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The Orchard Trust Domiciliary Care Agency Good


Inspection carried out on 25 April 2019

During a routine inspection

About the service: The Orchard Trust Domiciliary Care Agency is a supported living service. There were nine people receiving the regulated activity of ‘personal care’ from The Orchard Trust at the time of the inspection.

People’s experience of using this service:

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 coordinated person-centred support that was appropriate and inclusive for them.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways. People's support focused on them having as many opportunities as possible to gain new skills and become more independent. Where people lacked capacity to make decisions for themselves, the service used the least restrictive methods to support them. People were able to access the community and take part in activities which were tailored to their individual needs.

• People’s risks had been identified and appropriate safety measures were in place. People were supported by a consistent team of staff who were kind and caring.

• People received their medicines as prescribed and medicines were managed safely.

• Staff knowledge in relation to people’s conditions, their needs, and how to support them was thorough.

• Care plans were person centred and included people’s personal preferences. This meant people received a service which was tailored to their individual needs.

• Staff had good relationships with people and knew them well. People told us they were happy with the staff who supported them.

• People could see healthcare professionals when needed and supported to live healthy lives.

• People were supported to take part in various activities such as social farming, gardening, bingo and pottery.

• There was an open culture where staff and people could raise concerns or issues. People told us they felt safe at the service and felt happy to speak up.

• People, relatives and staff told us the service was well-led. The registered manager was a visible presence and knew people and their relatives well.

• People’s feedback was encouraged and used to shape the service.

The service met the characteristics of Good overall. For more details, please see the full report which is on the CQC website at

Rating at last inspection: At the last inspection the service was rated Good (This report was published on 4 October 2016).

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous Good rating. Previous CQC ratings and the time since the last inspection were also taken into consideration.

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

Inspection carried out on 13 September 2016

During a routine inspection

This was an unannounced inspection which took place over two days on the 13 and 14 September 2016. Orchard Trust Domiciliary Care Agency provides personal care for people with a learning disability living in their own homes in Gloucestershire. At the time of the inspection ten people were receiving shared care living together in two houses in Lydney.

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.

People received a service which was highly individualised reflecting their personal wishes, aspirations and routines important to them. They had been fully involved in all aspects of their care and support. People had been involved in developing their care records and reviewed them with staff making sure they continued to keep up to date with their changing needs. They had copies of easy to read care plans and other information had been made available to them in formats appropriate to their needs using photographs and pictures. People were supported to be independent around their home and in their local communities. They were helped to gain skills to live independent lifestyles whether managing their own medicines, cooking, cleaning or gaining the confidence to try other types of care and support. People’s days were busy doing meaningful activities of their choice.

People were supported by staff who had been through robust recruitment procedures ensuring all checks had been completed before they started working without supervision. People had been involved in the recruitment of staff. There were enough staff employed to meet people’s needs and to provide flexible cover which reflected people’s lifestyles. Staff had a good understanding of people’s needs. They were responsive to accidents and incidents making sure people had access to health care professionals if needed to keep them safe and well. Staff encouraged people to make decisions and choices about their day to day lives. If decisions needed to be made in people’s best interest this had been done in line with the recommendations of the Mental Capacity Act 2005.

People’s views and those of their relatives, staff and professionals involved in their care were sought as part of the quality assurance process. Feedback included, “Excellent service”, “Staff are very supportive and caring” and “People have a fantastic lifestyle.” The provider had systems in place to monitor and audit people’s experience of their care and support. Staff said the management team were open, accessible and very supportive. Managers and representatives of the provider attended local networks ensuring they kept up to date with best practice and changes in legislation.

Inspection carried out on 28 January 2014

During a routine inspection

We spoke with four people who use the service and reviewed the care records of four people. The records that we saw contained full and comprehensive assessments that had been personalised to people's needs. One person who used the service told us "I've been really well supported".

We saw that medicines were managed safely and that staff were trained to handle medicines.

We saw the training records and the training plan for staff. We spoke with two members of staff and one told us "the training is really good", and we saw evidence that staff were supported to perform their role.

We saw how the manager monitors the quality of service provision and how they sought feedback from people who use the service.

Inspection carried out on 3, 4 January 2013

During a routine inspection

People were asked for consent by staff supporting them. When one person said they would �rather manage their own medicines�, staff had completed a �self administration assessment� with them and had agreed how their medicines would be stored safely.

Staff demonstrated understanding of people�s needs and gave examples of how they worked with individuals to promote their independence within their homes and the local community, while keeping them safe. People told us that they felt safe when supported by staff and they would be happy to talk to them if they had a problem. We observed that people were relaxed and confident in their interactions with staff and spoke openly with them. One person said �I just like living here. It�s better than where I used to live�. They also said they liked staff and that there were always enough of them to look after them.

Systems were in place to monitor the quality of the service people received.