Eltham House provides care and accommodation for up to six people with a diagnosis of a learning disability or autistic spectrum disorder. On the day of our inspection visit there were five people living in the home. The home is located in Cheylesmore, Coventry in the West Midlands.

The home was last inspected in January 2017. At that inspection we found two breaches in the legal requirements and Regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014.

These breaches were in relation to the care and support people received. The provider did not ensure risks to people’s safety and well-being were assessed. Where risk had been assessed management plans were not up to date. This meant staff did not have the information they needed to keep people and themselves safe, including in an emergency. The provider did not have effective systems and process in place to monitor and improve the quality and safety of the service people received.

The home was rated as Requires Improvement. We asked the provider to tell us how improvements were going to be made. In response the provider sent us an action plan which detailed the actions they were taking to improve the service.

At this inspection on 31 October 2017 we checked to see if the actions identified by the provider had been taken and if they were effective. We found sufficient action had been taken in response to the breaches in Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the provider was no longer in breach of the Regulations.

There was a registered manager in post at the time of our inspection. A requirement of the service's registration is that they have a registered manager. 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 and associated Regulations about how the service is run. The registered manager is also the provider for this service and is referred to as the provider throughout this report.

Risks to people’s safety were identified and assessed. However, further improvement was needed to ensure records relating to the support people required in the event of a fire, or other emergency were clear and to ensure all staff knew where these records were kept. People told us they felt safe living at Eltham House and staff were happy working at the home. Staff understood how to protect people from abuse and their responsibilities to raise any concerns.

People’s care plans contained up to date information which provided staff with the guidance they needed to provide personalised care. Staff demonstrated a good understanding of the needs and preferences of the people they supported. People and some relatives were included in planning how they were cared for and supported.

There were systems in place to monitor the quality and safety of the care and support people received, and the provider regularly sought feedback from people and their relatives and other visitors. The provider used this feedback to make improvements to the service provided.

Staff were recruited safely and there were enough staff to support people at the times they needed. People received their care and support from staff who they knew and people were supported to take part in meaningful activities.

Staff completed an induction when they started working at the home and had their work practices regularly checked by a member of the management team. Staff completed training the provider considered essential to meet people’s needs safely and effectively. People received their medicines as prescribed from trained staff.

The management team and staff understood the principles of the Mental Capacity Act (MCA) and their responsibilities under the Act. Staff gained peoples consent before they p

This inspection took place on January 2017 and was unannounced. Eltham House provides care and accommodation to a maximum of six people. On the day of our inspection visit there were five people who lived at the home. The home provides care and support to people with physical disabilities, learning disabilities, or autism spectrum disorders. The home is located in Cheylesmore, Coventry in the West Midlands.

The home was last inspected on 7 March 2016, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, the home was awarded an overall rating of ‘requires improvement’. This was because care records and risks assessments had not been updated when people’s needs changed, and risk management plans were not always followed by staff. Medicines were not consistently managed in line with the provider’s medicines management policy. Systems to monitor and improve the quality and safety of the service had not identified where improvement was needed to mitigate the risk to people’s health and safety.

There was a registered manager in post at the time of our inspection. A requirement of the service's registration is that they have a registered manager. 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 and associated Regulations about how the service is run.

At this inspection on 4 January 2017, we checked to see if improvements had been made. We found some actions had been taken, but there were still areas where improvement was needed.

Risk assessments had not been updated when people’s needs had changed and did not give staff the information they needed to minimise risks associated with people’s care and support needs. Measures were not in place to enable staff to support people safely in the event of a fire, or other emergency at night.

Most care plans did not support staff to provide personalised care consistently as they had not been reviewed and information in them was not always accurate. However, where up to date information was lacking, staff demonstrated a good understanding of the needs and preferences of the people they supported.

The provider had not taken steps to ensure the systems used to monitor and check the quality and safety of service provided were consistently effective and supported the service to improve.

People and their relatives told us they felt safe living at the home and staff treated them well. Staff knew how to safeguard people, and were clear about their responsibilities to report safety concerns to the manager. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible; they were safe to work with the people who lived there.

Staff respected people’s privacy and dignity and supported people to maintain their independence. People who lived at the home were encouraged to maintain links with friends and family who could visit the home at any time.

Staff were available at the times people needed them and had received training so that people’s care and support needs were met. Staffing levels enabled people to have the support they needed to take part in interests and hobbies that met their individual needs and wishes.

People were encouraged to eat a varied diet that took account of their preferences and specific dietary requirements. People were supported to attend health care appointments with health care professionals when they needed to, and received healthcare that supported them to maintain their wellbeing. Medicines were managed and administered safely.

People were encouraged to make choices about their daily lives and were involved in decisions about their care. People and relatives knew how to make a

We inspected Eltham House on 7 March 2016. The inspection visit was unannounced.

Eltham House provides care and support for up to six people with physical disabilities, learning disabilities, or autism spectrum disorders. The home is located in Cheylesmore, Coventry in the West Midlands. There were five people using the service when we visited. Each person had their own bedroom and there was a shared lounge, conservatory and kitchen diner at the home.

There was a registered manager in post at the time of our inspection. A requirement of the service's registration is that they have a registered manager. 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 and associated Regulations about how the service is run. We refer to the registered manager as the manager in the body of this report.

People and their relatives told us they felt safe living at the home and staff treated them well. Staff knew how to safeguard people and were clear about their responsibilities to report concerns to the manager. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible; they were safe to work with the people who lived there.

Risks associated with the delivery of care and support for people who lived at the home had been assessed. However, risk management plans and risk assessments had not always been updated when people’s care or support needs changed, and were not always followed by staff. This meant the risks associated with people's care were not always monitored and managed, so that risks to people were minimised. Systems to ensure medicines were managed safely were not consistently effective. Staff had not followed the provider’s policy and procedure to ensure the safe management and administration of controlled medicines.

There were enough staff employed at the home to care for people safely and effectively. New staff completed an induction programme when they started work to ensure they had the skills they needed to support people effectively. Staff received training and had regular meetings with the manager in which their performance and development was discussed.

People were supported in line with the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The provider had made applications to the local authority in accordance with DoLS and the MCA, and at the time of our inspection was awaiting the outcome of those applications.

People were encouraged to eat a varied diet that took account of their preferences and specific dietary requirements. People had access to a range of healthcare professionals. However, the advice of health care professionals was not consistently recorded on care records, or followed by staff to ensure people received the care they needed when their health changed.

Staff treated people with respect and dignity, and enabled people to maintain their privacy and independence. People who lived at the home were encouraged to maintain links with friends and family who could visit the home at any time.

People were supported in a range of activities, both inside and outside the home. Staff were caring and encouraged people to be involved in decisions about their life and their support needs. People were supported to make decisions about their environment and choose how their room was decorated.

People’s care records were not always reflective of their care and support needs therefore did not provide staff with up to date information about how people should be cared for and supported. However, staff had a good understanding of the needs and preferences of the people they supported. People and their relatives thought staff were caring and responsive to people’s needs.

People knew how to make a

We visited the service unannounced on a weekday morning. One person was eating breakfast when we arrived. We sat with another person whilst they ate their breakfast later in the morning. We saw people made choices about food preferences, when they got up and how they wanted to spend their time.

Two members of staff were on duty providing personal care to four people throughout our visit, in addition to the manager and the assistant manager. The staff numbers allowed for individual attention for people and supported people to take part in activities inside and outside the home.

We saw people appeared to be enjoying different tasks and their daily routine. Everyone who used the service were happy to be introduced to us. Some people spent time chatting to us. Other people were happy to show us around their rooms and the communal areas. People indicated to us they enjoyed living at the home. One person said, "I like it here."

We were shown copies of customer satisfaction survey forms which had been completed recently. People were positive about the service. One person who lived there had written, "I like living here, it makes me happy."

We saw a system was in place to record and report any issues that could be considered as safeguarding. We saw contact numbers were displayed for the local authority and the CQC. The manager was clear about what to do when reporting safeguarding concerns.

We visited the service unannounced on a weekday morning. One person was eating breakfast when we arrived, we stayed until some people who lived at the home went out for the lunchtime meal. There were six people living at the home during our visit. Three members of staff were on duty providing personal care throughout our visit. In addition the manager and another member of staff undergoing a work placement was available.

We saw people appeared to be enjoying different tasks and their daily routine. Everyone who used the service were happy to be introduced to us. Some people spent time chatting to us. Other people were happy for us to be shown around their rooms and the communal areas.

People who lived at the home all had very different strengths and needs. We saw people being supported in ways that suited their individual needs. Staff we spoke with showed good knowledge of the skills and abilities of each person who lived at the home. We observed staff had a good rapport with people who used services.

We asked people if they were treated with consideration and respect. People told us they were treated with consideration and respect. One person told us “I can choose my activities and the meals that I want.”

People told us they enjoyed living at the home. One person said “I like it here.” Another person told us "I've been here a long time."

People living at Eltham House have complex communication needs. We used a variety of methods to understand their experiences of living in the home.

We used Makaton (a system of sign language and symbols) signs and observed their interaction with staff. We talked with people and to staff and managers.

People signed to us that the staff team and the home were "good."

People were clearly comfortable and relaxed with the staff team on duty. They showed this by seeking out staff members' company and smiling and laughing with them.

The two members of staff and two managers we spoke with were knowledgeable about people's needs and understood how to communicate with them and respond to situations that could cause people anxiety or distress or place them at risk of potential harm.