Archived: Little Orchard

Little Orchard is a residential care home providing personal care to people with learning disabilities and/or autism. The service can support up to six people. At the time of the inspection five people were living at the home.

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 at Little Orchard were living with a learning disability or autism, which affected their ability to make decisions about their care and support. Where people were not able to give consent the service delivered care in the person’s best interest. However, mental capacity assessments and best interest paperwork was not in place for people. This was discussed with the area manager who addressed this and showed us improvements on day two.

Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards inclusion and enabling people to learn essential life skills. Equality, Diversity and Human Rights were promoted and understood by staff.

People told us they were happy and felt safe. Relatives said that staff had a good understanding of their loved one’s needs and preferences. Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.

People, professionals and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging.

People received pre-admission assessments and effective person-centred support. The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

Care plans were personalised and updated. Staff listened to what people wanted and acted quickly to support them. Staff looked to offer people solutions to aid their independence and develop their skills.

Leadership was visible and promoted good teamwork. People, relatives, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the management team were keen to make changes that would impact positively on people's lives.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 2 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.

Little Orchard is located in the village of Hordle, near Lymington. It is run by Care Management Group who provide a number of other similar services. It is registered to provide accommodation and support for up to six adults with a learning disability. Little Orchard supports people with profound and multiple learning disabilities, communication and sensory impairments and complex health needs. At the time of the inspection there were six people living at the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. The registered manager was no longer in day to day charge of the service, however a new manager had been appointed who had worked in the service for a number of years. She was in the process of applying to CQC to register. People spoke very highly of her and she demonstrated she had a good knowledge and understanding of the needs of people living at the service.

Most people had lived at Little Orchard for a number of years and many of the staff team had worked there for a considerable time. This meant people knew each other well and there was a good family atmosphere in the home. People and their relatives were involved in developing the service, for example there was a large project underway to improve the garden area. All people we spoke with demonstrated great commitment to make this happen and the service had involved people living nearby both for fundraising events and to invite them to contribute their skills and knowledge.

People and their relatives were positive about the care and support they received. Staff understood how to meet their individual needs in a person centred way. We observed positive relationships between staff and people living at the home. Staff were kind and caring and respected people's privacy and dignity.

There were sufficient staff deployed to meet people's health care and social needs. Recruitment practices were safe and relevant checks had been completed before staff worked unsupervised. These measures helped to ensure that only suitable staff were employed to support people in their home.

Staff had a good understanding of the signs of abuse and neglect. Staff had clear guidance about what they must do if they suspected abuse was taking place. Individual risk assessments had been completed for people who used the service and covered a wide range of activities and tasks. This helped to protect people from avoidable harm and ensured people were safely cared for.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Where people’s liberty or freedoms were at risk of being restricted, the proper authorisations were either in place or had been applied for.

New staff received a comprehensive induction which involved learning about the values of the service, the needs of people using the service and key policies and procedures. The induction also introduced staff to the fundamental standards and aimed to ensure that the new staff member had a clear understanding of their role and responsibilities within the organisation.

Staff completed a range of essential training which helped them to provide effective care. More specialised training specific to the needs of people using the service was also provided, for example in the management of epilepsy. This helped to ensure that staff were equipped with the right skills and knowledge to meet people’s needs.

People were supported to have enough to eat and drink and their care plans included guidance, which staff followed, about their dietary needs and risks in relation to nutrition and hydration.

People told us they were able to raise any issues or concerns and felt these would be dealt with promptly.

There was an open and transparent culture within the service. Feedback from people, their relatives and staff was encouraged and was used to drive improvements. The manager had a clear vision for the service which focused on the delivery of person centred care. The provider and manager demonstrated a commitment to making the staff team feel valued and appreciated for the care they provided. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving the best possible support.