Garland House provides personal care and accommodation for a maximum of 19 older people. At the time of our inspection, there were 16 people accommodated in the service, five of whom were living with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people. There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role.

Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions. Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People were supported to have choice and their independence was promoted by staff who understood the needs of older people and of those living with dementia. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People were very complimentary about the meals and quality of food provided. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records help staff deliver care that met people’s individual needs. The activities provided were suitable for older people and people living with dementia.

The provider and the management team were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and care.

Further information is in the detailed findings below.

At the time of our inspection there were 19 people using the service. People told us that they were happy with their care, staff treated them with respect and that their privacy and dignity were maintained. We were told that the staff made sure that people's healthcare needs were responded to and appropriately met, and that staff had a good understanding of people's individual care and support needs. Care records were detailed, contained people's support plans and preferred routines throughout the day and staff were observed to follow these in practice. Risks to people's safety and welfare had been assessed and minimised as far as possible and kept under review. A visiting relative told us that they had never had any concerns, that they were welcomed as a visitor to the service and that "the family are very happy with the home".

All the people we spoke to expressed their satisfaction with the service and the level of support provided, and did not raise any concerns about the quality of care. They also said that they would go the manager or staff if they needed to raise a concern and would feel comfortable in doing so.

Many comments we received were complimentary of the service. One person said "the care is really extraordinary, they think of everything" and another stated that they were "well looked after" and "treated with respect". Another person commented how the staff "get to know people and what they like".

We spoke individually with nine people who lived at the home. We also used some other methods to gain information about what it was like to live there. We spoke with people visiting the home, spoke with staff, read records including care plans, and observed people during the day.

The people using the service told us they were given choices about their daily routines such as when to get up and go to bed, what to eat and what to do each day. They said staff respected their choices. One person told us they had chosen to have breakfast in bed that day and another that they had got up later than usual as they felt tired. They said staff understood that sometimes they liked to change their usual routines.

People told us that staff were kind and caring and when they needed assistance with anything, staff responded quickly during the day and at night.

People said they were happy with their rooms and said that that their rooms were always kept clean. They said the rest of the home was always kept clean and tidy.

People told us that they liked the meals at the home and there was enough choice. They said that if they did not like a meal there was always an alternative and that staff understood their likes and dislikes and made options available for them.

Some of the comments people living at the home made were,

“ The food is good and the place is kept clean”

“The food is excellent, remarkably good”

“I chose the home as this one had the right atmosphere, people were chatting to each other and seemed happy”

“They really look after you well “

“ The carers are absolutely marvellous but they can be short at weekends”

“The caring is 100%”

“ I manage my own medicines and they just check it is all there”

Garland House provides personal care and accommodation for a maximum of 19 older people. At the time of our inspection, there were 16 people accommodated in the service, five of whom were living with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good and met all relevant fundamental standards.

Staff knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.

Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. Appropriate steps had been taken to minimise risks for people. There was a sufficient number of staff deployed to meet people’s needs. Thorough recruitment procedures were in place to ensure staff were of suitable character to carry out their role.

Staff received essential training, additional training relevant to people’s individual needs, and regular one to one supervision sessions. Staff knew each person well and understood how to meet their support and communication needs. Staff communicated effectively with people and treated them with kindness and respect.

Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People were supported to have choice and their independence was promoted by staff who understood the needs of older people and of those living with dementia. Staff supported people in the least restrictive way possible and the policies and systems in the service supported this practice.

The staff provided meals that were in sufficient quantity and met people’s needs and choices. People were very complimentary about the meals and quality of food provided. Staff knew about and provided for people’s dietary preferences and restrictions.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. These records help staff deliver care that met people’s individual needs. The activities provided were suitable for older people and people living with dementia.

The provider and the management team were open and transparent in their approach. They placed emphasis on continuous improvement of the service. There was a system of monitoring checks and audits to identify any improvements that needed to be made. The registered manager acted on the results of these checks to improve the quality of the service and care.

Further information is in the detailed findings below.