Gardiner's

At the time of the inspection a registered manager was in post. 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.

The service was rated at the previous inspection of September 2015 as safe and remained safe. Sufficient staff were employed to manage people's needs, and enable them to engage in activities of their choice, through appropriate risk management. Staff knew how to safeguard people from abuse and were aware of the protocols to follow should they have concerns. Staff reported that they would not hesitate to whistle- blow if the need arose. Where staff were involved in medicine management this was managed safely. Staff were competency checked annually and audits were completed monthly to ensure people were supported by staff with the necessary skills to keep them safe.

The service remained effective. Support was delivered by a highly trained staff team, who were able to respond appropriately to people's changing needs. Staff were supervised and supported by an effective management team, who made certain they were available to staff at all times. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained caring. Staff were reported to be polite, respectful and ensured they maintained people's dignity when supporting them. They encouraged open communication and worked on motivating people to increase their independence. Evidence of using systems of communication that reflected the person's choice highlighted that staff communicated with people in the way they wished.

The service remained responsive. Care plans were individualised, focusing on people's specific needs. The service took necessary action to prevent and minimise the potential of social isolation. Activities were arranged and co-ordinated by the service to increase community engagement, and increase well-being. People reported having accessed the community after considerable length of time of not doing so. This reportedly made them feel a sense of belonging. People and staff were protected from discrimination. The service understood the importance of ensuring Equality Diversity and Human Rights (EDHR) was met, and that people's protected characteristics were not discriminated against. Measures were in place to allow people to be treated equally, with systems continually being reviewed to ensure exemplary practice was maintained. Systems to monitor and investigate complaints were in place.

The service had developed exceptional methods of good governance that provided real time evaluation of practice. A thorough quality assurance audit was completed annually with an action plan being generated, and followed upon. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management. Staff spoke highly of the registered manager's skills and how these were shared with staff to continually help them grow and achieve good practice. The service focused on developing relationships with the community and with relatives of people, so to ensure good practice was maintained for the person continually. The service was considering offering family carers the opportunity to attend training that would enable them to have an insight into their loved one's lives and how they saw the world. The service developed systems to help people achieve a fulfilling life. The service was well-led and focused on staff having ownership of the service.

The five questions we ask about services and what we found