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Inspection carried out on 20 March 2019

During a routine inspection

About the service: Orion Care Services provides care and support to people with learning disabilities living in their own home. 34 people were using the service at the time the inspection living across 13 tenancies (projects).

People’s experience of using this service: People told us staff were kind and caring in their approach. People told us staff communicated well with them and acted in an open and transparent way.

Care plans were person-centred and provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences.

Medicines were managed in line with good practice guidance.

Staff assessed risks to people’s health, safety and wellbeing and put plans in place to manage these risks.

People told us they would feel confident to raise any complaints they might have. We saw complaints were identified, investigated and used to improve the service.

There were processes in place to monitor the safety and quality of the service.

One relative said they had concerns about the suitability of staffing on one team and told us that their relative was not encouraged to take part in enough activity. The relative had raised this with the management team who were hoping to work with the team and make improvements.

The service had a registered manager in post at the time of our inspection.

The management team had the knowledge and oversight to operate the service safely and effectively. They demonstrated an understanding of all aspects of managing the service such as safeguarding procedures and medicines management.

People, relatives and staff were engaged by the service via meetings so that everyone could contribute to the development of the service. There was a credible strategy in place with plans for multiple new improvements and updates at the service. This was being implemented by the registered manager who was proactive in considering how the service could be improved.

People, staff and relatives spoke positively about the registered manager and management team who led the service well.

We have made a recommendation about staff training in both mental health awareness and equality and diversity.

The service met the characteristics of Good

Rating at last inspection: At the last inspection the service was rated as Good (15 July 2016).

Why we inspected: This was a scheduled inspection planned to check that the service was providing quality care that was safe, effective, caring, responsive and well-led.

Follow up: We did not identify any concerns at this inspection. Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for services rated Good.

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

Inspection carried out on 4 February 2016

During a routine inspection

Orion Care Services provides care and support to people with learning disabilities living in their own home. People lived in supported tenancies that the service called ‘projects’. At the time of our visit the service supported 12 projects and 26 people received personal care. Projects were staffed 24 hours a day, and people received personal care and support dependent on their assessed needs.

We visited the offices of Orion Care Services on 4 February 2016. We told the provider 48 hours before the visit we were coming so they could arrange to be there and for staff to be available to talk with us about the service.

The service has a registered manager. 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 told us they felt safe with their support workers and knew what they would do if they felt unsafe. Support workers were trained in safeguarding adults and understood how to protect people from abuse. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s support and for managing people’s medicines safely. There were enough experienced staff to provide the support people required. Checks were carried out prior to support workers starting work to ensure their suitability to work with people who used the service.

People told us support workers were kind and respectful and had the right skills to provide the care and support they required. The managers and support workers understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. People had consistent support workers who they were able to build trust and relationships with.

Support plans and risk assessments contained relevant information to help support workers provide the personalised care people required. People were involved in their care and were asked for their views and opinions about the service they received. People and support workers said they could raise any concerns with the managers knowing they would be listened to and acted on.

Support workers and people who used the service found the management team approachable and responsive. There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and support workers, and a programme of checks and audits.

Inspection carried out on 15 May 2014

During a routine inspection

During our inspection we saw that the service currently supported 34 people. We talked with the manager and looked in detail at the records for five people and three staff. We also talked with a senior staff member and the clinical lead. We spoke with two people who use the service and two relatives by telephone. One relative commented, �I can trust them with X, I don�t have to worry one little bit and X is very happy with them.�

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

The detailed evidence supporting our summary please can be read in our full report.

This is a summary of what we found;

Is the service safe?

The manager told us that a member of the team was available on call in case of emergencies at all times. People told us they felt safe. One person said "It's nice here, the people are nice." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported.

There was a comprehensive training programme including safeguarding for the staff team. The senior staff set the staff rotas. They take people�s care needs into account when making decisions about the numbers, qualifications, skills and experience required. There were policies and procedures in place to make sure that unsafe practice is identified and people are protected. This helps to ensure that people are kept safe.

Is the service effective?

All the people we spoke with told us that they were very happy with the care that had been delivered and that their needs had been well met. It was clear from the records we sampled and from speaking with staff that they had a good understanding of people�s care and support needs and that they knew them well.

We saw that wherever possible people received care from the same staff members. We found that the service was very person centred and staff were aware of peoples choices, preferences and support needs. We found evidence that people and their relatives had been involved in planning the care and support. One person told us, �The carers are nice, I go out with them everywhere.�

Is the service caring?

Everyone we spoke to on the telephone commented that the service was very caring. One relative told us �They�ve been absolutely wonderful; they are the best company yet.� When speaking with staff and the manager it was clear that they genuinely cared for the people they supported. We observed two people who came to the office and saw that staff were friendly and helpful with them. One member of staff told us �Orion really help people, one person came to us needing four to one support, now it�s one to one.�

Is the service responsive?

People had care and support delivered to them in a way they were happy with, and staff were aware that people�s needs changed. There was a process for making complaints, and the company had received many compliments in the past twelve months. The service worked well with other agencies and services to make sure people received their care safely and effectively. A member of staff said �Orion are a good company, I can come In with a concern and they deal with it.�

Is the service well-led?

All the staff we spoke with told us they were clear about their roles and responsibilities. There were clear processes in place to keep people safe and the manager knew what to do if there was a problem or concern. The manager was aware of their responsibilities in order to comply with current legislation. There was a quality assurance process and we were told of the plans to improve it. On member of staff said, �All the managers are really supportive, it�s a good team, I think they are a fantastic company.�

Inspection carried out on 3 December 2013

During a routine inspection

We made an unannounced visit to Orion Care�s office on 3 December 2013. We spoke with the registered manager, the care-coordinator, a house manager and a carer. After our inspection we spoke over the telephone with two carers, two people who used the service and two relatives of people who used the service.

At the time of our visit, Orion Care Services had 24 people who used the service and employed 50 staff.

People told us their care and support needs had been agreed with them and their family when the service started. We were told copies of care plans were available in people�s homes. People told us that staff were friendly and polite and always respected their privacy during personal care routines.

One person told us: �My carers are lovely.� A relative said: �They really do care.�

People told us care staff were able to do everything they needed. They also said staff took their time and did not rush. A relative said: �They are so patient.� A staff member said: �There is a very relaxed atmosphere and we get everything done stress free.� People and relatives said care staff did things in the way they preferred and respected their opinions.

Records showed the agency had systems in place to monitor the care provided and for managing identified risks.

People told us they felt safe with staff and they were friendly and helpful.

Inspection carried out on 3 January 2013

During a routine inspection

People told us that their care and support needs had been agreed with them and their family when the service started. We were told copies of care plans were available in people�s homes. People told us that care staff respected their privacy during personal care routines.

One person told us, �My carers are always very helpful and help me to live a full life.� Another person said, �I love the outings and day trips they organise.�

The files we looked at contained care plans that were personalised and included people�s preferences.

People told us care staff were able to do everything they needed. They also said staff took their time and did not rush. One person said, �They always do everything I need them to do.� People said that care staff did things in the way they preferred and respected their opinions.

Records showed the agency had systems in place to monitor the care provided and for managing identified risks. People said they were happy with the care they received. One person said, �I have never had to ask them to do anything differently.�

People told us that staff were pleasant and helpful. People told us they felt safe with staff.

Inspection carried out on 31 May 2011

During a routine inspection

We spoke with five people who either used the service or were relatives of people who used the service. They told us that people received good support from the staff. They confirmed that people were asked about what support people needed and how they preferred staff to provide this.

People told us that staff were pleasant and helpful. People told us that they felt safe with staff.