About the service: The Elms is a residential care home without nursing and provides care and support for up to 22 older people. On the day of our inspection there were 22 people living in the home. There were 20 single occupancy bedrooms and one shared room.

People’s experience of using this service:

Risks to people's health, safety and wellbeing were assessed. Support plans were put in place to ensure these were reduced as much as possible. People were protected from potential abuse by staff who had received training and were confident in raising concerns.

There was a thorough recruitment process in place that checked potential staff were safe to work with people living at The Elms. Staff were provided with the training, supervision and support they needed to care for people.

People received care, which met their needs. Guidance was in place to support people consistently and in the way, they wanted. Care plans were informative. People had access to other health care professionals when they needed it.

People were supported to pursue their interests and hobbies, and social activities were offered. Staff went the extra mile to support people meeting their aspirations. People were provided with food and drink to maintain their health.

Staff knew people well. They were caring and showed compassion in their approach. People and their relatives expressed their satisfaction with the care. People felt confident to talk about any concerns that they may have.

The service was well led. There were suitable quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

Rating at last inspection: Rating at last inspection: Good (report published December 2016).

Why we inspected: This was a planned inspection based on the rating from the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 25 October 2016 and was unannounced. When The Elms was last inspected in November 2015 there were no breaches of the legal requirements identified.

The Elms is a residential care home without nursing and provides care and support for up to 14 older people. On the day of our inspection there were 12 people resident in the home.

The service has a registered manager. 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 registered manager and provider had improved the quality monitoring systems in place These systems were used to improve the service and embed a culture of continuous improvement throughout the service.

People were involved in how the home was managed. Regular meetings took place to give people a chance to have their say; the feedback was used to improve the home and the people's experience of living there.

Staffing numbers were sufficient to meet people's needs and this ensured people were supported safely. Staff and people we spoke with felt the staffing level was appropriate. Staff demonstrated a detailed knowledge of people's needs and had received training to support people to be safe and respond to their care needs. We have however made a recommendation around competency checks for staff that have been trained with a previous employer.

Staff understood their safeguarding responsibilities and whistle-blowing policy and procedures. Staff supervision was undertaken regularly and staff felt well supported by the registered manager.

There were positive and caring relationships between staff and people at the service. People praised the staff that provided their care and we received positive feedback from people's relatives and visitors. Staff respected people's privacy and we saw staff working with people in a kind and compassionate way when responding to their needs.

Care provided to people met their needs. Care records provided personalised information about how to support people. We saw that the service took time to work with and understand people's individual preferences in order that the staff could respond appropriately to the person. People were also supported to undertake person centred activities and be involved in the local community.

The staff had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Meetings had been arranged in order to enable people's best interest to be assessed when it had been identified that they lacked the capacity to consent to their care and treatment.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support individuals to meet their needs.

People had their physical and mental health needs monitored. The service maintained daily records of how people's needs were meet and this included information about medical appointments with GP's and dentists.

There were suitable arrangements in place for the safe storage, receipt and administration of people’s medicines.

There was a complaints procedure for people, families and friends to use and compliments could also be recorded

We have made one recommendation in relation to training; We recommend that staff who have had training with a previous employer are checked for competency in these areas before they work unsupervised to ensure they are suitably skilled .

This inspection took place on 10 and 12 November 2015 and was unannounced. This was the first inspection of the home by the Commission; the home was registered with the Commission in November 2014.

The Elms is a residential care home without nursing and provides care and support for up to 14 older people. On the day of our inspection the home was at full occupancy.

The service has a registered manager. 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 registered manager was not available on the day of inspection. Senior members of staff were available however to assist the inspection.

The staff had received training regarding how to keep people safe. They were aware of the service safeguarding and whistle-blowing policy and procedures.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff we spoke with felt the staffing level was appropriate.

Staff demonstrated a detailed knowledge of people’s needs and had received training to support people to be safe and respond to their care needs. However staff supervision and refresher training had fallen behind.

There were suitable arrangements in place for the safe storage and administration of people’s medicines. Improvement was required in relation to processes for recording medicine stock levels and medicine disposal.

Care provided to people met their needs. However care records provided basic information and did not provide personalised information about how to support people. People were involved in regular activities.

The staff had a clear knowledge of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Meetings had been arranged in order to enable people’s best interest to be assessed when it had been identified that they lacked the capacity to consent to their care and treatment.

There was a robust staff recruitment process in operation designed to employ staff that would have or be able to develop the skills to keep people safe and support individuals to meet their needs.

People had their physical and mental health needs monitored. The service maintained daily records of how people’s needs were meet and this included information about medical appointments with GP’s and Dentists for example

There were positive and caring relationships between staff and people at the service. People praised the staff that provided their care and we received positive feedback from people’s relatives and visitors to the service. Staff respected people’s privacy and we saw staff working with people in a kind and compassionate way when responding to their needs.

There was a complaints procedure for people, families and friends to use and compliments were also recorded.

We saw that the service took time to work with and understand people’s individual way of communicating in order that the service staff could respond appropriately to the person.

The provider had quality monitoring systems in place which were used to bring about improvements to the service. Some improvements had not yet been embedded by the service.