Archived: Orion House

Updated 9 June 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 checked 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 inspection took place on 19 May 2017. We gave short notice to say we were inspecting because it is a small service and we needed to ensure people would be available to speak to. Also people with autism sometimes require time to process that a new person will be visiting. The inspection was completed by one adult social care inspector.

We spent time observing how care and support was being delivered and talking with one person who lived at the service. Other people were not able to comment specifically about their care experiences, so we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living with complex needs and communication difficulties. We also spent time touring the building and reviewed records and information relating to how the service was being run. We spoke with four staff including the registered manager/provider. We looked at two care plans and daily records relating to the care and support people received. Care plans are a tool used to inform and direct staff about people's health and social care needs.

We looked at three recruitment files, medication administration records, staff rotas and menu plans. We reviewed audit records relating to how the service maintained equipment and the building and the quality assurances processes in place.

The provider had completed a 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. We reviewed this and looked at all the information available to us prior to the inspection visits. These included notifications sent by the service, any safeguarding alerts and information sent to us from other sources such as healthcare professionals. A notification is information about important events which the service is required to tell us about by law.

Following the inspection we spoke with two relatives and contacted three health care professionals to gain their views about the service; two provided feedback.

Updated 9 June 2017

This was the first comprehensive inspection of Orion House since it was registered in July 2015. The inspection took place on 19 May 2017 and short notice was given. This was because it is a small service and we needed to ensure people would be available to speak to. Also people with autism sometimes require time to process that a new person will be visiting.

Orion House is registered to provide care and support without nursing for up to five people. They specialise in supporting people with autism. At the time of the inspection there were three people living at the service.

There was a registered manager who was also the registered provider. 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 benefitted from a team of staff who were skilled and understood the complex needs of each person. There was a varied activities programme which included various trips and outings into the local community and places of interest.

Care and support was well planned which enabled staff to ensure people received personalised care. People’s safety was considered in every aspect of their care and support. Risks were well documented and people were supported to have fulfilling lives with the least restrictions possible to keep them safe.

Medicines were safely managed. The provider operated safe recruitment processes to ensure only staff that were suitable to work with vulnerable people were employed. Systems were in place to ensure people’s personal monies were safely handled and records kept to show the audit trail of where monies had been spent. Staff knew who they should report any concerns about possible abuse to. They were confident their concerns, ideas and suggestions were listened to and acted upon.

People were supported by a staff team with a range of skills and qualifications. Training and support to staff was seen as crucial to proving the right service to people. Staff felt valued and supported by a registered manager who worked alongside them. There were sufficient staff available on each shift to ensure people’s needs and wishes were being met. People and their relatives were confident in staffs’ ability to provide effective and person centred care. One relative said “They are very proactive in their approach, they support people well.”

People’s privacy and dignity were fully respected. Staff supported people in a kind and compassionate way. We observed staff supporting people in a way which ensured their dignity and respect was being considered.

People were supported to have maximum choice and control of their lives. Where possible, consent was gained before providing care. Staff were skilled at understanding people’s non-verbal cues. Staff understood how to ensure they were acting in people’s best interests. Where people lacked capacity to make decisions, records showed best interest meetings and decisions were made with relevant people.

People were supported to eat a well-balanced diet and they had access to health professionals to make sure they kept as healthy as possible.

The environment was kept clean and safe. Systems were in place to audit the environment, records and care and support provided. People’s views were sought in a variety of ways to help improve the service and ensure their voice was taken into account when planning for the future with such things as activities and what they wanted to have included in their menu choices. People’s relatives, staff and visiting professionals believed the management team to be open and inclusive. One relative said “This is the best service we saw and the approach is so caring. They keep us constantly updated.”

There was a positive culture of striving to continually improve. The registered manager and provider had a proactive approach to seeking out best practice and advocating for the rights of individuals.