This inspection took place on 10 and 11 August 2017 and was unannounced. At our last inspection of the service, on 4 and 5 August 2015 we found the service to be meeting regulatory requirements and was rated 'good'. Queen Elizabeth House provides accommodation and residential care for 28 older people, including people living with dementia and with physical disabilities. At the time of our inspection the home was providing support to 26 people.

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

Risks to the health and safety of people were assessed and reviewed in line with the provider's policy. Medicines were managed, administered and stored safely. There were arrangements in place to deal with foreseeable emergencies and there were safeguarding adult’s policies and procedures in place. Accidents and incidents were recorded and acted on appropriately. There were appropriate numbers of staff to meet people’s needs.

Staff new to the home were inducted into the service appropriately. Staff received training, supervision and appraisals. There were systems in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.

People were treated with respect and their support needs and risks were identified, assessed and documented within their care plan. People were provided with information on how to make a complaint. People using the service and their relatives were asked for their views about the service to help drive improvements.

At our inspection on 04 December 2013, we followed up compliance action that we had required following our inspection on 24 July 2013. We found the provider had suitable arrangements in place to ensure that people's needs were adequately assessed, and care and treatment was planned and delivered in line with their care plan and risk assessments. Staff we spoke with demonstrated awareness of people’s current care needs and the management plans in place to mitigate people’s identified risks. On this occasion we did not speak to people using the service as they were engaged in a lunchtime activity at the time of our inspection.

People using the service were complimentary about the care and activities on offer in the home. One person told us “staff are good”, and another person said that “I get help when I need it”. We found that a few people had been assessed as needing nursing care and therefore their needs could not be adequately met in the residential home. We saw that alternative placements were being sought for people needing nursing care in liaison with external healthcare professionals. Some care plans and risk assessments had not been updated to reflect people's current care needs. We found most people’s care needs were met by staffing levels in place, however staff told us current levels of care could not be maintained given the number of people with increased and / or nursing needs. The provider had effective systems in place to reduce the risk and spread of infection.

People using the service told us that they were very happy living at the home and had no concerns with regard to their care. Comments from people using the service included staff are” kind and patient”, “nice atmosphere”, “marvellous care”, “excellent activities” and “as good as you’ll get”. We saw that the home was part of Eden Alternative programme which is a designed to empower and improve the quality of life for people living within the home.

We found that people’s health and social care needs were assessed and that care was delivered and monitored in line with their individual care plans and risk assessments. People told us that they received care, treatment and support they agreed to. The provider had suitable arrangements in place to manage and administer medicines safely to people using the service. Staff we spoke with told us that there were sufficient people on duty to meet people’s needs and they had received adequate training and support to undertake their roles. Management and personal records were fit for purpose, securely stored and destroyed when appropriate to do so.

All the people we spoke with told us they were very happy with the care and service provided by the home.

People told us that they could always speak to staff about any problems and that staff were always responsive to people’s needs.

People told us that they had been involved in needs assessments and the development of care plans.

Visitors to the home told us that the home was always “spotlessly clean” and that they were always kept informed about any changes in the care and welfare of people living in the home.

People told us that they could raise any issues with management and where this had been done in the past, the home had always responded satisfactorily.

This inspection took place on 4 and 5 August 2015 and was unannounced. At our previous inspection in December 2013, we found the provider was meeting the regulations in relation to the outcomes we inspected.

Queen Elizabeth House provides accommodation and residential care for 28 older people, including people living with dementia and with physical disabilities. At the time of our inspection the home was providing support to 26 people. The home had a registered manager 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.

People were protected from the risk of abuse because staff had received appropriate support and training which enabled them to identify the possibility of abuse and take appropriate actions to report and escalate concerns. People and their relatives told us they felt risks related to individuals care was identified and managed appropriately. Risk assessments were person centred, detailed and responsive to people’s needs.

Medicines were managed, stored and administered safely. There were safe staff recruitment practices in place and appropriate recruitment checks were conducted before staff started work ensuring people were supported by staff that were suitable for their role.

There were systems in place to monitor the safety of the environment and equipment used within the home minimising risks to people. There were arrangements in place to deal with foreseeable emergencies.

There were processes in place to ensure new staff were inducted into the home appropriately and staff received regular supervision and annual appraisals. Staff were aware of the importance of gaining consent to the support they offered people and the registered manager and staff we spoke with were able to demonstrate their understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards legislation.

People were supported to maintain good health and had access to a range of health and social care professionals when required. People’s nutritional needs and preference were met.

Staff demonstrated a good understanding of the needs of the people they supported and could describe peoples’ preferences in how they liked to be supported. We observed staff speaking to, and treating people in a respectful and caring manner and interactions between people, their relatives and staff were relaxed and friendly.

People received care and treatment in accordance with their identified needs and wishes. Care plans documented information about people’s personal history, choices and preferences, preferred activities and people’s ability to communicate.

People were supported to engage in a range of activities that met their needs and reflected their interests. There was a complaints policy and procedure in place and information on how to make a compliant was on display in the entrance hall of the home so it was accessible to all.

People and their relatives told us the atmosphere in the home was open, friendly and welcoming. People told us and we observed that the registered manager and staff were approachable. The home and provider took account of people’s views with regard to the service provided through satisfaction surveys that were carried out on an annual basis. There were systems and processes in place to monitor and evaluate the quality of the service provided.