Garfield Grange

Garfield Grange is registered to provide accommodation for people who require personal care. The service supports people living with learning and physical disabilities. It is located in Preston, a village on the outskirts of Hull. At the time of this inspection no one was living at the service.

The service is also registered to provide personal care. It provides care and support to young and older adults who have learning disabilities and/or autism, physical and sensory needs living in 10 'supported living' settings', so that they can live in their own home as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support. Of the 27 people receiving support from the service at the time of the inspection, nine were receiving 'personal care'. Because of this we focussed our inspection on people who received personal care.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

The service had a registered manager who was present during this inspection. 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 our last inspection in December 2015, we rated the service as good. This inspection found the service has improved its rating from good to outstanding.

The provider had an extremely positive person-centred culture and this underpinned their service. The registered manager and staff were committed to delivering a service which was extremely caring and empathetic. Without exception, people, their relatives and healthcare professionals expressed their satisfaction about the service.

People received care and support that was extremely responsive to their individual needs and preferences. Staff worked collaboratively with other professionals to ensure people received care that enabled them to live as full a life as possible, particularly where their skills had deteriorated. A healthcare professional and relatives spoke very highly of the service provided. We saw examples where staff and the registered manager had gone above and beyond to support people to grow in confidence and regain as much independence as possible.

Staff supported people to do the things they enjoyed and encouraged independence with daily living. Support plans contained clear information about the person's level of independence as well as details of areas where staff support was required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff were trained and understood the principles of the Mental Capacity Act. People were involved in their own care planning and were able to contribute to the way in which they were supported.

People we spoke with felt safe using the service. We saw that risks were well managed. People were safely supported with their medicines where required. There was a procedure in place to ensure any safeguarding concerns were addressed and reported. There were sufficient numbers of staff deployed to meet people's needs and it was clear from the evidence we reviewed that staff had been safely recruited.

Complaints, concerns and feedback were taken seriously and used as an opportunity to improve the service. The registered manager had informed the CQC of significant events. Record systems were accurate, well maintained and held securely.

The provider had effective quality monitoring arrangements through which they continually reviewed evaluated and improved people's care. People, their relatives, staff and healthcare professionals felt the service was well managed. Staff described the registered manager as approachable and supportive. There was a positive culture and ethos at the service which was driven by the registered manager. Staff were positive about the service and their contribution to supporting people to lead full lives.

The five questions we ask about services and what we found