Archived: The Old Orchard

The Old Orchard is a residential care home providing personal care and support for up to six people. At the time of the inspection, six people were using the service. The service primarily supports people with a learning disability/ and or autism diagnosis.

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 received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service and what we found

Staff were innovative in meeting people’s communication needs. Due to the hard work of staff, and the use of innovative tools; people’s communication had improved. This had resulted in people being more engaged with decisions about their care and becoming more independent. People were supported to be active members of the community and engage in activities that were important to them. The service had used communication aids and multi-professional involvement to assess people’s end of life wishes. This meant their needs and preferences would be met in the event of an unexpected death.

Staff were empowered to come up with suggestions. This had resulted in innovative care provision, which positively impacted on people. People were empowered to make complaints, and any concerns were responded to fully. The service was exceptionally well led, with the registered manager and provider completing comprehensive audits and employing external professionals to also audit the service. The robust level of governance meant the service provided was of a high quality.

The service was safe. High quality staff training had resulted in incidents reducing. Where incidents did occur, these were recorded and learnt from. Care plans were of a good quality to guide safe and effective care. Medicines were managed safely. The service was clean, and staff followed safe infection control practices. There were enough staff at the service.

People were supported to eat and drink what they wanted. If people were at risk of choking from food, specialised guidance had been created with professional involvement. The building was adapted to meet people’s needs. Staff worked with different health and social care professionals to ensure people’s needs were met.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

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.

Staff were caring and driven to provide good outcomes for people. People were involved as partners of their care. People lived as independently as possible, with dignity and privacy.

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 20 July 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.

At the last inspection, in November 2014, the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’.

The service is managed by the registered provider, so does not require a registered manager. Registered providers are ‘registered persons’ who have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to receive safe care. Most staff had received appropriate adult safeguarding training and were aware of their role and responsibilities to protect people from avoidable harm. Risks associated with people’s individual needs, including the environment and premises had been assessed and plans were in place to mitigate any risks. Procedures were in place to report any accidents and incidents and these were investigated and acted upon appropriately.

Staff underwent appropriate recruitment checks before they commenced their employment. Staffing levels were flexible and met people’s individual needs. People were supported to receive their medicines safely.

People continued to receive effective care and support. Staff received an appropriate induction, ongoing training and opportunities to discuss and review their work, development and training needs.

The principles of The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied where required. People were supported with any dietary and nutritional needs and meal preferences were known and respected. People were supported appropriately with their health care needs and the staff worked well with external healthcare professionals following any guidance and recommendations made.

People continued to receive good care. People had developed positive relationships with staff who understood their individual routines and preferences, and knew what was important to them. Staff were caring and treated people with respect, kindness and dignity. People influenced their care when they were able to do so.

People continued to receive a service that was responsive to their individual needs. Staff had information available to support them to provide an individualised service based on people’s needs, preferences and routines as well as anything else that was important to them. The provider had a complaints policy and procedure.

People continued to receive a service that was well-led. People who used the service were positive and said that the leadership and ethos of the service was good. The provider improved their quality assurance system when we identified it was not identifying some improvements that were needed.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two care workers and the registered manager (who is also the provider). We also looked at some of the records held in the service including the care files for one person. We observed the support provided by care workers and carried out a brief tour of the building.

We found appropriate care and support was provided. We found the staff team were supported through training and the provider assessed and monitored the quality of the service.