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.
The Orchards is a care home providing support for up to five people. The service provides care and support to people with mental health or learning disability and complex needs. Care is provided in a large adapted house close to amenities in the local community. At the time of our inspection five people were using the service.
People’s experience of using this service and what we found
People were positive about their experiences at the service and told us they were happy living there.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting underpinning principles of Right support, right care, right culture. Staff promoted people’s independence and care was personalised to each individual person’s needs. Staff supported people to develop confidence to live full lives.
We received information of concern that the provider may not have shared information or taken action across the organisation following a specific incident at another location.
We found systems had been put in place to share learning with staff through briefings, guidance, supervisions and meetings. We saw additional support and training had been provided to staff on closed cultures and there was an independent ‘Freedom to speak up’ service staff had received further training and information on.
There were systems in place to provide a good oversight of the service with additional audits and monitoring by the management team.
The senior management team were more visible and held regular briefings with staff. Registered managers were supported with the providers initiative ‘project best’. Where through regular coaching meetings registered managers were supported to drive improvements in outcomes for people.
Rating at last inspection: The last rating was good report published 4 July 2019.
Why we inspected: We undertook this targeted inspection to follow up on specific concerns we had about the provider. The inspection was prompted in response to concerns received on safeguarding and culture. A decision was made for us to inspect and examine those risks.
CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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.
The Orchards provides accommodation, care and support for up to five people with a learning disability. There were four people living at the service on the day of inspection.
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 receive 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
People, their relatives and professionals were complimentary about The Orchards. One relative said, “They [staff] are outstanding, they really look after [person].” A professional commented, “The staff seem a nice bunch there and people seem to have a good rapport with the staff.”
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.
People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Staff were recruited safely and there were enough staff to meet people’s individual needs. People’s medicines were managed safely. Incidents and accidents were investigated, and actions were taken to prevent recurrence. The environment was clean and comfortable.
People's needs were assessed, and support was planned to ensure that it promoted positive outcomes for people. Staff received relevant training, support and supervision to enable them to carry out their roles and responsibilities. People were involved in the planning and preparation of meals. Staff worked well with external professionals to promote people’s health and wellbeing.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were cared for by staff who knew them well and were kind and compassionate. Positive relationships had been formed between staff and people using the service.
People were supported by competent staff who supported them according to their needs and preferences. People were very involved in how the service was run and encouraged to be as independent as possible. They had the choice to participate in activities which promoted a good quality of life. People's views were listened to and action was taken to improve the service as a result.
There was no registered manager in post, however, the team leader had good oversight of the service and was visible and approachable. There were systems in place to monitor the quality of the service. The team leader and staff engaged well with other services and had developed positive relationships.
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 24 November 2016).
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.
The Orchards provides a 24 hour care environment for people with mental health needs and learning disabilities. The service enables people to develop essential daily and community living skills. For some people this forms part of a pathway towards accessing supported living services. At the time of our inspection there were five people living at the home.
The home did not have a registered manager in post at the time of our inspection, although a new manager had been appointed and their application to become registered was being processed. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. A team leader had been appointed to the home to support the manager with the day to day running of it. They were also supported by the provider’s regional manager.
Staff were aware of the safeguarding process. Personalised risk assessments were in place to reduce the risk of harm to people, as were risk assessments connected to the running of the home, and these were reviewed regularly. Accidents and incidents were recorded and the causes of these analysed so that preventative action could be taken to reduce the number of occurrences. Where people had been involved in incidents because of behaviour that could have a negative effect on others, the triggers for such behaviour had been identified and action taken to reduce the occurrence of such behaviour. People received their medicines as they had been prescribed and there were robust procedure for the safe management of medicines.
There were enough skilled and qualified staff to provide for people’s needs. Robust recruitment and selection processes were in place and the provider had taken steps to ensure that staff were suitable to work with people who lived at the home. Staff received training to ensure that they had the necessary skills to care for and support the people who lived at the home, and were supported by way of supervisions and appraisals. Staff were encouraged to undertake training to gain professional qualifications.
People’s needs had been assessed before they moved into the home and they, their relatives and other healthcare professionals had been involved in determining their support needs and the way in which their support was to be delivered. Their consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards were met.
People decided what food and drink they had and a variety of nutritious food and drinks were available to them. People were encouraged to assist in buying and cooking the food. Snacks and fruit were available to people throughout the day.
Staff were kind, caring and protected people’s dignity. They treated people with respect and supported them in a way that allowed them to be as independent as possible.
Information was available to people about how they could make a complaint should they need to, although none had been made recently. Information was also available in formats that people understood about the services provided at the home. People were assisted to access healthcare services to maintain their health and well-being. Staff worked with healthcare professionals and people’s relatives to ensure that the support provided to people best met their needs.
Staff were encouraged to attend meetings with the registered manager at which they could discuss aspects of the service and care delivery. People were asked for feedback about the service to enable improvements to be made. There was an effective quality assurance system in place and senior managers within the provider’s organisation were made aware of any required improvements identified during the monthly review of performance completed by the regional manager.
We saw that people were involved as far as possible about making decisions about their daily life. People's diversity was recognised and their privacy respected.
We found that people's care and treatment was planned and reviewed with their involvement. Risks to people's health, welfare and safety were identified and well managed. Our inspection showed us that the service was safe, responsive and caring.
We saw that people's nutritional needs were assessed and monitored to ensure their on-going wellbeing.
We found that people were cared for by staff that were sufficiently trained and supported.
We found that there were systems in place to assess and improve the quality of service provision.