Background to this inspection
Updated
20 November 2015
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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
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. The expert-by-experience at this inspection was a carer of a relative with complex needs including a learning disability.
Prior to the inspection we looked at information we held about the service and used this information as part of our inspection planning. The information included notifications. Notifications are information on important events that happen in the home that the provider is required by law to notify us about.
We spent time in the shared areas of the home where we observed how the staff interacted with people who lived at Orchard Manor. The majority of people who lived at Orchard Manor did not use words to communicate. We used a number of ways to communicate with people, including sign language and pictures. With the aid of their supporters, we spoke at length with two people who used the service and briefly with several other people during the day. We spoke with eight support staff, one relative, one therapist and the registered manager. We looked at two people’s care records as well as some other records relating to the management of the home, including medication administration records. Following the inspection we spoke with four people’s relatives on the telephone. Two healthcare professionals completed a questionnaire we sent them. Their views have been included in the report.
Updated
20 November 2015
Orchard Manor Transition Service is registered to provide accommodation and personal care for up to 31 young adults aged 19 to 25 years. On the day of the inspection there were 17 people in residence. Short and long stays were offered.
The service is housed in three buildings, which are linked by a conservatory. There are three flats with lounge/dining and kitchen areas and each person has their own room and ensuite bathroom. The building has wide corridors and plenty of storage space for any equipment that people need. There are a number of large therapy rooms as well as a hydrotherapy pool and trampoline. Only two of the flats were in use when we inspected. The service provided care and support to people with profound disabilities and complex needs.
This inspection took place on 11 and 25 August 2015 and was unannounced. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 service had received numerous compliments about the care and support provided to the people who lived there. One relative summed it up by saying, “We’ve been really impressed with everything. I can’t think of anything I’d change at all.” The service had a very strong, person-centred culture. Everything was based on the needs and wishes of the individual and how those needs and wishes could be recognised, supported and met to give each person the best life they could have.
We saw that people were comfortable and well cared for. People and the staff supporting them had warm, caring relationships and there was a lot of laughter and fun. Staff treated people well and respected their privacy and dignity. Communication between staff and the people they were supporting was exceptionally good, because staff used a wide range of methods to communicate in the best possible way with each person.
The service was safe because there were enough staff on duty to support people in the way they wanted to be supported. Pre-employment checks had been carried out before staff started to work at Orchard Manor and staff had been trained to recognise and report any incidents of harm to people. Any potential risks to people were managed so that the risks were minimised, whilst ensuring that people were enabled to be as independent as possible. People were given their medicines safely.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed by staff trained to do so. This meant that the rights of people not able to make their own decisions about aspects of their care were protected.
People were supported by a highly motivated and well trained staff team. The service provided a very wide range of opportunities for therapy sessions, activities and outings and people’s individual hobbies and interests were encouraged. People were part of the local community.
People and their relatives were involved in the planning and reviewing of their care. Detailed information was available to staff so that each person received the care and support they needed in the way they preferred. Staff were pro-active in finding and using the most up to date assistive technology to support people to be as independent as they could be.
The service was managed effectively and was constantly striving for excellence. People, their relatives and the staff were encouraged to give their views about the home and put forward their ideas for improvements. The provider’s complaints procedure was well advertised and relatives said they felt comfortable to raise any issues with the management team. An effective system was in place to monitor and audit the quality of the service being provided.