An unannounced inspection took place on 24 &25 April 2018.

At the previous inspection in April 2017 we found that the provider was in breach of 2014 Regulations with regard poor recording practices for medication administration and storage of medicines and the lack of a governance system in place to assess the quality and effectiveness of the service provided. At this inspection we found improvements had been made.

Eldonian House Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Eldonian House Care Centre accommodates 30 people living with dementia in one adapted building. Accommodation includes all single bedrooms with ensuite facilities, two main lounges and a dining room. There are two outdoor enclosed areas for people to enjoy.

There is a registered manager at the home. 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.

We found that medicines were administered and managed safely in the home. Regular stock checks and weekly medication audits were now completed. A Medication Administration Record (MAR) file was in place to guide for staff for safe administration of medication. For each person there was a photograph with details such as name, date of birth, any allergies, their GP and any medical conditions. All staff that administered medication received medicines administration training and competency checks were completed every year.

The registered provider had put a number of checks and audits in place since our last inspection which were used to improve the quality of care provided.

There was a sufficient number of suitably trained and qualified staff on duty to meet the needs of the people who lived at the home. Staff were supported regularly through supervision meetings, annual appraisals and staff meetings, which were held every three months

The staff presented as caring, kind and knowledgeable about people's needs.

Safeguarding systems processes and practices helped staff to understand how to protect people from abuse, neglect, harassment and breaches of their dignity and respect. Risk assessments were undertaken to support people safely and in accordance with their individual needs. They were updated each month to reflect any changes in people's needs monthly to ensure they received the appropriate care and support.

The home was odour free, clean and kept hygienic. Personal protective equipment (PPE) such as aprons and gloves were available and used when supporting people with personal care and administering medication.

A four week menu was in place and people were offered nutritious meals. People told us the food was good. People's nutritional needs were assessed and recorded. Food allergies, likes/dislikes and requirements were recorded. Staff monitored people's dietary intake and weight.

The environment and equipment was well maintained and subject to service contracts and safety checks.

Staff sought advice from external health and social care professionals at the appropriate time. This ensured people's health was monitored effectively.

Care staff respected and promoted people's privacy, dignity and independence. They were caring and compassionate in their approach and encouraged people to express their views.

People were involved in making decisions about their care and support. Managers and staff acted in accordance with the Mental Capacity Act and ensured that people received the right kind of assistance to support them in making decisions.

Activities were provided regularly for people, such as games, craft

The inspection took place on 25 & 26 April 2017 and was unannounced.

Eldonian House Care Centre is a purpose built care home for 30 older people. It is part of the Eldonian Village community in the Vauxhall area of Liverpool, close to the city centre. Accommodation includes all single bedrooms with en-suite facilities, two main lounges and a dining room. There were 29 people living in the home on the day of our inspection.

There was 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.

Systems and processes were not all in place to assess, monitor and improve the safety and quality of the service.

Medicines were not always managed safely in the home. Not everyone had a photograph to ensure staff gave medication to the right person. Support plans for giving people ‘as required’ medication were not always completed.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported.

Safety checks of the environment and equipment were completed regularly.

Improvements were required to make the home a more dementia friendly environment. Signage and pictures around the home to assist people with independence and orientation were poor.

There were enough staff on duty to provide care and support to people living in the home.

The provider had robust recruitment procedures in place to ensure staff were suitable to work with

vulnerable adults.

Staff worked in partnership with health and social care professionals to make sure people received the care and support they needed.

Staff were trained to ensure that they had the appropriate skills and knowledge to meet people's needs. They were supported by the registered manager.

Staff sought the consent of people before providing care and support. The home followed the principles of the Mental Capacity Act (2005) for people who lacked mental capacity to make their own decisions.

People liked the food and were able to choose what they wanted to eat.

We found that staff had a good understanding of people's care and individual needs.

People at the home were listened to and their views were taken into account when deciding how to spend their day. Activities were not organised on a regular basis available for people living at the home to participate in.

Care plans provided information to inform staff about people's support needs, routines and preferences. They had been reviewed and most reflected people's care needs accurately.

We observed positive interaction between the staff and people they supported.

A process for managing complaints was in place. People we spoke with knew how to raise a concern or make a complaint.

People living in the home and relatives were able to share their views and were able to provide feedback about the service. Feedback we received from people, relatives and staff was mostly complimentary regarding the management of the home.

You can see what action we told the provider to take at the back of the full version of this report.