All inspections: The Old Orchard Care Home

We carried out an unannounced inspection of the service on 21 January 2016.

The Old Orchard Care Home provides accommodation and personal care for up to five people living with severe learning disabilities, physical and sensory needs, including autistic spectrum disorder. At the time of our inspection there were five people living at the service.

The Old Orchard Care Home is required to have 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 time of the inspection there was a registered manager.

People received a safe service. Staff were aware of the safeguarding adult procedures to protect people from abuse and avoidable harm and had received appropriate training. Risks were known by staff and managed appropriately. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. People received their medicines as prescribed and these were managed correctly.

Safe recruitment practices meant as far as possible only people suitable to work for the service were employed. Staff received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people’s needs. People’s dependency needs had been reviewed and were monitored for any changes.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People received appropriate support with their eating and drinking needs and independence was promoted. People’s healthcare needs had been assessed and were regularly monitored. The service worked well with visiting healthcare professionals to ensure they provided effective care and support. When concerns were identified about people’s healthcare needs swift action was taken.

The manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people’s rights were protected.

Staff were kind, caring and respectful towards the people they supported. They had an excellent person centred approach and a clear understanding of people’s individual needs, preferences and routines. The provider asked relatives and visiting professionals to share their experience about the service provided. Communication between relatives, external professionals and the service was good.

People were involved as fully as possible in their care and support, this included participating in person centred reviews. Staff used excellent communication tools that were based on individual needs. There was a complaint policy and procedure available and confidentiality was maintained. The provider arranged for people to be supported by an independent advocate. There were no restrictions on people visiting the service.

People were supported to participate in activities, interests and hobbies of their choice. Staff were creative and thoughtful and had a positive approach in providing new experiences and opportunities for people.

The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences.

During our visit we saw staff were kind, polite and respectful. We spent 25 minutes in the dining room at lunchtime and observed the care being provided. We saw staff provided one to one support at the preferred pace of people using the service.

We spoke with four relatives. They told us their family members were offered choices and were well cared for. One relative said, 'They're attuned to when care is needed.' Another relative said, 'I am pleased with The Old Orchard. I'm pleased with the way [their family member] seems to be happy, safe and does some interesting activities.'

Relatives told us they felt the premises were safe, secure and well equipped. One relative said, 'It's lovely. It's got everything [their family member] needs.'

We found staff received an induction, supervision and training.

We found people were made aware of the complaints system.

In this report the name of a registered manager Paula Henderson appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant most people were not able to tell us their experiences during our visit.

We spoke with one person using the service. They could only communicate with us by using sounds. They used a particular sound to give the answer 'yes' and used this sound when we asked them if they were well cared for and if their needs were met. They also communicated to us that they had enough to eat and drink and took part in social activities.

We spoke with two relatives. They told us their relative was well cared for. One person told us, 'I have no worries.' They told us staff would contact them if there were concerns. They also told us their relative had enough to eat and drink and staff provided good monitoring of their relative's wellbeing.

Relatives also told us their relative had been involved in different social activities and enough activities took place. They told us they were kept informed and all the staff were caring. They told us their relative was safe. One person told us they were, 'Very safe. Absolutely.'

During our visit we saw that staff were kind, polite and respectful. We spent 30 minutes in the dining room at lunchtime and used a specific way of observing care to help to understand the experience of people who could not talk with us. During this time, we saw that staff respected people's dignity. We saw staff sat next to people and communicated with them in an encouraging and supportive way. We saw that staff asked people using the service about their preferences. We saw that they were provided with appropriate support when they needed it.

Relatives we spoke with told us staff were well trained and good at their jobs. One person told us, 'The staff are well aware of what they need to do. Even the bank staff are good.'

However, other evidence did not support this. The manager told us no formal induction programme was in place. They showed us an induction checklist that was used, but this did not list training sessions.

We saw evidence in the staff training matrix that training had taken place. However, we saw there were some gaps in training. We saw, for example, that eight staff had not attended infection control training. Six staff had not attended food hygiene training. Three staff had not attended fire training and five staff had not attended it during the twelve month period before our visit. This meant there was a greater risk staff would not have up-to-date knowledge to provide appropriate support.

Relatives we spoke with told us they felt listened to if they raised any concerns. They told us the service was, 'Open to ideas and suggestions from family.'

Archived: The Old Orchard Care Home

All Inspections

21 January 2016

During a routine inspection

10 April 2013

During a routine inspection

25 July 2012

During a routine inspection