The inspection took place on 23 February 2017 and it was unannounced, which meant that the provider did not know that we were coming.Orchard View is a small residential home in Rochester that supports adults with learning disabilities to become as independent as possible. At the time of our visit, there were eight people who lived in the home. Some people required one to one staff support while others needed additional support to meet their needs, particularly in the areas of behaviour that could challenge the service. The people who lived at Orchard View had diverse and complex needs such as learning disabilities, autism, downs syndrome and limited verbal communication abilities.
At the last Care Quality commission (CQC) inspection on 5 March 2015, the service was rated Good in all domains and overall.
At this inspection we found the service remained Good.
There was a registered manager at the home. 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.
The provider continued to have systems in place to safeguard people from harm and abuse and make sure that safeguarding alerts were raised with other agencies, such as the local authority safeguarding team, in a timely manner. Staff knew how to report any concerns related to abuse.
The staff had risk assessments in place to identify risks when meeting people’s needs. The risk assessments showed ways that these risks could be reduced.
There continued to be sufficient numbers of qualified, skilled and experienced staff to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe recruitment procedures.
Medicines were stored and administered safely. Clear and accurate medicines records were maintained.
Staff knew each person well and had a good knowledge of the needs of people. Training records showed that staff had completed training in a range of areas that reflected their job role and enabled them to deliver care and support as appropriate.
Staff received Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) training to make sure they knew how to protect people’s rights. The registered manager made decisions by liaising with social workers, health professionals, relatives and advocates.
The registered manager continued to make Deprivation of Liberty Safeguards (DOLs) applications to local authorities as appropriate.
People said the food was good. The menu offered variety and choice. It provided people with a well-balanced diet that met their needs and preferences. People had choices of hot foods each day. People’s independent skills were promoted in food preparation.
People and their relatives told us that they were involved in their care planning, and that staff supported people with health care appointments and visits from health care professionals. Care plans were amended immediately to show any changes, and care plans were routinely reviewed when necessary to check they were up to date.
People told us that staff were caring. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed. Staff had suitable training and experience to meet people’s assessed needs; staff encouraged people to make their own choices and promoted their independence.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person and their relatives.
People were encouraged to take part in activities and leisure pursuits of their choice, and to go out as they wished.
People knew how to make a complaint if they were unhappy. There was a complaint process guide for people on the notice board. This enabled people to know how to complain in a format they could understand
People spoke positively about the way the home was run. The provider had a clear set of values, which we observed that both the registered manager and staff followed. The registered manager and staff understood their respective roles and responsibilities.
The provider continued to have systems to monitor and review the quality of service they provided. Prompt action was taken to improve the home and put right any shortfalls they had found. Information from the analysis of accidents and incidents was used to identify changes and improvements to minimise the risk of them happening again.