This inspection visit took place on 18 September 2018 and was unannounced.

Elliott Residential Care Home 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. The service is provided in a three-storey adapted Victorian villa. The service is registered to provide care and accommodation for up to 17 people. At the time of our inspection, there were 15 people using the service. Many of the people using the service were living with mental health needs and some people were living with dementia.

At the last inspection in November 2017, the service was rated as Requires Improvement. At this inspection, we found the evidence supported an improvement in the rating of the service to Good.

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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place and provided detailed information and guidance for staff about the potential risks people faced. Staff supported positive risk taking which enabled people to manage risks whist also promoting their independence. The service learnt from incidents and accidents and took action to minimise the chance of these occurring again.

People were supported by sufficient numbers of staff to meet their needs. Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

People were supported to take their medicines as prescribed. Infection control procedures were in place and followed by staff to protect people from the risk of infection.

Staff were supported and supervised and completed induction and development training. This helped to ensure they had the skills, knowledge and expertise they needed to perform their roles. Specialist training was provided to ensure people's needs were met.

People's needs were assessed and people were supported to maintain good nutrition and access healthcare to maintain their health and wellbeing.

People's consent was gained before any care was provided. People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way possible. Staff had received training and information which enabled them to provide care in line with the guidance of the Mental Capacity Act 2005.

The provider had begun work to improve the premises, which included replacement of furniture and fittings and redecoration. Some work had been completed at the time of our inspection visit and further work was planned to complete the upgrade of the service.

People received care from staff that knew them well and consistently treated people with dignity and respect. People were supported to maintain their independence and staff protected people's right to privacy.

People were involved in developing their plans of care which enabled them to receive care and support in line with their preferences. People and relatives were involved in reviews of people's care to ensure the care provided met people's current needs.

A process was in place which supported people to raise concerns and complaints. People felt confident their concerns would be listened to and acted on.

People, relatives and staff had confidence in the leadership and governance of the service. The provider had effective systems in place to monitor the quality of the service to ensure people received good care. Actions were tak

This inspection took place on 28 November 2017 and was unannounced. This was the first inspection of this service since they registered with us.

Elliot Residential Care Home provides accommodation and personal care for up to 17 people and is based near the centre of Leicester. The service specialises in supporting people who are living with mental health needs. Accommodation is provided over three floors, accessible only by stairs. At the time of our inspection there were 13 people using the service.

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.

Records showed people were involved in the development of their care and supported to make day-to-day decisions and choices. The provider had not undertaken assessments of people's mental capacity to make specific decisions about their care, support and treatment. Records did not reflect the possibility that people may lack mental capacity at times to make decisions in their best interests due to their health needs. This meant that people may not receive the support they need to make their own decisions and choices in line with relevant legislation and guidance.

People told us they felt safe in the service and relatives felt their family members were safe. Staff were trained in safeguarding and knew what to do if they had concerns about the well-being of people.

Potential risks people were exposed to and assessed and reviewed. Risk assessments lacked the detail and guidance needed regarding measures staff should take to reduce the risk of harm.

Care plans identified where people and others were at risk through behaviours that may challenge. However records did not include clear guidance on the nature of behaviours and interventions required by staff to keep people safe.

The provider had effective recruitment processes in place which helped ensure only suitable staff were employed in the service. There were sufficient staff to meet people's needs. People received their medicines safely and as prescribed.

Systems were in place to ensure the risk of infection was prevented and controlled. The registered manager reviewed incidents to improve safety within the service.

People's needs and choices were assessed and their care provided in line with their wishes and preferences.

Staff had most of the skills and knowledge to meet people's needs. Staff had undertaken training to enable them to provide effective care and support. We have made a recommendation that staff receive specific training in managing people’s complex mental health needs as a matter of priority.

Staff felt supported in their roles through supervision and were encouraged to develop within their roles through additional training and opportunities.

People were supported to have sufficient to eat and drink and maintain their health and well-being. Staff supported people to use and access a wide variety of services and health professionals to ensure they received healthcare to meet their needs.

The provider was in the process of upgrading the premises to meet people's needs. This included replacement of furnishings and redecoration.

People had developed positive relationships with staff, who were caring and treated people with respect. Staff understood and promoted people's right to privacy and dignity. Staff were knowledgeable about people's needs and effective communication ensured people were supported to make decisions about how their care was provided. Staff encouraged people to be as independent as possible.

Staff were knowledgeable about the people they supported and knew their likes, dislikes, preferences and interests. Care plans were not consistently person centred as t