Orby House

Updated 20 November 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was undertaken by one inspector.

Service and service type

Orby House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since our last inspection and sought feedback from the local authority. The provider completed a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with the six people using the service. We spoke with five members of staff including the registered manager, the location support manager and three care workers. We reviewed a range of records. This included three people’s care records and all the medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were also reviewed.

Updated 20 November 2019

About the service

Orby House is a residential care home providing accommodation and personal care to six people at the at the time of the inspection. The service can support up to seven younger adults with a learning disability and/or autism. Each person had their own flat within one overall building, on a larger site accommodating a day centre and other facilities. There were office facilities and a sleep-in room within the building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

People were happy living at the service; they told us staff were like family members to them and always acted in their best interests. Services were delivered in a way that was flexible, provided choice and ensured continuity of care. People were truly placed at the centre of the service and were consulted and involved in decision making. Care was individualised and tailored to the needs and wishes of the people using the service.

People were protected from avoidable harm and abuse by staff who were alert to the signs of abuse and knowledgeable about the action to take if they identified a concern. Staffing levels were planned to take into account people’s planned and spontaneous activities. Medicines were managed safely and people told us they received their medicines regularly.

Staff were supported to deliver effective care and received training to gain and further develop their knowledge and skills. They received regular supervision and appraisal. Consent was gained for the care and support people required in line with the relevant legislation. People had access to healthcare and preventative services according to their needs.

People continued to be supported by staff who showed empathy and kindness toward them. They supported people physically and emotionally, to enable them to lead fulfilled lives. People’s privacy and dignity were respected.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. This was illustrated by a person who told us of the progress they had made following admission to the service, moving from requiring one to one support initially, to preparing to move towards supported living. They said, “I have had a lot of support and they have helped me through it.”

Leaders were enthusiastic and committed to providing the high standards of care. They led by example. Processes were in place to monitor quality of the service provided and action was taken to bring about continuous improvement. People and staff felt listened to, valued and involved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 28 February 2017). At this inspection the service remained good.

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.