This inspection took place on 22 March 2017 and was unannounced. We carried out this inspection because we found one breach of regulation at the last inspection carried out on 25 March 2015. The provider sent us an action plan which we reviewed during this inspection.

Orchard Leigh is registered to provide personal care and accommodation for up to seven people. The home specialises in the care of people with a learning disability. At the time of our inspection there were seven people living in the home.

There was a registered manager in post. 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 of the Health and Social Care Act 2008 and associated Regulations about how the home is run.

People were kept safe from abuse because staff understood what abuse was and the action they should take to ensure actual or potential abuse was reported. Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff said there were sufficient numbers of staff on duty at all times.

The registered manager and staff understood their role and responsibilities to protect people from harm. Risks had been assessed and appropriate assessments were in place to reduce or eliminate the risk.

All medicines were stored, administered and disposed of safely. The service had policies and procedures for dealing with medicines and these were adhered to.

The home was meeting the requirements of the Deprivation of Liberty Safeguards. Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported to access health care professionals and health care services when needed. They were offered a choice of foods they enjoyed.

Activities were personalised for each person. People made suggestions about activities they wanted to participate in each day. People were offered the choice if they wanted to go out with staff daily.

People were treated in a kind and caring way. Their privacy and dignity was promoted by staff and they were encouraged to be independent. Care records contained detailed information about people's needs, wishes, likes, dislikes and preferences.

The registered manager assessed and monitored the quality of the service provided for people. Systems were in place to check on the standards within the home. These included regular audits of care records, medicine management and health and safety.

We used a number of different methods to help us understand the experience of people using the service, because some people were unable to verbally communicate and were not able to tell us about their experience.

There were eight people living at the service at the time of our inspection, including one person in a supported living flat adjoining the home. We spoke with five people in the service and four members of staff.

Throughout the visit, we saw that people were being treated with dignity and respect and that people’s independence was encouraged. People we spoke to told us that the staff were friendly and always helpful. One person told us they ”like all the workers”. Another person told us “oh yes, it’s alright here, nice”.

People in the service told us that staff knew what to do when supporting them. One person told us staff “looked after” them well. One person told us they “love this place because the staff are so good”.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met their needs. One person we spoke to told us “staff always do things as I want them to”.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting. Records showed that the staff team had received safeguarding training and were aware of how and when to report any concerns. People told us they felt safe living at the service.

During our visit we spoke with three people who were able to tell us about their experience of living in the home. We also spent time observing people in the communal areas. The atmosphere in the home was relaxed and people were able to move freely around the home choosing where and how to spend their time. Staff were observed interacting with people in a respectful manner that showed that they understood each individual’s needs and how best to communicate with them.

Care plans were personalised to each individual's needs and gave detailed guidance for staff to follow to meet people’s needs and wishes. Risk assessments had been completed where necessary and people’s capacity to make day-to-day decisions was assessed. All care records were regularly reviewed.

There were enough qualified, skilled and experienced staff to meet people’s needs. Staff we spoke with told us they enjoyed working in the home and felt supported to carry out their role. Care was provided in an environment that was safe, well maintained and met people’s needs.

During this inspection to check improvements we did not receive any information from people who use the service or their representatives.

We looked at the care files for all of the people living in the home and found that people or their representatives had signed their support plans confirming that they had been involved in the writing of their support plan. We also checked the care files for evidence that staff had signed to state that they had read and understood the support plans for each individual. We saw that all staff had signed each section of the support plans for all of the people living in the home.

When checking the care files we also looked to see if there was a relevant risk assessment to correspond with each section of the individual's support plan. We saw that each support plan had a relevant and up to date risk assessment for every section of the support plans.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. We looked at records of monthly service reviews and saw that any actions set were being completed.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We looked at the results of surveys where the provider had asked people and their families for their feedback on the care and support provided to them.

One person told us that he was very happy at the home. He told us about all of the activities he does. He said that he likes his room, the food “is alright and the staff are too.”

One family member commented that “all the care team are pleasant to deal with.” He said that he was very happy that his relative was living at Orchard Leigh. Members of staff spoke very positively about working at Orchard Leigh. One said “I love it here.” Another said “everything here is focussed on the individual resident, and the manager always makes time for both the people and the staff.”

We saw that people living at Orchard Leigh were very comfortable in their relationships with members of staff and there was a good atmosphere. Both staff and the people living at Orchard Leigh reported having confidence in the manager

This unannounced inspection took place on 24 and 25 March 2015.

Orchard Leigh is a care home for up to seven people with a mild to moderate learning disability, autism or sensory impairment. The service also provides personal care to one individual in an adjoining flat. Orchard Leigh is situated on the outskirts of Cheltenham.

There was 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.

Medicines were administered safely and there was detailed information for each person about, ‘How I like to take my medicines’ which the staff followed. Individual medicine storage did not comply with the recognised safe standard and was unsafe. The provider was not meeting the requirements of the law by not ensuring medicines were managed safely.

Staff supported two people in the community and travelling time reduced their time caring for people in the care home and affected continuity of care. The registered manager clearly recognised this but had employed additional staff and planned to recruit more bank staff. We recommend there are sufficient numbers of suitable staff to keep people safe and meet their needs.

People were safeguarded because staff knew how to raise concerns and were trained to identify different types of abuse. Staff knew people well and how they liked to be supported and cared for. Staff had the skills and knowledge to meet people’s needs which included qualifications in health and social care. Visiting healthcare professionals told us people were well cared for, were supported to achieve through their individual strengths and were happy and secure in the home.

Staff respected people’s personal wishes and treated them as individuals. Care plans were personalised and people were involved in planning their care as much as possible. Staff were trained to support people’s independence and improve their quality of life. People were given choice for their meals and activities which were individual and well planned. There was a wide variety of activity choices that included visiting a sensory centre, local markets, cinema trips and local community groups. People went out in the community most days if they wanted to. Weekly meetings were held where people discussed their activity and food choices and could raise any concerns. Relatives told us they had no worries about the care and support provided and people “loved” living there.

Staff communicated well between shifts during handover meetings to provide continuity and pass on important information about peoples support. The registered manager and deputy manager provided good leadership and management. The vision and values of the service were apparent in how people were treated with respect and encouragement. The quality of the service people received was continually monitored and action was taken when required. Staff clearly felt well supported and motivated in their roles.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We completed this inspection at a time when the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the Care Quality Commission (Registration) Regulations 2009 were in force. However, the regulations changed on 1 April 2015; therefore this is what we have reported on. You can see what action we told the provider to take at the back of the full version of this report.