Background to this inspection
Updated
22 January 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
This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Orla House 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
Before the inspection we looked at the information we had received about the service since the last inspection. This includes notifications and information from other agencies and professionals.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We contacted Healthwatch for information they held about the service on their database. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and two visiting relatives and friends about their experience of the care provided. Five people living at the service were attending day centres during the inspection, but arrived home at the end of the inspection. We spoke with seven members of staff including the registered manager, senior care staff, care staff and a member of domestic staff. Some of the people living at Orla House had limited verbal communication and therefore we observed staff interaction with people living there. Some people were able to understand our questions and responded to us in their own individual ways. We spoke with one visiting health professional during the inspection, to gain their opinion of the service.
We looked at records relating to the service including staff recruitment files, rotas, medicine administration, care plans and daily records, audits and monitoring reports.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
22 January 2020
About the service
Orla House is a residential care home providing personal care and support to 10 people living with learning disabilities such as autism, and physical disabilities, who were aged 40 and over at the time of the inspection.
The service is registered for the support of up to 14 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area along with other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.
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 is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were supported by an exceptionally caring staff team who knew them well. The staff team demonstrated passion and determination to support people to lead fulfilling lives.
There was a strong focus on treating each person as an individual and supporting people to be active participants within their local community. Staff clearly understood the support each person needed.
Care plans were highly personalised in relation to all aspects of the support each person needed. Staff understood each person's individual style of communication.
Staff worked with a wide range of professionals to improve peoples' health. Peoples' social needs were met through a clear understanding of the things people enjoyed doing.
People were safe. There were sufficient staff with the skills and knowledge to give people the support they needed, at the right times. This meant people received support from a consistent staff team they knew and trusted.
Measures were taken to minimise risks to people's safety. Risks to people's health and safety were assessed and staff knew how to support people to remain healthy and safe. Medicines were stored and administered safely. Staff understood how to keep people safe from infection. The accommodation and equipment were well maintained, checked and serviced.
The service was well-led. There were checks and measures in place to ensure all aspects of the service was consistent. The registered manager and established staff team reviewed the service regularly and consulted with people who used the service, friends and family to consider any improvements needed.
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 9 June 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.