Elm Cottage, Middlewich is part of the David Lewis organisation and is registered to provide accommodation for four people who require support and care with their daily lives. The home is approximately one mile from the centre of Middlewich. The two-storey domestic type property is close to shops, public transport and other local amenities.

The home is a detached house in the area of Middlewich in East Cheshire. At the time of our inspection there were four people living there.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

We spoke with the people who lived in the home and two relatives who all gave positive feedback about the home and the staff who worked in it.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they had positive relationships with the people in their care.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required.

The residential manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected. Assistive technology was in place to maximise people’s independence and the least restrictive options had been taken.

Care plans were person centred and driven by the people who lived who lived in the home. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required.

The residential manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. The staff team were consistent and long standing. They demonstrated that they were committed to providing the best care possible for the people living in the home.

During our announced inspection on 28 November 2013 we spoke to the registered manager, the residential manager, two members of staff, three of the four people who lived at the house and two of their relatives.

People we spoke to told us that they were happy with the care they received and could make some of their own decisions about how they spent their time. One person said “Happy here, everything good.”

We saw that staff interacted well with people using the service and were kind and caring in the way that they delivered care to people.

We were told that the people living in the house had been encouraged to become involved in the growing of produce and had found this particularly enjoyable.

The staff we spoke to told us that there was effective team work in place. One member of staff told us; “It’s good having a small team, it means the guys get consistent care and that communication between staff members is very good.”

We spoke to staff who confirmed that they knew what to do if a person made a complaint.

We found that people who used the service were given information in a suitable format and helped to express their views about their care and treatment.

People who use the service and their families were involved in Person Centred plans and making choices about care and treatment. People were supported in promoting their independence and community involvement.

People's diversity, values and human rights were respected. A staff member said that people who use the service are, "treated as individuals."

We found that people’s needs were assessed and care and treatment was planned and delivered in line with peoples individual care plan in a way that was intended to ensure their safety and welfare.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening, through regular staff training and a clear policy.

There were enough qualified, skilled and experienced staff to meet people’s needs.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

One relative said, "My son can't tell us how he is, but we can tell by his demeanour that he is really happy"

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During our inspection we spoke with people who use the service and a relative.

The relative we spoke with told us they were satisfied that staff treated people with respect and maintained they dignity. They also told us that their family member would tell them if they were unhappy with staff. We were told by the relative they were very involved with their family member. They also told us they supported them with decisions about the care and treatment they received.

According to the relative they have seen their family member’s person centred plans and that they included the wishes and choices of the individual. They also told us they were kept informed of incidents that may affect the well being of their family member

We were told by the relative they were satisfied their family member was receiving appropriate support with their health and social care needs.

The relative we spoke with told us that had no concerns or worries about the safety and well-being of people who use the service. They said they visit the home on a regular basis and have always seen staff support people in a kind and caring manner.

The relative we spoke with told us that staff were kind, caring and made them feel welcome when they visited the home. They also told us that because of the support and help offered by staff they had no concerns about the care their family member was receiving.

The relative we spoke with told us staff asked for their views about the service offered to their family member. They said they attended reviews and spoke with staff on a regular basis. They told us they knew who to speak with if they had any concerns or worries. The relative also told us they would take action if they felt their family member was not receiving appropriate care and treatment. .

The inspection was unannounced and took place on18 March and 29 May 2015. This location was last inspected in January 2014 when it was found to be compliant with all the regulations which apply to a service of this type.

Elm Cottage is part of the David Lewis Centre which supports adults with complex needs to attain quality of life and to maximise their potential in a safe residential environment. The home is registered to provide accommodation for four people who require support and care with their daily lives. There were four people living there at the time of the inspection.

The home is approximately one mile from the centre of Middlewich. The two-storey domestic type property is close to shops, public transport and other local amenities. The home draws on the rest of the David Lewis Centre for certain support arrangements most notably clinical, social work and administrative services.

There is a registered manager at Elm Cottage. 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 care was provided in an environment which was as homely as possible. Staff went to considerable lengths to make sure that people who lived there experienced it as their own home and undertook the many of the same tasks and made the same choices as other people living in the community.

Staff knew about the need to safeguard people and were provided with the right information they needed to do this. They knew what to do if they had a concern. They were well-trained. There were sufficient staff to meet the needs of the people who lived in the home

The home was well-decorated and maintained and adapted where required. People had their own bedrooms which they could personalise as they wished. As well as community facilities people also had access to the specialist services available at the main David Lewis Site.

As part of the larger David Lewis Centre the home benefitted from being able to use many of the corporate systems which the main provider had developed. This meant that the home was well managed.