27 June 2017
During a routine inspection
The home has been operating for a number of years, but this was the first inspection since Aurora Care and Education Opco Limited took over as the provider in May 2016.
The inspection visit to this home took place on 27 June 2017 and was unannounced. There were 18 young people living at the home on this date. There was a registered manager in place. 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 2008 and associated Regulations about how the service is run.
The young people who lived at the home showed us and told us that they were very comfortable, truly happy and felt completely safe at Aurora Orchard Manor and in the company of the staff. Several of their relatives were very keen to be involved in the inspection to tell us how exceedingly satisfied they were with the service provided to their young family members. They were fully confident that their family members were safe, well cared for and treated extremely well by the staff team.
Young people’s relatives and healthcare professionals were effusive in their praise of the staff. Staff were exceptionally kind, caring and compassionate. They were fully aware of the importance of getting to know each young person as well as possible in order to support them to lead an amazingly full, interesting and fun-filled life. Staff treated all the young people with the utmost respect and supported them in a way that completely preserved their privacy and dignity.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. If a young person lacked the mental capacity to make certain decisions, the staff were clear about their responsibilities in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff always asked for the young person’s consent to care and the young people were encouraged to make as many choices as possible in their everyday lives. Advocates visited the home regularly to support young people who wanted an independent person to act on their behalf. The young people were involved in making best interest decisions whenever possible.
The culture of the home was exceptionally open, inclusive and caring. The culture focused strongly on the holistic needs and preferences of each young person and how those needs and preferences could be recognised and met. Fully personalised support plans gave staff detailed guidance on the ways in which each young person preferred to be supported so that consistent care was provided.
Staff received a wide range of training, delivered in creative ways, to ensure they were fully equipped to do their job as well as possible and to maintain the high standards required by the provider and registered manager. Staff felt fully supported by the management team and had numerous opportunities to put forward their views about ways in which the service delivered to the young people could be improved.
Staff demonstrated that they were completely confident to recognise and report if they felt any of the young people were at risk of avoidable harm. They had received training and showed that they were fully aware of their responsibilities to keep people safe. All potential risks to each individual were rigorously assessed. Actions were put in place to minimise the risks without overly restricting what the young person wanted to achieve. Young people had been enabled to do some potentially risky activities such as abseiling and climbing a climbing wall due to the thorough and informed risk assessment process.
There was a high level and good skill mix of staff on duty. This meant that each young person had at least one-to-one support, with additional staff, including a Physiotherapist, Occupational Therapist, Speech and Language Therapist and managers available if required. Thorough pre-employment checks were carried out to ensure that only staff suitable to work in this care home, and with the right ethos and values, were employed.
Personal evacuation plans were very detailed, ensuring staff and the emergency services would know how to support each young person in an emergency. Staff meticulously carried out required checks of the fire safety system and young people were included in fire drills. Staff followed robust prevention and control of infection procedures to make sure any suspected infection was not spread. Security of the grounds had been much improved so that young people were protected from strangers who might have wanted to do them harm.
Young people’s nutritional needs were assessed and appropriate, appetizing diets and meals were provided. Staff used each young person’s preferred method of communication to ensure the young person had what they wanted to eat and drink. Healthcare needs were fully met by the involvement of a range of healthcare professionals so that the young people were supported to maintain good health. Staff had tirelessly and selflessly, in hospital, in a local hospice and at home, supported one young person who was dying.
Young people who lived at Aurora Orchard Manor were given the widest possible range of activities to choose from, both within the home and in the community. Staff were innovative in finding things for the young people to do in order to make their lives as fun and fulfilling as possible.
The registered manager provided strong leadership and led by example. Everyone involved with the home was given opportunities to comment on the service and an effective system was in place to monitor and audit the quality of the service being provided. Accidents and incidents were investigated thoroughly and ‘lessons learnt’ were shared with the staff to promote improvement. Complaints were welcomed, listened to, investigated and responses were given within the required timeframe.