Garland House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred support; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred support.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The values of the service to be ‘honest, open, meaningful and empowering’ were understood and acted upon by the management team and staff. Staff were overwhelmingly positive about the culture of the service where they were valued and praised for their roles and people were at the centre of their care. Comments from staff included, “They strive to make you the best you can be. You do it for those smiles”; “I asked for more training on dementia and did the dementia bus, where you put these glasses on to see what it is like to have dementia. It was eye opening and has given me more confidence”; and “It always feels what you have done is appreciated and everyone cares.”

The provider encouraged staff to express their suggestions and ideas and acted on them. Staff had been consulted about what changes could be made to improve the service. This had included buying bathrobes for people when the shower room was completed and to put a poster on one person’s room as a prompt to remind them to clean their teeth.

Relatives and health and social care professionals said the culture of the service had a positive impact on people’s well-being. Feedback from relatives included, “What I liked was when I rang up have a look around they said to just come when I wanted to. I was expecting to make an appointment like the other care homes I rang.”; “The staff act as a team: Some quite young to quite old. But they all muck in to make a nice atmosphere”; “I have recommended them many times over. This home has atmosphere. It is wonderful”; and, “It is small like a little family. It is a happy uplifting home. Very human and we can have a giggle.”

There was a positive culture where the management team focused on things they had accomplished that they were proud of and had improved people’s and staff’s quality of life. Staff had celebrated one another’s birthdays as well as that of residents with birthday cakes. The ‘golden nugget’ scheme was integral to celebrating little things that made a such a difference to people’s lives.

The provider had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty.

People, relatives, staff and health and social care professionals all told us about the exceptional management of the service. They told us managers were compassionate, genuinely interested in the welfare of people and staff and were especially skilled in supporting people with their health needs. A social care professional told us about the registered manager and provider, “They take great care in their roles and are exceptional managers, supported by a strong and dedicated staff team.” We received a compliment about the management of the service in 2025: ‘The home is very well led by management.’

People told us the registered manager was a strong role model and that their person-centred and caring leadership style had permeated to the rest of the management and staff team. They were supported by 2 deputy managers. The deputy managers spent time working alongside the staff team, so they were knowledgeable about people’s support needs. Comments from relatives about the registered manager included, “The manager is amazing and that is why it is such a good care home as her ethos is handed down”; “She said she would not ask staff to do anything she would not do herself”; and “The manager is incredible. A real professional and caring. She loves her staff and her communication skills are brilliant. She cares.” Relatives told us they would or had recommended the service to others due to the qualities of the registered manager.

Staff concurred it was due to the management style and the atmosphere in the service that they had stayed at the service for a long period or did not intend to leave. They explained management supported and valued them whilst also ensuring they provided individual care to people. A staff member told us, “We are very blessed. Colleagues and management are amazing. They are not just colleagues: It is relationships. It is very well-led. I never feel stressed as know if I ask someone they will always help.” Another staff member said, “Management are genuinely excellent in terms of how they organise and prioritise and make sure the best care is given to clients and how they look after staff. We work well as a team.”

The management prioritised keeping up to date with best practice through regular training, attending conferences and attending provider forums. A member of the management team was undertaking level 5 in management and leadership.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us there was a positive culture at the service where they were enabled to speak up and were listened to. Staff said the management team were proactive in enabling them to speak up. They said a member of the team often ‘checked in’ on them during the day to ask how they were which gave them the encouragement to speak up if they needed to. Staff told us any concerns they raised were dealt with appropriately.

Relatives told us they were always warmly welcomed at the service and were able to speak to a member of the management team. A relative told us, “The management is approachable. I would certainly, recommend it because of the atmosphere."

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

There were policies in place to promote equality, diversity and inclusion. Training records demonstrated that promoting understanding of equality and equity for people was part of their mandatory training practices. Staff told us these policies were followed at the service and that they were treated fairly. Reasonable adjustments and adaptions had been made as needed.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had established effective processes to monitor the quality of the service. There were a series of audits with regards different aspects of the service. These were assigned to senior staff and the management team with oversight by the registered manager. In addition, the service had used an external provider to assess the service in line with the outcomes of safe, effective, caring, responsive and well-led. When shortfalls had been identified these had been acted on to ensure the necessary improvements had been made.

Feedback from staff and people who used the service was an integral part of the governance of the service. An external provider was used to gain feedback from staff, relatives, people and health and social care professionals annually. The results of the survey from 2025 and preliminary results from 2026 were that there was high satisfaction with the service. Staff suggestions, ‘golden nuggets’ and people’s feedback from the ‘resident of the day’ was reviewed. This was to highlight areas for improvement but also to highlight what was going well with the service so staff could continue to these things.

Staff understood their responsibilities and roles. There was a clear management structure and staff knew who they were accountable to and their role in supporting people. Staff views and feedback was regularly sought through staff meetings, supervisions and opportunities to speak to members of the management team. Staff said communication with the management team was regular through different channels so they were kept up to date with what was happening at the service.

All the information gained from internal audits, surveys and feedback was set out in the service’s strategic development plan. This set a list of priorities for the service, with timescales and who was responsible for each action. For example, one priority was dementia care development. The service had identified all staff had received relevant training in this area. They had identified that signage in the service and sensory activities could be improved. Additional signage was being sought. Brainstorming had taken place to add more sensory activities which included ‘Sniff Tests’ and for people to feel ‘What’s in the Bag?"

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The management team had built and maintained strong relationships with health professionals, working in collaboration with other services to ensure good, joined up care for people. These health care professionals had complimented the service directly and given very positive feedback during this assessment about the high quality of these working relationships.

The management team understood the benefits of working with members of the local community. They had received visits from a nursery and people with a learning disability in which both people at the service and the visitors had benefitted. The service had visits from volunteers and was looking into links with other community groups.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

There was a strong focus on looking at ways to improve the experience of people using the service. When people had particularly enjoyed aspects of their day, these were celebrated by staff. Feedback from people had been used to make changes to the service such as developing a new menu. Staff well-being was central to the providing people with quality of life. The provider had invested in a staff wellness programme and praised staff when they had supported people according to the service’s values. This encouraged staff to continue to provide individual care to people. Staff were provided with continuous training and learning, in differing formats to accommodate their learning styles. Staff had been appointed champions in a number of areas to encourage them to improve their knowledge and skills in specific areas which they could share with the staff team.

During the assessment we identified some areas for improvement. This included the management of infection control and staff guidance for supporting people with a hoist. The provider acted on this advice and made the necessary changes. The provider’s plans to drive continuous improvement in 2026 had been identified in their strategic development plan.