The Orchard

Updated 16 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection which took place on the 15 August 2016 by one inspector and was unannounced.

Before the inspection we looked at all the information we had collected about the service. The service had sent us notifications about injuries and safeguarding investigations. A notification is information about important events which the service is required to tell us about by law. We looked at the provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we observed the care and support provided throughout the home. We spoke with people who lived in the home. The majority of people living in the service were unable to provide us with any verbal feedback about their experience of the care provided. However, we spoke with six people one of whom was able to provide positive feedback about their experience. We spoke with the manager of the home, two assistant managers and four staff in private. In addition, we received email feedback from one member of staff. We contacted a range of health and social care professionals and received information from three local authority commissioners. We also received a quality report which had resulted from a recent quality visit undertaken by two members of the host local authority.

We looked at three people’s care plans and records that were used by staff to monitor their care. We also looked at duty rosters, menus and records used to measure the quality of the services which included health and safety audits.

Updated 16 September 2017

This inspection took place on the 15 August 2017 and was unannounced.

The Orchard is a care home which is registered to provide care (without nursing) for up to ten people with a learning disability. The home is a large detached building situated on a village style development together with other similar care homes run by the provider. It is situated some distance from local amenities and public transport. At the time of the inspection there were eight people living in the home.

There was a manager for the service who was in the process of registration. 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.

The recruitment and selection process undertaken by the provider organisation ensured people were supported by staff of good character. The number of qualified and trained staff was sufficient to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse. Medicines were managed and administered safely. Routine health and safety checks were completed in accordance with legislation and guidance. Infection control procedures were followed.

People were provided with effective care from a core of dedicated staff who had received support and guidance from the management team. Care plans were detailed and included how people wanted their needs to be met. Risk assessments identified risks to people associated with personal and specific behavioural and/or health related issues. They supported staff to promote people’s independence whilst minimising the risks. Staff treated people with kindness and respect. The service had regular contact with people’s families and representatives to make sure they were fully informed about the care and support the person received.

The provider was meeting the requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. Consent to care and support was sought in line with legislation and guidance. When appropriate mental capacity assessments had been completed and where people had been assessed as not having mental capacity to make a decision, a best interests meeting had taken place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were provided with the training and development they required to care for and support people’s individual needs through regular supervision, meetings and updating their training. The provider had taken steps to periodically assess and monitor the quality of service that people received. This was undertaken by the home manager and delegated staff within the home. The process was carried out through internal audits, care reviews and requesting feedback from people and their representatives. There was evidence that any required actions that resulted from quality monitoring had been identified and undertaken in a timely manner.

The manager received consistent praise and positive feedback from staff, relatives and professionals. They uniformly expressed the difference his leadership had made to the service. We found an open and positive culture in the service and the staff team was supported to bring forward suggestions to better the service. There was a strong emphasis on team working and staff confirmed they worked well together. Standards of care were high as a result of the example set by the management team and their expectations. The staff worked hard to meet the standards and expectations set and took pride in achieving positive outcomes for people. There were strong links built with the community which benefitted people. The provider valued and developed staff. They involved people in contributing to all aspects of the service and sought views and feedback in order to improve and develop.