Background to this inspection
Updated
22 February 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 8 February 2022 and was announced. We gave the service just over 24 hours’ notice of the inspection.
Updated
22 February 2022
4 Orchard Close is a residential care home providing care for up to seven people with a learning disability. All of the people using the service also had a range of physical disabilities and healthcare needs. This meant staff were required to work closely with other health and social care providers to provide specialist care and support.
This inspection took place on 18 and 24 October 2017 and was unannounced. At our previous inspection on 29 October 2015 we found that the service was meeting all the legal requirements we looked at and was rated as good.
At this inspection we found the service remained Good.
There was a registered manager in place at the time of the inspection. 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.
Everyone we spoke with who either used the service, relatives, and a healthcare professional praised staff for their caring attitudes. The service was tailored to not only meet people’s needs but to do so in the most caring and unique way possible, taking account of people as individuals and not making people fit around procedures or processes. Care plans showed that considerable emphasis was given to how staff could ascertain each person’s wishes including people with limited verbal communication. Staff demonstrated not only that they knew the people they supported but went the extra mile to care about people’s best interests and enhance their life experiences. Staff were committed to this by doing as much as they could to promote people’s emotional as well as physical wellbeing.
The service is owned and run by the London Borough of Islington and used the local authority’s borough wide safeguarding adults from abuse procedures. The provider ensured that staff had training about safeguarding people from abuse and members of staff, whether management or care staff all told us they were trained about protecting people from abuse, which we verified on training records.
Potential risks to people were assessed and responded to, this too helped to keep people safe from known risks and avoidable harm. These assessments were detailed, and were regularly reviewed.
There were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected. The service was applying MCA and DoLS appropriately and making the necessary applications for assessments when these were required.
Most people had complex healthcare needs which were assessed, and care was planned and delivered in a consistent way. Staff knew about, and were very familiar with people’s needs and the information and guidance provided to staff was clear.
The staff team demonstrated that there was a real commitment to providing the most caring and person centred support possible. This meant the staff team took time to really get to know people and support them, not least when people needed to spend time in unfamiliar places such as hospital, to looking to make a positive impact on people’s life and life experience opportunities. Assumptions about people and their support needs were not made and significant effort was put into exploring the possibilities for real effective and beneficial changes, this effort achieving notable success and praise from families and other professionals alike.
Significant efforts continued to be made to engage and stimulate people with activities whether these were day to day living activities or those for leisure time. People received the support they required to engage in these activities, maintain contact with family and friends and to maximise their opportunities to engage in normal life experiences.
The staff team did work as a team and views about the way the service operated were respected. Everyone’s input was valued and we observed conversations that demonstrated that the staff team co-operated and saw their work as collaborative in order to maximise the effectiveness of the service.
The provider carried out regular audits of all aspects of the service. The provider monitored the operation of the service, carried out regular reviews of the service performance, as well as regularly seeking people’s feedback on how well the service operated.
At this inspection we found that the service met all of the key lines of enquiry that we looked at and was not in breach of any of the regulations.
Further information is in the detailed findings below.