The inspection took place on the 5 September 2016 and was unannounced.

Dystlegh Grange provides accommodation and personal care for up to 40 people who have needs related to old age or physical disability. The home is located in Disley near to the local golf club and is set within landscaped gardens. It was once the nineteenth hole of the local golf club and since the early 1980’s the building has been transformed through a programme of imaginative re-design and development.

The service had a registered manager in post, who was also the managing director of the company that owned the home. He had been in post since the home opened 35 years ago. 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.

Prior to this inspection we received feedback from the local authority contract monitoring team. Their latest quality monitoring report from June 2016 stated “All residents and relatives commented that the home is excellent and whatever they wanted would be provided. The accommodation is of a high standard, the staff and especially the owner will go above and beyond what is required of them”.

The service provided outstanding care and support to people enabling them to live fulfilled and meaningful lives. People told us they liked living there and the staff were extremely kind and supportive. One person said “They do it with love”. Another said "I can honestly say that I have never regretted my decision to take up residence within this happy community".

The registered provider’s philosophy was that the staff were there to help people to make a new home at Dystlegh Grange and support them to live their lives as they wished, consistent with their needs. In conversation with staff, it was clear that they saw their role as supporting people to maintain as much independence and self-determination as possible.

People visited Dystlegh Grange and were assessed prior to admission to determine whether the home could meet their needs. People generally moved there when they had few personal care needs, but if they became more dependent with advancing age or illness the staff, together with local health services, were able to support them.

The interactions we observed between people and staff were positive. We heard and saw people laughing and smiling. People looked comfortable, relaxed and happy in their home and with the people they lived with.

People’s health and well-being needs were well monitored. The registered manager and staff responded promptly to any concerns in relation to people’s health and were knowledgeable about people’s medical history. Staff always accompanied people to hospital appointments and visited them in hospital.

People had their medicines managed safely, and received their medicines in a way they chose and preferred.

People were fully involved in menu planning and the meals were varied and of a high standard. Any special diets were catered for.

People who lived at Dystlegh Grange were supported to lead a full and active lifestyle. Activities and people’s daily routines were personalised and dependent on people’s particular choices and interests. People were supported to develop their skills and pursue their hobbies and interests.

People were able to express their opinions and were encouraged and supported to have their voice heard. People were fully involved in planning and reviewing their care and support needs.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation

We spoke with four people who used the service as well as one visitor who had previously used the service.

One person told us, "It's brilliant; there is no limit to what the staff will do, they're fabulous." Another person told us, "The manager is an exceptional person, a one-off."

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that care plans clearly identified the needs of the person and had been reviewed on a regular basis.

One person told us, "If I hadn't come here, I wouldn't be alive today. The staff are very good."

The home had a safeguarding adults procedure that complied with all of the relevant legislation and good practice guidelines. Staff understood their responsibilities to protect people from harm.

People were supported in premises that were suitably designed and adequately maintained to meet their needs.

The manager told us training was delivered by a variety of methods. For example, in-house training and attending courses with external training providers. We saw a detailed and comprehensive training schedule.

People's records, staff records and other records relevant to the management of the services were up to date, accurate and fit for purpose.

We spoke with seven people who used the service as well as several visitors, including a visiting GP. All the people we spoke with told us they were extremely happy with the care and support they received. One person told us, "I love living here. Everything about it’s brilliant". Another person commented, “It feels like a hotel with care”.

We found evidence that there were procedures in place to assess the capacity of people to consent to their care and treatment. We found that people’s decisions about how they wished their support to be provided were respected.

We saw that care plans clearly identified the needs of the person and had been reviewed on a regular basis. One person told us, "The care I receive is excellent. I always get what I need when I need it”.

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People spoken with told us they received appropriate support with their medication. We found evidence that there were systems in place for the safe administration of medicines.

We saw evidence that there were effective recruitment procedures in place to ensure that people who used the service were protected from inappropriate staff.

We found that suitable arrangements were in place to manage an effective complaints process for identifying, receiving and handling complaints for people living at Dystlegh Grange.

We spoke with eight of the people who lived at Dystlegh Grange and a number of their visiting relatives and friends. All without exception spoke highly of the home praising it for high standards of care and accommodation. One person told us that the standard of care was excellent. They described how the staff team had supported them and encouraged them to stay as independent as possible. They told us that they had great confidence in the staff because they were well trained, skilled and carried out their duties and responsibilities in good humour.

All the people we spoke with told us that they had their needs assessed before they moved so they were confident that their needs would be met. One person who had recently moved in told us that the home exceeded all their expectations and said it was absolutely marvellous. They told us that the information they had been given was good and that they had been made to feel very welcome by the staff. They told us that the staff treated them with dignity and respect so they made the decision to move in very easy.