This inspection was undertaken on 24 January 2017 and was unannounced.

The provider of Elmfield Cottage is registered to provide accommodation and personal care for up to five people who may have learning disabilities. At the time of our inspection three people were living at the home.

At our last inspection, the service was rated Good.

There was a registered manager in post who was supported by a deputy 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.

People who used the service were safe as the provider, registered manager and support staff had a clear understanding of the risk associated with people’s needs as well as activities people chose to do. There were sufficient numbers of suitably qualified staff, who had a good understanding of protecting people from the risk of abuse and harm and their responsibilities to report suspected abuse.

Medicines were administered by staff that had received training to do this. The provider had procedures in place to check that people received their medicines as prescribed to effectively and safely meet their health needs.

Where appropriate, include the following about Mental Capacity Act People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People told us they were supported by staff to make their own choices and decision’s about their care and support. We saw people were actively involved in how their care was planned and their needs met.

People told us they had positive relationships with the staff supporting them. Staff assisted people in a number of ways to maintain their health and wellbeing such as choosing menus; cooking and helping them access health and social care services.

People’s needs were assessed and changes communicated to staff, who responded appropriately. People’s interests and preferences were documented and they were encouraged to pursue social events and areas of interests of their own choice.

Effective quality assurances processes were in place to ensure continuous improvement of the service provided. People's views and comments were listened to and used as part of the quality assurance process to look to make continuous improvements.

The inspection took place on 5 June 2015 and was unannounced.

Elmfield Cottage is registered to provide accommodation and personal care for up to five people with learning disabilities. At the time of this inspection four people lived at the home.

The manager was appointed in January 2015 and is currently registering with us. 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 felt supported by staff, who knew how to keep people safe and were aware of their support needs. Staff were aware of how they would identify and report potential harm and abuse. There were sufficient staff on duty to respond to people’s health and welfare needs. Staff had received specialist training in assisting to meet and support people with their behaviour which challenges.

Staff respected people’s rights to make their own decisions and choices about their care and treatment. Staff knew how to communicate with people and provided reassurance when people became anxious and or had changed their minds when making decisions and choices.

Where people did not have the mental capacity and received care to meet their safety and wellbeing (which may be restricting their liberty) the manager had made applications to the supervisory body. By taking these actions the manager made sure people’s liberty and freedom were not being unlawfully restricted.

People were offered choices regarding their food. Staff encouraged healthy eating to support and effectively meet people’s individual eating and drinking requirements. Staff showed us how they helped one person keep to their weight loss diet, as recommended by the dietician.

Staff asked people for their permission before entering their rooms and asked whether they wanted to join in social events. People liked living at the home and we saw that there was lots of laughter and jokes during conversations between staff and people. Staff showed they cared for people who lived at the home and that positive relationships had been formed.

People told us that they knew how to make a complaint but they had not needed to. They felt able to discuss any concerns with either staff or the manager. These were acted upon and recorded.

Staff were clear on their roles and felt supported by the management team. We saw systems were in place to monitor the quality of care. The acting manager indicated that they had a clear vision on how they wanted to lead the service.

We were unable to speak with the people who lived there due to their complex health needs. However we observed how staff cared for people, we spoke with staff and we looked at care plans for two of the people who lived at the home. We found that the care plans covered a range of information about meeting people's needs and were being reviewed regularly to ensure that staff had up to date information. There were also detailed assessments about the person's health. All the staff we spoke with had knowledge about the needs of the people who lived there.

We saw that staff helped and supported people. We saw that people had received care that met their individual needs.

People living there were being treated with diginity and respect.

Medicines were stored and administered appropriately

We found that there were regular audits and quality checks. We also saw that the provider learnt from incidents to improve the quality and effectiveness of the care they delivered.