This unannounced inspection took place on 15 September 2017.

Elm House provides accommodation with personal care for up to eight people with learning disabilities. The home is situated in the market town of Bolsover and is a two floor property with a number of communal areas and large garden available for people to use. There were eight people in residence when we inspected.

At the last inspection on 28 May 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were safe. There were sufficient numbers of experienced and trained staff to safely meet people’s assessed needs.

People’s needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe. Risks to people’s safety were reviewed as their needs and dependencies changed.

People received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. People were treated equally and shown respect as individuals with a range of needs that came together from a diverse backgrounds.

People were protected by robust recruitment procedures from receiving unsafe care from staff that were unsuited to the job. They were safeguarded from abuse and poor practice by staff that knew what action they needed to take if they suspected this was happening.

People’s individual preferences for the way they liked to receive their care and support were respected. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive them. They had insight into people’s capabilities and aspirations. People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.

People were encouraged and supported to use community facilities and attend day centre activities and work placements.

People had enough to eat and drink. People who needed encouragement and support with eating a healthy diet received the help they required.

People that required support with taking medicines received the help they needed. Medicines were appropriately and safely managed and staff had received the training they needed in the safe administration of medicines. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups.

People, and where appropriate, their family or other representatives were assured that if they were unhappy with the care provided they would be listened to and that appropriate action would be taken to resolve matters.

This unannounced inspection took place on 15 September 2017.

Elm House provides accommodation with personal care for up to eight people with learning disabilities. The home is situated in the market town of Bolsover and is a two floor property with a number of communal areas and large garden available for people to use. There were eight people in residence when we inspected.

At the last inspection on 28 May 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 were safe. There were sufficient numbers of experienced and trained staff to safely meet people’s assessed needs.

People’s needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe. Risks to people’s safety were reviewed as their needs and dependencies changed.

People received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. People were treated equally and shown respect as individuals with a range of needs that came together from a diverse backgrounds.

People were protected by robust recruitment procedures from receiving unsafe care from staff that were unsuited to the job. They were safeguarded from abuse and poor practice by staff that knew what action they needed to take if they suspected this was happening.

People’s individual preferences for the way they liked to receive their care and support were respected. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive them. They had insight into people’s capabilities and aspirations. People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.

People were encouraged and supported to use community facilities and attend day centre activities and work placements.

People had enough to eat and drink. People who needed encouragement and support with eating a healthy diet received the help they required.

People that required support with taking medicines received the help they needed. Medicines were appropriately and safely managed and staff had received the training they needed in the safe administration of medicines. Medicines were securely stored and there were suitable arrangements in place for their timely administration.

People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups.

People, and where appropriate, their family or other representatives were assured that if they were unhappy with the care provided they would be listened to and that appropriate action would be taken to resolve matters.

We spoke with two people living at Elm House and observed how staff supported them. One person living at the home told us that they were happy there. We looked at some people's care records and saw they were detailed and personalised.

We saw that documents about people's care were compiled using picture images so that they would more easily understand what they were about. We found that any risks that could affect people , these were properly assessed and managed, and people had positive behaviour support strategies to help them if they felt anxious, angry or upset.

We found that medicines safety was much improved and saw the provider had good recording and auditing systems in place. However the provider did not ensure the safe storage and handling of people's medicines.

People told us they moved in four years ago and chose to live here on advice from friends. People we spoke with said they were happy at the home and liked living there. We were told that they could choose what video and TV they watched, and what time they got up and when to bed.

We were told that they do not have service users meetings but would sort out things with the staff.

People said "I do not know what a care plan is , but would speak to the staff if there was anything I wanted to do."

People we spoke with told us that they enjoyed living at Elm House, and they were happy with the care they received. However, we found that peoples’ care records did not provide sufficient information to show the care support and treatment needed to ensure that people received safe and appropriate care.

People we spoke with told us they had been to the cinema, been to the Friends club in Chesterfield and had attended the day centre in the week. Then at weekends they liked to take it easy.

We were shown one person’s bedroom and the new furniture which had been purchased for them by the family.

We found that the provider had systems in place to ensure the administration dispensing and monitoring of controlled drugs but not for general prescribed medicines.