About the service: Elderthorpe is a residential care home that was providing personal and nursing care to 26 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

Staff were caring and knew people well. People and relatives complimented the service and said they would recommend the home. There was a culture within the service of treating people with dignity, respect and compassion.

A range of meaningful activities were on offer to keep people occupied, according to their interests.

Medicines were being administered safely and people’s dietary and healthcare needs were met. Infection control procedures were being followed. The service was clean and tidy, and the registered manager acted to resolve concerns raised about malodour detected in a small area of the lounge and lobby.

Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. Staff were receiving appropriate training which was relevant to their role. Staff were supported by the registered manager and were receiving group and formal supervisions where they could discuss their on-going development needs.

Care plans were up to date and most accurately detailed the care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate any risks which had been identified. Appropriate referrals were being made to the safeguarding team when this had been necessary.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

The registered manager provided staff with leadership and was approachable and keen to keep high standards within the service. Audits and checks were carried out and used to drive continuous improvements to the service people received. We identified some additional areas which needed to be included in safety and environmental checks.

People’s feedback was used to make changes to the service.

At this inspection, the service continued to meet the characteristics of Good in the Caring, Responsive and Well-Led domains, had improved to Good in the Effective domain and was rated Requires Improvement in the Safe domain. This means the service is rated Good overall. More information is in the full report.

Rating at last inspection: The service was rated as Good at our last inspection, published on 14 October 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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 16 August 2016 and was unannounced. This means the provider did not know we were coming. We last inspected Elderthorpe Residential Home in August 2013. At that inspection we found the service was meeting the legal requirements in force at the time.

Elderthorpe Residential Home is a care home which provides residential care for up to 26 people, including people living with dementia. There were 26 people living in the home at the time of this inspection.

The service had 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 a 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 kept safe from harm. Staff were aware of the different types of abuse people might experience and of their responsibility for recognising and reporting signs of abuse. Full details of any incidents including safeguarding incidents were held and analysed on a regular basis to identify patterns or trends. Possible risks to the health and safety of people using the service were assessed and appropriate actions were taken to minimise any risks identified.

Robust staff recruitment processes were in place to ensure applicants were properly assessed as to their suitability for working with vulnerable people. There were enough staff to meet people’s needs safely. The staff team were flexible which meant the service did not make use of agency staff therefore ensuring continuity of care for people using the service.

People were assisted to take their medication safely. The service had a good relationship with the supplying pharmacy and appropriate measures were in place for the supply, storage and administration of medication. The service had introduced a process for administering ‘as required’ medication which ensured there was always a sufficient therapeutic gap between administrations. Staff who administered medication had received training and had their competency to administer medication safely monitored on a regular basis.

Staff had been provided with ongoing training and support to assist them in performing their roles. Staff we spoke with told us they felt well supported and had the necessary skills needed to care for people effectively.

People using the service were asked for their consent to their care and treatment although we found ‘best interests’ decisions were not always formally recorded. We made a recommendation in relation to this.

People were assisted to maintain a balanced diet although systems in place to monitor people’s food and fluid intake were not always completed consistently or in a timely manner. We highlighted this to the registered manager who told us this would be addressed with all staff members.

People were supported to maintain their independence and access support and treatment from external healthcare professionals.

Staff demonstrated a sensitive and caring manner in their interactions with people using the service. Care provided was person-centred, people were provided with choice about their care and treatment and their privacy and dignity was maintained.

People and their relatives were involved in care planning and were actively encouraged to share their views and opinions of the service. Care plans were reviewed and updated on a regular basis to reflect changes in people’s needs. Feedback was sought from people, their relatives and staff about the quality of the service provided and action taken in response to people’s comments.

The service had a range of systems in place to monitor and improve the effectiveness of the service although we found records were not kept of all checks performed. We made a recommendation in relation to this.

During the inspection we had the opportunity to speak with six people who used the service, a relative, a community staff nurse, the maintenance technician and three staff members.

The people who used the service told us they were looked after well and felt safe with the care and treatment provided. Their comments included: "It is fabulous here", “They look after me” and “I feel safe here”.

We found that Elderthorpe Care Home had appropriate systems in place to ensure consent was gained before staff proceeded with personal care.

We saw evidence there was an appropriate system in place for listening to and acting on people’s comments and concerns.

We spent time observing the lounge and dining area during the day of our inspection. We looked at how people spent their time and how staff interacted with people using the service.

The interactions we saw between carers and people who used the service and visitors were respectful. We saw some people engaged in activities with members of staff such as watching TV and hand massages.

We spoke with five out of the 21 people who live at the service, they told us that they were happy and felt safe living at Elderthorpe Residential Home and that they got the care and support they need.

People we spoke with told us they received care that was appropriate to their needs. One person told us “I call this home; It’s lovely to be at home.”

Other comments made on the day that we inspected the home included "I get looked after really well, its fine” and “I can do what I want, they look after me here”.

Staff we spoke with told us they felt supported and had the knowledge and skills to support people who lived at Elderthorpe Residential Home. One staff member said "I enjoy working here, I enjoy the care”.