This unannounced inspection took place on 1 September 2017. This residential care service is registered to provide accommodation and personal care support for up to 32 people. At the time of the inspection there were 30 people living at the home.

At the last inspection in December 2014 this service was rated as good.

At this inspection the service was rated overall outstanding.

There was a registered manager 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.

The service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the management team. The service put people's views at the forefront of the service and designed the service around their needs. Staff were encouraged and enabled to work creatively which achieved consistently outstanding outcomes for the people receiving care and support. There was a strong system of quality assurance led by the provider and manager that ensured people consistently received exceptional care and support.

The registered manager was inspiring and dedicated to providing care which met the highest of standards. They strived for excellence through consultation, research and reflective practice. They were passionate and dedicated to providing an outstanding service to people. They led with a dynamic approach and continually reflected on how to improve the service further. They demonstrated a strong and supportive leadership style, seeking feedback in order to further improve what was offered. The provider's vision and values were understood and shared across the staff team.

The service was exemplary in responding to people's needs and preferences. People were supported by a service that was devoted to getting to know the people they supported. Relatives told us the service was responsive and well managed. The service sought people's views and opinions and acted upon them.

People were supported with care and compassion and there was an ethos of care which was person centred and valued people as individuals. People received a personalised service which was responsive to their individual needs and there was an emphasis on each person's identity and what was important to them from the moment they moved into the service.

There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks. People were supported to take their medicines as prescribed and medicines were obtained, stored, administered and disposed of safely. People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person and people were actively involved in decisions about their care and support needs.

Staff had received training in the Mental Capacity Act 2005 (MCA) to make sure they understood how to protect people's rights. There was guidance in relation to the MCA and people were asked for their consent before staff carried out any care or treatment. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which

We inspected Gregory House on 02 December 2014. This was an unannounced inspection. Gregory House provides accommodation for up to 32 older people who require nursing or personal care. There were 31 people living in the home when we carried out our inspection some of whom lived with dementia related needs and complex care needs.

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 Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is to protect them. At the time of the inspection no people had their freedom restricted.

People who lived in the home told us that they were happy with the care they received. They felt safe living in the home and said that staff treated them with kindness and respected their privacy and dignity.

On the day of our inspection there were enough staff on duty to meet people’s needs. We found that there were additional senior staff to assist staff when required during busy periods. We found that action had been taken by the registered manager and the provider to increase the staffing levels to reflect the needs of people who lived in the service.

Staff understood people’s needs, wishes and preferences and they had been trained to provide effective and safe care which met people’s individual needs.

People and their relatives were able to raise any issues or concerns and action was taken to address them.

Robust arrangements for ordering, storing, administering and disposing of medicines were in place.

We found that people were provided with a choice of nutritious meals. When necessary, people were given extra help to make sure that they had enough to eat and drink.

People had access to a range of healthcare professionals when they required specialist help.

The home had a dedicated staff member to provide social activities for people and assist people in enjoying their hobbies and interests.

The registered manager assessed and monitored the quality of the service provided for people.

The home had established strong links with local community groups which benefited people who lived in the home.

During our visit we spoke with two people who used the service, two members of staff and the interim manager. We observed the care people received and looked at three people's care records in detail.

One person told us “It’s lovely, we had a lovely Christmas.” A relative said, “In a really good place here.”

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We observed care and saw staff were responsive to people's needs.

We saw from the care plans and observations people received care which was appropriate to their needs.

People told us the staff were caring and looked after them well. When we looked at the records we found they detailed the care people required and care was delivered safely to meet people's needs.

We saw people received appropriate nutrition in order to meet their needs.

We looked at the process for administering medicines and saw it was safe and effective.

The provider had a responsive complaints process in place which effectively dealt with and resolved complaints.

As part of our inspection we spoke with three people who used the service.We also spoke with staff and relatives and looked at records.During our visit we observed how care was provided to people to help inform our judgements.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We saw people were treated with dignity and respect and supported to make decisions about their care. The quality assurance systems in place enabled people to express their views about the services and care they received.

People told us they liked living at the home.

People said the food was good and were given a choice of two dishes at mealtimes.They said, “Food very good” and “Spoilt for choice.”

One person told us about their care they had, "No complaints."

People told us they could usually get help when they needed it. One person said, "I have a call bell,I sometimes get frustrated as can't get to the toilet as quick as I want." We observed people using their call bells and saw staff responded promptly.