Orla House

Orla House is a residential care home providing personal care and support to 10 people living with learning disabilities such as autism, and physical disabilities, who were aged 40 and over at the time of the inspection.

The service is registered for the support of up to 14 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area along with other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.

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.

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

People were supported by an exceptionally caring staff team who knew them well. The staff team demonstrated passion and determination to support people to lead fulfilling lives.

There was a strong focus on treating each person as an individual and supporting people to be active participants within their local community. Staff clearly understood the support each person needed.

Care plans were highly personalised in relation to all aspects of the support each person needed. Staff understood each person's individual style of communication.

Staff worked with a wide range of professionals to improve peoples' health. Peoples' social needs were met through a clear understanding of the things people enjoyed doing.

People were safe. There were sufficient staff with the skills and knowledge to give people the support they needed, at the right times. This meant people received support from a consistent staff team they knew and trusted.

Measures were taken to minimise risks to people's safety. Risks to people's health and safety were assessed and staff knew how to support people to remain healthy and safe. Medicines were stored and administered safely. Staff understood how to keep people safe from infection. The accommodation and equipment were well maintained, checked and serviced.

The service was well-led. There were checks and measures in place to ensure all aspects of the service was consistent. The registered manager and established staff team reviewed the service regularly and consulted with people who used the service, friends and family to consider any improvements needed.

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 9 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

At the last inspection, in March 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. They were supported by staff who were aware of their role and responsibilities to protect people from avoidable harm.

Risks relating to people’s needs including the environment, had been assessed and planned for and were regularly monitored and reviewed. Procedures were in place to report any accidents and incidents and these were investigated and acted upon appropriately.

Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their individual needs. People were supported to receive their medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles.

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 support this practice. People were supported to maintain good health and nutrition.

People continued to receive good care from staff that they had developed positive relationships with. Staff were caring and treated people with respect, kindness and dignity. Staff supported people to maximise their independence. People had access to information about independent advocacy should they have required this support. People were involved in discussions and decisions as fully as possible about how they received their care and support.

People continued to receive a service that was responsive to their individual needs. Staff had information available to support them to provide an individualised service based on people’s needs, preferences, routines and what was important to them. The provider’s complaints policy and procedure had been made available for people.

The service continued to be well-led. People, relative’s and external health and social care professionals were positive that the leadership was good. Communication was open and transparent.

The provider had effective arrangements for monitoring and assessing the quality and safety of care and support people experienced. The provider had quality assurance processes in place that encouraged people to give feedback about the service.

Further information is in the detailed findings below.

We found that suitable arrangements were in place for assessing people's capacity to make decisions about their care and treatment. However, we identified some concerns during our visit. People's care plans did not always contain the required information.

We also found that arrangements for reporting incidents were not adequate and that quality monitoring systems were not sufficient to ensure that risks were identified or managed appropriately.

We spoke with two relatives. They told us their relatives' privacy and dignity were respected. They told us the care home kept them informed and involved in decisions about their relatives' care. They told us the care met their relatives' needs. One relative said, 'I'm happy about the care [their relative] is given.' Another relative said, 'I think they do magnificently' and told us their relative was, 'Very well cared for.'

During our visit we saw that staff were kind and supportive and communicated with people using the service in a respectful manner.

People using the service told us they were happy with their bedrooms and expressed no concerns about the building.

We found staff received an induction, supervision, training and appraisals.

One person using the service told us they would talk to the manager if they wanted to make a complaint, but told us they had no concerns.

Relatives told us they had never had to make a complaint, but would contact the manager if they wanted to. They told us they felt they would be listened to if they raised any concerns.