Orion House

We found the following examples of good practice.

Staff were aware of the correct personal protective equipment (PPE) they needed to wear to keep people and themselves safe. Staff confirmed they had not run low on stocks.

Staff were observed wearing PPE throughout the building during the inspection.

Where they had identified one person struggled to accept staff wearing masks, they had an additional measure of a face screen to help stop the person from ripping the staff face masks off.

The registered manager had been proactive in helping people with cognitive understanding to feel safe and have some understanding of why restrictions were in place. Social stories and easy read information had been used. They had also tried to be inventive in thinking of ways people could still enjoy activities through lockdown. This included in house discos, crafts and enjoying walks out.

Staff had training and support to understand the fundamentals of infection control and Covid 19. There was a contingency plan for if the service had an outbreak.

All visitors were only allowed into the home once they had declared their health status, provided their contact details and had their temperature checked. The provider had a visiting room within the grounds of the home. This meant families could visit without having to enter the main building. Visits were via prior appointment. The room was large enough to ensure social distancing and each visit and person had a dynamic risk assessment in place.

Staff testing was working well, and the service had completed a vaccination programme for people and staff.

Cleaning schedules had been increased to ensure high touch points were being cleaned.

The registered manager had completed a detailed chronology of all advice from government, local authorities, CQC as well as their own changes in response to this advice. This helped them to keep abreast of current changes. They had been proactive in keeping up to date with best practice via webinars and websites.

Orion House provides care for people with a learning disability and associated conditions such as autism. On the day of our inspection there were 5 people living at the service.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in post who was also a joint owner. 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.

We checked the service was working in line with ‘Registering the Right Support’, which makes sure services for people with a learning disability and/or autism receive services are developed in line with national policy - including the national plan, building the right support - and best practice. For example, how the service ensured care was personalised, how people’s discharge if needed, was managed and people’s independence and links with their community.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

We met and spoke to four people during our visit, one person was away for the weekend. However, people who lived at Orion House had some communication difficulties due to their learning disability and associated conditions, such as autism. Therefore, they were not able to tell us verbally about all their experience of living there. We spent short periods of time with people seeing how they spent their day and observing the interactions between people and the staff supporting them. One relative who provided feedback said; “He has always been very happy and they have encouraged him to grow and develop.”

People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines.

People who required it had two to one or one to one staffing at certain times. Staff confirmed there were sufficient numbers of staff to meet people’s needs and to help keep them safe. Staff were recruited safely and checks carried out with the Disclosure and Barring Service (DBS) ensured they were suitable to work with vulnerable adults.

Staff had completed safeguarding training and further updates were arranged. Staff had a good knowledge of what constituted abuse and how to report any concerns. Staff understood what action they would take to protect people against harm and were confident any incidents or allegations would be fully investigated. Staff confirmed they’d have no hesitation reporting any issues to the registered manager.

All significant events and incidences were document and analysed. Evaluation of incidents was used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback to assess the quality of the service provided was sought from people living in the home, relatives, professionals and staff.

Staff had completed appropriate training and had the right skills and knowledge to meet people’s needs. New staff completed an Induction programme when they started work and staff competency was assessed. Staff also completed the Care Certificate (A nationally recognised training course for staff new to care) if they did not have any formal care qualifications. Staff meetings, one to one supervision of staff practice, and appraisals of performance were undertaken.

People’s risks were documented, monitored and managed well to ensure they remained safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. People had input as much as they were able to in preparing some meals and drinks.

People were engaged in different activities during our visit and enjoyed the company of the staff. People were busy; however, there was a happy, calm and relaxed atmosphere within the service.

People were supported to maintain good health through regular access to health and social care professionals, such as epilepsy nurses. The registered manager worked with external health and social care professionals to help ensure a coordinated approach to people’s care.

The service was responsive to people's individual needs and provided personalised care and support. People’s communication needs were known by staff. Staff had received training in how to support people with different communication needs. The provider had taken account of the Accessible Information Standard (AIS). The AIS is a requirement to help ensure people with a disability or sensory loss are given information they can understand, and the communication support they need. Staff adapted their communication methods dependent upon people’s needs, for example using simple questions. Information for people with cognitive difficulties and information about the service was available in an easy read version for those people who needed it.

People’s care records were detailed and personalised to meet individual needs. Staff understood people’s needs and responded when needed. People were not able to be fully involved with their support plans, therefore family members or advocates supported staff to complete and review people’s support plans. People’s preferences were sought and respected.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were upheld and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; considering people’s preferences and wishes. Overall, people’s individual equality and diversity preferences were known and respected. Information recorded included people’s previous medical and social history, and people’s cultural, religious and spiritual needs. People were treated with kindness and compassion by the staff who valued them. Staff had built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.

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.

People could make choices about their day to day lives. The provider had a complaints policy in place and it was available in an easy read version. Staff knew people well and used this to gauge how people were feeling.

The registered manager and had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.

People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the registered manager was approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

People lived in an environment that was clean and hygienic. The environment had been refurbished to a satisfactory standard taking into account people’s needs.