The Orchard Trust - Sevenoaks

Updated 1 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC's response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 15 February 2022 and was announced. We gave the service 48 hours notice of the inspection.

Updated 1 March 2022

About the service: The Orchard Trust - Sevenoaks is a care home and supported people with learning disabilities and/or autism.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. Ten people were using the service. 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 and other large domestic homes of a similar size.

The service was divided into two homes/areas known as Larch and Rowan, each with its own communal rooms and facilties. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when accessing the community with people.

For more details, please see the full report which is at the CQC website at www.cqc.org.uk

People’s experience of using this service:

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways:

• Staff understood how to communicate with people effectively to ascertain and respect their wishes and preferences.

• People’s independence was respected and promoted. Staff prompted people during household tasks and activities, to enable them to do things for themselves and learn new skills.

• People's support focused on them having opportunities to be part of their community, meet others and maintain existing relationships.

We received positive feedback about the service and the care people received. The service met the characteristics of ‘Good’ in all areas.

• Risks to people had been assessed and plans were in place and followed by staff to keep people safe.

• Safe recruitment practices were followed to protect people from unsuitable staff.

• Staff were knowledgeable around safeguarding and understood provider policies and procedures in this regard. There were good links with local safeguarding bodies.

• Systems were in place to ensure people received appropriate support to take their medicines safely.

• Health and social care professionals guided staff to support people with their behaviour and epilepsy in accordance with national best practice guidelines.

• Staff received regular managerial supervision, felt supported in their role and received the training they needed to support people’s needs.

• All staff had a good understanding of the principles and application of the Mental Capacity Act. The Deprivation of Liberty Safeguards (DoLS) had been followed.

• Staff attitudes and behaviours were responsive, respectful and caring.

• People were supported through appropriate communication methods by staff that knew how to involve people in their own care.

• Interactions between staff and people demonstrated personalised, collaborative, action-oriented care planning and care delivery.

• There were processes in place to manage adverse incidents and complaints. There was evidence that learning from incidents and complaints was shared across the service.

• Effective quality monitoring systems were in place and regular audits and checks supported managers to identify concerns promptly to take action to improve the service.

• 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.

For more details, please see the full report which is at the CQC website at www.cqc.org.uk

Rating at last inspection: We last inspected The Orchard Trust – Sevenoaks on 9 November 2017. At the last inspection the service was rated Requires Improvement (this report was published on 19 January 2018). The provider had taken the required improvement actions and our rating of the service improved at this inspection.

Why we inspected: We inspected this service as part of our ongoing Adult Social Care inspection programme. This was a planned inspection based on the previous Requires Improvement rating. We also follow up on progress against agreed action plans to address the breaches in regulation we found at our previous inspection in November 2017. Previous CQC ratings and the time since the last inspection were also taken into consideration.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.