This inspection took place on 2,3 and 4 October 2018 and was unannounced. On 2 October 2018, we visited the home and on 3 and 4 October 2018, we spoke with three health care professionals on the telephone and reviewed other records sent to us by the registered manager.

Elmhurst 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 care home can accommodate up to 20 older people and older people living with dementia in one adapted building. Accommodation is provided over three floors. At the time of our inspection there were 18 people living at the home.

This is the first inspection since the provider registered with the CQC under a new legal entity in January 2018.

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 were mostly recruited safely. Overall records showed appropriate recruitment checks had been completed. However we have asked the provider to ensure comprehensive records of all recruitment checks were consistently maintained.

There were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was effective and relevant to their role. Staff were supported by the registered manager and received formal supervision where they could discuss their ongoing development needs.

People who used the service and their relatives told us staff were helpful, attentive and caring. We saw people were treated with kindness, respect and compassion. People felt safe at the home. Staff and the registered manager understood how to make appropriate referrals to the safeguarding team when this was necessary.

Care plans were updated regularly and most reflected accurately what 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. Accidents and incidents were well documented which reflected outcomes and actions taken to mitigate the risk of reoccurrence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service was complying with the legal requirements of the Mental Capacity Act 2005. We saw good evidence people's consent was sought. Consent had been obtained from people about the use of CCTV used within the home and signage about this was visible in the entrance hallway.

People’s healthcare needs were being met and medicines were being stored and managed safely.

Staff knew about people’s dietary needs and preferences. People told us there was a good choice of meals and said they enjoyed the food. There were plenty of drinks and snacks available for people in between meals.

Activities were on offer, according to people’s preferences and choices. Visitors were made to feel welcome and staff knew people and their relatives well. The home was homely, well decorated, clean and tidy.

The complaints procedure was displayed. Records showed complaints received would be dealt with appropriately although none had been received since the provider’s re-registration.

Everyone spoke highly of the registered manager, said they were a visible presence in the home, and were approachable and supportive. The provider had systems in place to monitor the quality of care provided and where issues were identified, action was taken to make improvements. People's feedback was sought though regular me