We carried out a review of the data available to us about The Orchards on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Orchards, you can give feedback on this service.
About the service
The Orchards is a care home providing residential care for up to 4 adults with learning disabilities or other complex needs. The home is an all-male service. The home was formed of one adapted residential building. At the time of the inspection there were 4 people living at the home.
People’s experience of using this service and what we found
Right Support
Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff supported people to take part in activities and pursue their interests in their local area and to interact online with people who had shared interests. Staff supported people to achieve their aspirations and goals. One relative said of their loved one being at The Orchards, “It changed my life and changed my view. I've been able to relax. This placement feels much better. It meets (persons) needs.”
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Where appropriate, staff encouraged and enabled people to take positive risks. Staff knew the best way to communicate with people. Usually, communication was either verbal or through observing people’s reactions to suggestions or actions. We spent time observing interactions between people and staff and these were caring and supportive.
Right Culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. The service enabled people and those important to them to worked with staff to develop the service. Staff valued and acted upon people’s views. One relative said, “There's nothing that they can improve on. I couldn’t ask for any more. As far as I'm concerned, they are tops.”
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 25 October 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Orchards on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This inspection took place on 25 October 2017. The service was given short notice of our visit. This was to ensure people would be available to support us with the inspection.
We had previously inspected the service on 19 May 2015, when the service was rated as good in all areas. We found this good practice had been sustained, and the service remains rated as Good.
The service has a registered manager. 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 registered manager was on leave at the time of our inspection so the inspection was carried out with a senior support worker. A regional manager also attended the service to assist us with the inspection. Following the inspection we contacted the registered manager to gather any information they wished to contribute to the inspection process.
The provider and registered manager had clear and well organised systems in place to ensure people received high quality, safe care and support. Systems ensured priorities for improvement were identified and accountability was understood. For example regular audits were carried out of the service from both the registered manager and teams from within the organisation. Any recommendations were included on a consolidated action plan, which was dated to show when actions had been completed or were due to be completed by.
Feedback was obtained and acted upon from people, relatives, staff and healthcare professionals in order to improve the service. Questionnaires were completed annually and people could also give feedback at reviews, or during regular meetings for staff and people living at the home. We saw people interacting freely with staff throughout the inspection.
Risks to people’s health or well-being were robustly assessed and managed, including risks from the environment or in relation to people’s healthcare. We saw risk assessments were being used in a positive way to support people to develop new skills and have new experiences, for example such as using kettles independently or spending time without direct staff supervision. Incidents were analysed to identify trends and prevent re-occurrences.
There were sufficient staff on duty to meet people’s needs, and staff were recruited safely. The service ensured there was a full staff recruitment process undertaken, including disclosure and barring service (police) checks. People living at The Orchards had sufficient staff to help them follow their chosen activities as indicated in their care plans. For example on the day of the inspection people went swimming, shopping, attended a work placement and went to a local garden centre.
People received their medicines safely, and with support to help them understand why this was needed if appropriate. One person’s prescription needed clarification by the prescribing GP and senior staff agreed to request this.
Staff had built positive relationships with people and their families. People’s wishes were respected and staff supported them to develop new skills and have new experiences. Plans included people’s goals and aspirations for their future. People had a say in making choices, for example about holidays they wanted to go on or activities they wished to take part in. People were valued for their individual strengths and personalities, and the service had a happy, positive and welcoming atmosphere.
People were treated with dignity and respect. For example we saw staff including people in all conversations and speaking with them respectfully. People’s communication was understood, and staff worked hard to develop this further. This included supported communication, which was used by one person. The staff member who was the person’s keyworker was attending an evening course to learn the person’s communication. The person was also being involved in supporting staff to understand how they communicated, by teaching them new signs to use. This helped demonstrate the person was valued.
Systems were in place to ensure complaints or concerns were responded to and managed. People living at the service were encouraged to ‘speak out’ if they were unhappy about something. People’s rights were respected. Staff had a clear understanding of the Mental Capacity Act 2005. Where people lacked capacity to make an informed decision, staff acted in their best interests. Appropriate applications had been made to deprive people of their liberty under the Deprivation of Liberty Safeguards (DoLS).
People were supported to have enough to eat and drink and to choose their own meals. This included information on making healthy choices, and people were able to be involved in shopping for and preparing meals as they wished. One person had been baking during the inspection at a local centre and bought evidence of their handiwork back to share.
People’s healthcare was supported. Each person had an annual healthcare review at the local GP practice and any additional support needed, such as from Physiotherapy services, was accessed. People were encouraged to follow a healthy diet. One person living with a long term health condition had managed to lose weight and take further control of their healthcare with staff support.
The premises offered people a homely and comfortable environment in a residential area, but close to the services and facilities in the town centre, such as cinemas and a leisure centre. People were able to walk into the local town from the service’s location, and there was access to local public transport services. The service had an attractive garden and good parking. Each person had their own bedroom, with adapted bathing facilities to meet the person’s needs.
Records were well maintained and kept securely.
The service had notified the CQC of incidents at the home as required by law.
The inspection took place on 19 May 2015 and was announced.
The Orchards is a small care home registered to accommodate up to four people with a learning disability and/or other complex needs. There were four people living at the service at the time of our inspection. The Orchards is a modern, detached house situated on the outskirts of Crawley town centre. It has a rear garden, communal dining area, sitting room and kitchen. All bedrooms have either en-suite facilities or a bathroom next door. All areas are easily accessible to people living at the service. There is a local bus service into town and people can also receive lifts from staff via a fleet car.
The service has a registered manager. 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.
People felt safe living at the service and were looked after by staff who had been trained in safeguarding adults at risk. Staff knew what action to take if they suspected abuse was taking place. New staff were checked to ensure they were safe to work at the service. However, if concerns were raised following a Disclosure and Barring Service check, the registered manager had not always risk assessed or had discussions with new staff to ensure they were safe to work with adults at risk. Medicines were generally managed safely, however, a bottle of Paracetamol was still in use which was beyond its ‘use by’ date. Risks to people were generally identified, assessed and managed safely. There were sufficient numbers of staff on duty at all times to keep people safe.
Staff received all essential training and were encouraged to undertake a level 2 qualification in health and social care. They had monthly supervision meetings and annual appraisals. Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and the associated legislation under Deprivation of Liberty Safeguards (DoLS). They put this into practice. People were encouraged to prepare and cook their own meals and were involved in choosing main meals for the week ahead. People had access to healthcare professionals and all their appointments were recorded in a diary. Staff were on hand to support people to attend their healthcare appointments.
People were cared for by kind, caring and understanding staff. The service had a homely atmosphere. People had their own keyworkers with whom they could discuss any aspect of their care. They were supported to express their views and make decisions. People’s privacy and dignity were promoted and they were treated with respect by staff. They were encouraged to be as independent as possible
Care plans provided staff with comprehensive information about people, and, how they wished to be supported. Daily records were kept for each person and staff completed information in an individual diary. People could choose the activities they wanted to participate in and staff planned these activities for them. Some people volunteered at local charity shops. People maintained close contact with their families and others who mattered to them. Complaints were dealt with promptly and in a timely fashion.
People were actively involved in developing the service. Regular service users’ meetings took place and people were asked for their feedback about the service through these and through regular meetings with their keyworkers. Friends and family were also asked for their views. Staff were supported to question practice and were encouraged to make suggestions about the service to the registered manager. Where possible, these were put into practice. The provider undertook audits of the quality of the care provided by the service and how they met their registration requirements in line with legislation. The service had good links with the community and other stakeholders. A newsletter was produced and circulated to inform families and external stakeholders about the service.