This inspection took place on the 14 May 2018 and was unannounced. Elston House 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. Elston House is registered for eight people with learning difficulties and Autism in one adapted building,within the building two people lived in two flatlets to support them lived more independently, but accessed the main building on a regular basis. On the day of our inspection, eight people with learning difficulties and or autism were living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

On the day of our inspection there was a registered manager in post who was available throughout the inspection. 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.

People living at the service were protected from harm as the provider had robust processes in place to ensure their safety. Staff were aware of these processes and understood their responsibilities in relation to protecting people from abuse. They had received appropriate training to support their understanding of any safeguarding issues. The registered manager reported any issues of concern to both the CQC and the local safeguarding teams and worked in an open and transparent manner. There were clear processes in place to ensure lessons were learnt following any incidents or events.

The risks to people’s safety were clearly identified and measures in place to reduce these risks. The environment was well maintained and essential equipment regularly maintained.

People were supported by well trained and competent staff in sufficient numbers to keep them safe. Their medicines were managed safely and people were protected from the risk of infection through good hygiene practices and staff knowledge on reducing the risks of cross infection.

People’s needs were assessed using effective evidenced based assessment tools. These were then used to provide clear guidance for staff to assist them to gain a good understanding of an individual’s needs and offer the most effective support to people. Staff were supported with appropriate training for their roles. This included mandatory training and specialist training to manage the different aspects of people’s care.

People were supported to maintain a healthy diet, with all staff showing excellent knowledge of each person’s nutritional needs. There were a number of initiatives in place to support people achieve a healthy lifestyle.

People received excellent support to manage their health needs through well-developed links with internal and external health professionals. Staff used the guidance and support available to affect positive outcomes for people to manage their health needs.

People lived in a well maintained safe environment that supported their privacy and provided space to enjoy a number of social activities.

Staff sought consent from people before caring for them and they clearly understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Staff took great care and time to ensure that the views of people with communication difficulties were captured and acted upon. The service was extremely person-centred and the staff were passionate about caring for people, without discrimination.

People at the service an