We inspected Elstree Court Care Home on 19 and 26 April 2018 and our visit was unannounced. Elstree Court Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Elstree Court Care Home accommodates up to 41older people in an extended and adapted building. It provides accommodation and facilities over three floors and most areas have level access with chair lifts available in areas where steps are located. Care is provided to people whose main needs relate to nursing, and related physical health needs. This includes people who have had a stroke or live with a chronic health condition like Multiple Sclerosis, Diabetes or Motor Neurone Disease. People's nursing needs varied, some had complex nursing and care needs, others also required support with dementia and memory loss. Elstree Court Care Home also provides end of life care and used community specialist to support them in this care.

The service had a registered manager in place. 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.

At the time of this inspection 33 people were living in the service. Elstree Court Care Home was taken over by a new provider at the end of December 2017 and this is the first inspection under new ownership.

The provider had not ensured everyone had an opportunity to engage in meaningful activity. There was an activities co-ordinator who had developed an activities programme. This provided some group activity but did not ensure people’s individual needs were responded to effectively. We have made a recommendation that the provider seeks advice, guidance and training from a reputable source, to support staff in providing suitable activities and entertainment to meet people’s individual assessed needs.

People were happy with the care and support they received and they felt safe. Family members were complimentary about the care and support provided to people. Visiting professionals provided very positive feedback on the staff and the delivery of care. Medicines were handled safely and risks to people’s health and support were identified and responded to appropriately.

People were looked after by staff who knew and understood their individual needs well. Staff were kind and treated people with respect, and promoted their individuality. One relative complimented the staff and said, “It is wonderful here, I thought they had kindness lessons, they are so wonderful and kind.” Staff spoke to people in an appropriate way, promoted communication and took a genuine interest in what they had to say. There were enough staff to respond to people’s care needs on a daily basis.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse or discrimination. Recruitment records showed there were systems which ensured as far as possible staff were suitable and safe to work with people living in the service. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and followed correct procedures to protect people’s rights.

People were supported to receive regular drinks and the meals that reflected their choices and needs. Visitors told us they were welcomed and people were supported to maintain important relationships and friendships. The environment was clean and well maintained. The provider had ensured safety checks had been maintained and equipment and facilities in the servi