Orchard End

Orchard End is a 'care home' which provides accommodation and personal care for up to six people with learning disabilities. At the time of our inspection visit, six people were living at the home. People in care homes receive accommodation and nursing or personal care as a 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 is required to have a registered manager and 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.

At the last inspection on 30 December 2015, the service was rated Good. At this inspection, we found the service remained Good.

Staff received training in, and understood, their responsibility to protect people from harm and abuse. The risks to people had been assessed, reviewed and plans were in place to manage these. Staffing levels at the home enabled staff to safely meet people’s individual needs. People received their medicines safely and as prescribed from trained staff. Staff protected people from the risk of infection.

People's individual care and support needs were assessed prior to them moving into Orchard End, enabling the provider to develop effective care plans. Staff received a range of training and ongoing management support to enable them to work safely and effectively. People had support to eat and drink safely and comfortably, and made choices about their food and drink. People had support to maintain their health and attend routine medical appointments. People were involved in decision-making about changes to the home’s environment. People's rights under the Mental Capacity Act 2005 were promoted by staff and management.

Staff treated people with kindness and compassion. People had support to express their views and participate in decision-making that affected them. People's rights to privacy, dignity and independence were recognised and promoted by staff.

People received person-centred care and support. They were supported to participate in a range of recreational and social activities which they enjoyed. The provider had procedures in place to ensure concerns and complaints were dealt with in a fair and consistent manner.

The registered manager was accessible, approachable and promoted an open and inclusive culture within the service. Staff were motivated, well-supported and clear what was expected of them at work. The provider completed audits and checks to assess, monitor and improve the quality of the service people received.

Further information is in the detailed findings below.

As we watched we saw the staff were very attentive towards them. We saw that the staff always asked them how they would like things to be done, were always mindful of their privacy and treated them with respect. We saw that staff talked with them as they provided their support.

Staff told us that they felt able to raise any issues with the manager or senior staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

We saw staff were always available when people needed help.

The provider had developed a system whereby they can monitor how well the home is meeting the needs of the people who live there.

Staff interaction was friendly and patient so that people made choices which were respected. People had regular stimulation and exercise, and privacy in their rooms when they wanted it. Staff checked on their wellbeing. Independence was encouraged and people had individual support at mealtimes.

Families and professionals met with staff to make and review best interest care and treatment decisions. Staff and health specialists monitored health and behaviour. Staff supported people during examinations and hospital stays. There was a safe system to manage and administer medication, and medicines were regularly reviewed by doctors.

There were thorough recruitment checks and ongoing training which made sure staff were safe and fit for their roles. Staffing arrangements had improved since our last inspection so that people had flexible and consistent care.

A relative lost confidence in the complaints system and wanted reassurance about people's safety. We found people well cared for. There was a lack of records to demonstrate the complaints process was always followed. Action was taken after the inspection to formalize how complaints are managed and to reassure the relative.