New Elmcroft

Systems to monitor the quality and safety of the service were not robust enough to identify shortfalls in people's care, communication or records relied upon to demonstrate the care people had received. The service had a new manager who had begun to implement changes to improve the standard of care and overall governance of the home. However, these changes were not yet embedded or sustained and required more time to embed them in everyday practice and monitor their overall effectiveness to improve people's care.

People's and most relative's experience of using the service was positive. People told us they felt safe and were cared for by staff who knew them well and understood their needs. Staff understood their safeguarding responsibilities and knew how to escalate concerns. There were enough staff to meet people's needs and changes made to the skill mix and deployment of staff, meant nurses had more time to provide care for people.

People and their relatives thought the home was clean and hygienic and people were protected from the risk of infection. Comments included, "The home seems clean and [person's] room is well maintained", and, "The home was clean when I visited before and staff were all wearing PPE, as did we as visitors."

People received care that was responsive to their needs. People were offered choice and their preferences respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's communication needs were assessed, and people had access to information in the way they preferred when needed. People were offered a range of activities which would promote their emotional

wellbeing and reduce the risk of isolation. People were supported to maintain contact with their loved ones and this continued if the home was closed due to COVID-19. One person's relative told us, "The home arranged video calls at times when we couldn't visit."

People received care and support at the end of their lives which was in line with their wishes and preferences. The managers acted on feedback and had taken action to enhance the quality of care people received at the end of their lives.

The managers of the service promoted a positive and person-centred culture which aimed to achieve good outcomes for people. Most feedback received was complimentary about the way the home was managed and the care people received. One person told us, "I enjoy it here, it is different from anywhere else and you know you'll have a good time. The staff are very good really, I have no problems at all."