about the caring a