Harleston House is a residential care home that provides care for up to 39 older people. Some people using the service were living with dementia. At the time of this unannounced inspection of 12 November 2018, there were 38 people who used the service. This service was registered on 7 December 2010.

At our last inspection on 20 April 2016, we rated caring as outstanding and the service overall as good. At this inspection we found that the service had continued to develop and improve, with caring, responsive and well led now rated outstanding. The overall rating for the service is outstanding.

A registered manager was in post at the time of our 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.

People were at the heart of the service; receiving outstanding care that was personalised to them, taking account of their individual needs and wishes. Without exception people, relatives and professionals were full of praise about Harleston House. They were extremely complimentary about the approach of the staff and the management team, describing them as incredibly kind, compassionate and respectful towards them. People and relatives shared numerous examples of how compassionate and dedicated staff repeatedly went the extra mile to ensure they were extremely satisfied with all aspects of their care. This included taking the time to ensure every small detail of the care provided met the person's individual needs and wishes to provide a positive outcome for the person. Everybody we spoke with said that they would highly recommend the service.

Harleston House was exceptionally well led. There was dynamic and effective leadership within the service. The service was organised and extremely well run, with an open, transparent and empowering culture. Morale in the service was extremely high, at all levels within the service.

Staff were proud to work at Harleston House and were remarkably motivated and enthusiastic about delivering high quality care. The registered manager led by example and was passionate and committed to ensuring people received tailored care to meet their diverse needs. They were visible and hands on in the home, supported by a management team that demonstrated a holistic approach to achieving positive outcomes for people through person centred care. The registered manager had clear oversight of how the home was meeting people’s physical, emotional and social needs. They effectively demonstrated how their robust quality assurance systems had sustained continual development and improvement at the home.

All the staff continued to be extremely compassionate, attentive and caring in their interactions with people. They consistently promoted and encouraged people’s independence and treated them with the utmost dignity and respect. Staff understood the importance of obtaining consent when providing care. 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.

Ensuring people received care and support tailored to meet their individual needs to enhance their quality of life was integral to the ethos of the home. Staff demonstrated an enhanced understanding about people’s choices, views and preferences and acted on what they said. An enabling and supportive culture focused on meeting the diverse needs of people had been established and was clearly documented in people’s care records.

The staff and management team were exceptionally responsive to meeting people’s needs. People were actively involved in contributing to the planning of their care and support. This was regularly reviewed an

Harleston House is a residential care home which provides accommodation and personal care for up to 39 people, some living with dementia.

There were 35 people living in the service when we inspected on 20 and 21 April 2016.

There was a registered manager 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 provided care and support to people which took account of their individual needs, preferences and wishes. Staff and management were dedicated to providing care which exceeded people’s expectations. Meaningful relationships had been built up between people and staff, and we observed caring and compassionate interactions. Feedback from people, relatives, and professionals during the inspection was very positive.

Staff were motivated to provide care which impacted positively on people’s well-being. Staff worked in partnership with people to ensure that the care delivered was individualised. We observed people and staff singing, dancing and laughing throughout the day. The atmosphere was relaxed and vibrant.

Effective systems were in place which protected people from the risk of abuse. Staff were trained to identify potential signs and knew how to report any concerns.

Risks to people were identified, monitored and reviewed regularly. Assessments guided staff on how to ensure the safety of the people who used the service.

The registered manager and staff supported people who may not be able to make decisions about their own care in line with relevant legislation.

People were supported to maintain good health and had access to a range of health and social care professionals when required.

Appropriate systems ensured people received their medicines safely.

A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner. The service encouraged feedback from various sources, and used this as an opportunity to make changes.

The service had effective management and leadership. There was an open and inclusive culture within the service. There were systems and processes in place to monitor and evaluate the quality of the service provided. Any issues identified by these systems were acted upon quickly and the appropriate actions taken.

During our inspection we spoke with five people who used the service and a relative of a person who used the service. We asked them to tell us how they felt they were being cared for. One person told us, “I love it.” Another person said, “It is very nice. The food is good." We asked people how they felt the staff treated them. One person said, "I haven't got a complaint about anybody." A relative of a person that used the service said, "People are cared for in a dignified way."

We saw that staff asked the people who used the service if they wished to participate in activities and receive support to meet their personal needs. We observed that staff gave people choices.

The service had good infection control procedures in place and there had been no complaints since our last inspection.

The service had appropriate recruitment processes in place to ensure that staff were recruited and vetted before starting work with the service.

People told us that they were happy and content to be living in Harleston House. They appreciated the chances to do different things, and rekindle old interests. They thought the staff were excellent and they could not do enough for the people living there.