Background to this inspection
Updated
1 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 completed by one inspector.
Service and service type
Little Orchard is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 was an unannounced inspection.
What we did before the inspection
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 reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and professionals who work with the service.
During the inspection
We spoke with one person who used the service and one relative. We met with the area manager, a supporting manager and five support workers.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including health and safety and quality audits.
We walked around the home and observed care practice and interactions between support staff and people.
After the inspection
We looked at quality improvement plans and policies.
Updated
1 January 2020
About the service
Little Orchard is a residential care home providing personal care to people with learning disabilities and/or autism. The service can support up to six people. At the time of the inspection five people were living at the home.
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 at Little Orchard were living with a learning disability or autism, which affected their ability to make decisions about their care and support. Where people were not able to give consent the service delivered care in the person’s best interest. However, mental capacity assessments and best interest paperwork was not in place for people. This was discussed with the area manager who addressed this and showed us improvements on day two.
Staff were well trained and skilled. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards inclusion and enabling people to learn essential life skills. Equality, Diversity and Human Rights were promoted and understood by staff.
People told us they were happy and felt safe. Relatives said that staff had a good understanding of their loved one’s needs and preferences. Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.
People, professionals and their families described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging.
People received pre-admission assessments and effective person-centred support. The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.
Care plans were personalised and updated. Staff listened to what people wanted and acted quickly to support them. Staff looked to offer people solutions to aid their independence and develop their skills.
Leadership was visible and promoted good teamwork. People, relatives, professionals and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities.
Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the management team were keen to make changes that would impact positively on people's lives.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
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.
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 2 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.