Sanderling House

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of good for the safe, effective and well led domains. There has however been a change of rating for the service to Outstanding based on our findings for the caring domain and responsive domain.

People told us that the staff provided very good care and support in respect of their health and wellbeing. We saw excellent evidence of the positive impact this had on people's lives, with emphasis on the promotion of people's rights and independence. Staff and people using the service had developed very caring, strong, meaningful relationships.

Supporting people to live in the community was very well managed with on-going staff support for all stages of the transition. Staff went out of their way to build up close working relationships that were based on trust, understanding and the promotion of people's independence and self-worth to aid people's personal development. Staff told us this was a key element of people's recovery and integration back into independent living. We saw how this had been achieved with the service's dedicated staff and their promotion of enriched innovative care, rehabilitation and social programmes.

The culture of the service ensured people felt they mattered in all aspects of their lives. People and relatives we spoke with were very complimentary regarding the supportive and very caring nature of the manager and staff.

Care was recorded in a very person centred way with excellent emphasis on how people wished and needed to be supported. Staff fully involved people and/or relatives with support plans and care reviews. People were encouraged to make decisions about how their support was provided and staff were very respectful and understanding of people's rights and choices.

The service placed a strong emphasis on a 'person centred approach' to enrich people's lives. This meant care and support was centred on people's individual needs and wishes. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. Relatives told us staff had an exceptional understanding of people's beliefs, values and how they wished their family member to be supported. Feedback from relatives was excellent regarding all aspects of the service.

People's individual communication needs were understood and information provided in a format appropriate for them, which meant they could participate fully.

Staff supported people to access a wide range of community based healthcare services in accordance with individual need. External health professionals spoke highly about the service and the committed values of the highly trained staff team.

People had access to an excellent range of social activities which they enjoyed and people were encouraged to take part in new areas of interest.

People living at the home and relatives we spoke with told us the staff were very caring, polite and exceptionally supportive in achieving daily life goals, developing personal interests and overseeing their health needs.

People told us they enjoyed the menu options and took part in choosing recipes and food shopping.

Staff had been recruited safely so they could work with vulnerable people.

People were supported by a good consistent skilled staff who received appropriate training and support.

Medicines were managed safely and people were encouraged to be responsible for their own medicines according to assessed risk.

Staff were aware of safeguarding procedures and the concept of whistle blowing.

The service had a robust complaints procedure which was accessible for everyone in the home.

The registered manager and staff displayed a clear vision and consistent values in relation to the provision of care and the ethos of the service.

Systems and process were in place to ensure standards were maintained and to drive forward improvements.

People using the service, relatives, staff and external professionals were complimentary regarding the registered manager's leadership and the overall management of the service.

Sanderling House's rating with us, Care Quality Commission (CQC) was displayed at the care home and on the provider's website.

The five questions we ask about services and what we found