Little Orchard

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment, the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events.

Lessons were learnt to identify and embed good practice. Staff knew what incidents to report and how to report them. The registered manager shared learning with staff through supervisions and team meetings. We saw evidence of change as a result of incidents which had occurred.

The registered manager had an open door policy and fostered a no blame culture. This enabled staff to raise any concerns which mitigated the risk of a closed culture.

The registered manager told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks along with themes and trends to ensure the provider could take appropriate action to mitigate these risks.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

One relative told us, “My relatives moved here as an emergency placement as the previous home was unsuitable. We were involved; communication and care needs were looked at. Little Orchard were brilliant, given the circumstances.”

When asked how transitions into the home are managed a staff member told us, “We visit the person, and they visit the home. It is well planned.”

People were consistently supported when they were distressed and there was a focus on planning for a good day and understanding what had caused people distress so positive changes could happen.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on protecting people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect.

Relatives told us they felt their relatives were safe living in the home. One relative told us, “There are no issues. I am not worried at all. There has been a couple of minor things but nothing that would raise a real concern.”

Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally. The service shared concerns quickly and appropriately.

Where restrictive practices were in place Deprivation of Liberty Safeguards (DoLS) were in place to legally authorise, restrictions placed on people to keep them safe.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them.

Staff supported people to manage risks whilst maintaining their independence by promoting positive risk taking. People were assessed for risks of falls, risk of choking and risk to their skin integrity. When risk had been identified staff followed actions to keep people safe such as using specialist equipment to monitor people’s health conditions.

The registered manager told us how they liaised with a person’s relative to manage a risk, due to the person lacking capacity. They then managed to successfully reduce the person’s level of support when they leave the home, resulting in the person being able to go out more often.

The service detected and controlled potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care.

We saw evidence people and their relatives were consulted about the environment to ensure adaptations and reasonable adjustments were made to meet their individual needs.

Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure they were safe to use. Any concerns with equipment were reported to the management team or appropriate person for further action.

The service made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

A relative told us, “Staff are trained. The level of expertise and confidence staff have to look after my relative is brilliant. My relative has a key worker who is a good fit with them. The manager looks at making sure it is a good match for both of them.”

Staff received effective support, supervision, and development. Staff told us managers were supportive, and they had regular supervisions and a comprehensive induction. Two staff members who had been working as support workers, had been recently promoted.

The manager had a training matrix in place which evidenced most staff had completed all of their statutory and mandatory training. Competency assessments took place to ensure staff were able to meet people's needs. Where staff had not completed training, they had been booked onto courses to complete this. The provider followed safe recruitment practices.

The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading.

We observed a bedroom and the lounge with paint missing on areas of the walls, the stair carpet was stained, and some bins had no lids with personal protective equipment (PPE) in. We spoke with the provider about this. They immediately purchased new pedal bins, and they organised for a maintenance team to come into the home and redecorate the required areas. The manager told us they would ensure the carpets were cleaned and this would be added to the cleaning schedule.

In the kitchen, we found food was not always managed in accordance with good practice increasing the risk of contamination. We spoke with the provider about our concerns They removed the incorrectly labelled and out-of-date foods and told us they would put robust systems in place to mitigate the risk of this happening again.

The provider had an up-to-date Infection Prevention and Control (IPC) policy. Staff attended IPC training. We reviewed cleaning schedules which were consistently completed. Relatives told us the home was always clean. We observed the home was mostly clean.

The service made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff received medication training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines.

Staff told us they felt well trained and confident to support people to receive their medicines safely. Staff supported and involved people to manage their medicines and followed best practice guidance for administering medicines. Records showed people had received their medicines as prescribed. The staff team were proactive at reporting any changes to people’s medicines promptly.

The registered manager told us, during people’s annual health reviews, Stopping Over Medication of People with a learning disability and/or autism (STOMP) plans were reviewed.