The Old Orchard

Updated 19 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector

Service and service type

The Old Orchard is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

The provider is legally required to notify us of significant events that have occurred at the service. We reviewed this information that the provider had sent. We also asked the Local Authority for feedback on the service. We considered information that had been sent to us by members of the public since the last inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service. Due to people's communication needs their feedback about aspects of the service was limited in parts. We used observation to help us understand people's experience of the care and support they received. After visiting the care home, we phoned people’s relatives to gather their feedback on the service.

We spoke with three members of care staff and the registered manager. We reviewed a range of records. This included the relevant parts of three people’s care records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We read positive feedback from two professionals.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 19 March 2020

About the service

The Old Orchard is a residential care home providing personal care and support for up to six people. At the time of the inspection, six people were using the service. The service primarily supports people with a learning disability/ and or autism diagnosis.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service and what we found

Staff were innovative in meeting people’s communication needs. Due to the hard work of staff, and the use of innovative tools; people’s communication had improved. This had resulted in people being more engaged with decisions about their care and becoming more independent. People were supported to be active members of the community and engage in activities that were important to them. The service had used communication aids and multi-professional involvement to assess people’s end of life wishes. This meant their needs and preferences would be met in the event of an unexpected death.

Staff were empowered to come up with suggestions. This had resulted in innovative care provision, which positively impacted on people. People were empowered to make complaints, and any concerns were responded to fully. The service was exceptionally well led, with the registered manager and provider completing comprehensive audits and employing external professionals to also audit the service. The robust level of governance meant the service provided was of a high quality.

The service was safe. High quality staff training had resulted in incidents reducing. Where incidents did occur, these were recorded and learnt from. Care plans were of a good quality to guide safe and effective care. Medicines were managed safely. The service was clean, and staff followed safe infection control practices. There were enough staff at the service.

People were supported to eat and drink what they wanted. If people were at risk of choking from food, specialised guidance had been created with professional involvement. The building was adapted to meet people’s needs. Staff worked with different health and social care professionals to ensure people’s needs were met.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff were caring and driven to provide good outcomes for people. People were involved as partners of their care. People lived as independently as possible, with dignity and privacy.

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 20 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.