Ellacombe

Where people were meant to have additional calories added to their diets to support weight management, records did not show this was consistently being provided. This was of particular concern where their daily food records showed they had experienced an overall poor intake.

If people smoked, particularly if using flammable creams on their skin, management plans in place to protect them from harm were found not to be consistently followed.

Some people were known to be at risk of accessing other people's bedrooms, going through drawers and potentially taking items without staff support and supervision. We found drawers containing craft and gardening items, as well as personal cigarette lighters and tobacco, alcohol and items of food that was not found to be stored securely. The assessment of such risks was required to maintain people's individual safety, particular for people living with dementia.

Some improvements to the management of people's medicines were required, in relation to the consistent application of creams. Also, in relation to the guidance in place for staff to follow where people received their medicines covertly (hidden in food or drink).

Whilst we identified some areas of improvement still required at the service, we also identified areas of development and changes made as an outcome of findings from our last inspection. Overall, we found a clear intent by the registered manager to support ongoing improvement at the service.

There were sufficient numbers of suitably trained staff available to meet people's needs. We observed kind and meaningful interactions between people and staff during our inspection. We received mainly positive feedback from people living at the service and their relatives.

We found the registered manager and staff team responsive to our feedback and were keen to make improvements and changes to ensure people received good standards of care. Staff proactively fund raised to support inhouse and external activities, and wanted to ensure people's wellbeing remained a priority of their care.

Staff morale was observed to be good, and we received positive feedback about working at the service. Staff showed compassion and changes in leadership at the service since our last inspection were supporting a changing culture within the staff team.

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.