The inspection was announced and took place on 11 December 2017.

This service was last inspected on 9 and 16 August 2016 where we found that the provider was in breach of four of the regulations in relation to safeguarding, quality assurance systems and registration requirements. At this inspection, we found that improvements had been made and the provider was no longer in breach of any of the regulations.

Orcadia is privately owned and is located within walking distance of Disley town centre. The home is registered to accommodate 10 people who require support with their personal care and day-to-day living. The accommodation consists of nine single bedrooms, set over two floors, all of which contain handwashing facilities. Access between the two floors is via a staircase and chair lift. There are three bathrooms, two lounge areas and a large enclosed garden. On the day of our inspection there were 9 people living in the home.

Orcadia has a registered manager. 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.

People were provided with care that was person centred, sensitive and compassionate. Staff supported people to maintain independence and there was an emphasis on everyone being involved in the daily running of the home and being involved in decision making in relation to what went on in the home.

The home was managed and staffed by a consistent team of support workers who were well trained and well supported. Our observations showed there was plenty of staff around the home to help people with their day to day needs.

There were systems and processes in place to ensure that people who lived at the home were safeguarded from abuse. Staff we spoke with confirmed they knew how to raise concerns.

Risk assessments were detailed and specific and contained a good descriptive account for staff to follow to enable them to minimise the risk of harm occurring to people who lived at the home.

Medication was well managed and only administered by staff who had the correct training to enable them to do this. There was a process for analysing incidents, accidents and general near misses to determine what could be improved within the service provision.

Staff were clear on the principles of the Mental Capacity Act 2005, and best interest processes. Consent was sought and clearly documented in line with legislation and guidance.

Menus were varied and people told us they had input into the menus and food preparation where appropriate. There was access to other medical professionals who often visited the home and were involved with people from a clinical point of view.

The building had been recently refurbished to include a new kitchen and chair lift. Both these improvements were in response to feedback from the people living in the home.

Staff treated people with kindness and respect. People were treated as individuals, and their choices and preferences were respected by staff. This was evident throughout our observations around the home, and the information recorded in people’s care plans. People were included in their care and support as much as possible, and there was evidence to suggest that person centred plans had been discussed with people and their relatives.

People’s support plans were person centred and contained a high level of detail about the person, their likes, dislikes and how they want to be supported. Activities were centred around the interests of the people living in the home and were flexible to accommodate spontaneous outings as well as more planned activities that occurred on a weekly basis. People were supported with employment and local community activities. There was a process to listen to and respond to complain

The inspection was unannounced and took place on 09 August and 16 August 2016.

This service was last inspected on 15 January 2014 where it was found to be compliant in all the areas we looked at.

Orcadia is privately owned and is located within walking distance of Disley town centre. The home is registered to accommodate 10 people who require support with their personal care and day-to-day living. The accommodation consists of nine single bedrooms, set over two floors, all of which contain handwashing facilities. Access between the two floors is via a staircase. There are three bathrooms, two lounge areas and a large enclosed garden. On the day of our inspection there were 9 people living in the home.

Orcadia had a registered manager, however they were currently away from work, but visiting the home to keep an overview of the service on a frequent basis. The deputy manager was currently in charge of the day to day running of 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.

At this inspection we identified breaches of the relevant regulations in respect of the need for good governance, safeguarding and notifications. You can see what action we told the provider to take at the back of the full version of the report.

We found that people were provided with care that was person centred, sensitive and compassionate. Staff supported people to maintain independence and there was an emphasis on everyone being involved in the daily running of the home and being involved in decision making in relation to what went on in the home. The home was managed and staffed by a consistent team of support workers who were well trained and well supported.

Although most people told us they felt safe and the provider had a safeguarding policy, we found that the policy was not in line with current guidelines and managers had not reported the safeguarding incident that had occurred in the last year to the relevant external authorities. Staff were also not clear on the correct procedures on reporting safeguarding incidents externally to protect vulnerable people from abuse and neglect.

We found a number of issues with medication as we found the booking in system was not effective and was not cross-referenced with the MARs sheet. The storage of medication needed improvement as there were a number of disused medications that had not been disposed of and the temperature was not being monitored. Improvements were observed on the second day of our inspection which need to be maintained.

We found management were conducting very few audits of the systems and processes which meant that they were not picking up any discrepancies in their records.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that it was up to date.

The provider had a range of policies and procedures which included guidance on the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and staff and management were clear on the processes to be followed when someone lacked mental capacity.

The provider was not submitting the required notifications to the Care Quality Commission (CQC) as required by the regulations.

We found that the staff team were very caring and knew the residents very well. We saw care being carried out in a dignified and respectful manner. We observed that everyone living at Orcadia was encouraged to take part in the running of the home and they were supported to be as independent as possible.

We found Orcadia to be a comfortable home for up to ten service users. The service users were encouraged to participate in all aspects of care planning and to make choices in hobbies and activities. We were told “I am very happy here, I love it.” Another person told us “I like everything about it, it feels like a family” and “It is home.”

The care plans were person centred and focused on opportunities to increase the service user’s independence whilst monitoring and reducing risk. A person who used the service told us “I am able to make the tea and made Shepherd’s pie last night.”

We found the home to be very clean and the people who lived there were encouraged and supported to help clean their rooms and do their laundry.

Staff appeared to be very happy working at the home and there was good staff retention. We were told that there was always plenty of training and staff felt trained to carry out their job. One person who lived there said “The staff are lovely and helpful.”

Staff could tell us the process for managing a complaint. Service users told us they felt able to talk to staff if they had any concerns.

In a satisfaction survey carried out with relatives comments included “There is good communication between staff and family” and “The staff are very kind and caring.”

During our visit we spoke with people who used the service and health and social care professionals. We did not receive any information of concern about the home from the health or social care professionals.

People who used the service told us that they were able to make choices in their daily lives. They told us that staff treated them with respect and they were able to share any concerns or worries with staff and that these were listened to. They also told us they were happy living in Orcadia, that they ‘’were spoiled’’ by staff and that staff were kind and caring.

The people we spoke with also said they were asked for their views about the service and if they liked living there. Some of the people we spoke with told us they had lived there a long time and that it ‘’was their home’’.