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 wer

The inspection took place on 05 March 2015 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.

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 had 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 were 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 recently made Deprivation of Liberty Safeguards (DOLs) applications to local authorities after a best interest meeting, which was granted.

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. One relative said, ‘If I need to complain, I will go to the manager’. Complaint process guide for people was 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 had a system 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.

We used a number of different methods to help us understand the experiences of people who used the service, because some of the people who used the service had complex needs and communication difficulties, which meant they were not all able to tell us their experiences in detail. This included observing the care and interactions between the people who used the service and staff.

People we spoke with told us that the service responded to their health needs quickly and that staff spoke with them regularly about their plan of care and any changes that may be needed. All staff spoken with demonstrated an appropriate level of experience and knowledge that enabled them to support people who lived at the service with their needs effectively.

We saw that the people who used the service made choices about their lives and were part of the decision making process. People had their own individual routines which were respected. One person who used the service said, "Staff are very good. I have no concerns". Another person said, “They look after me well here”. A relative said, "The staff are very friendly they do a good job, they are excellent I would give them all a gold star".

The service was generally clean and free from offensive odours. Medication was handled appropriately and systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

The visit lasted for three hours, and during this time, we met and talked with six people living in the home, and talked with five staff. The deputy manager and senior staff were present during the day, and we were able to talk with them about ongoing processes and the running of the service.

We saw that people living in the home were relaxed with the staff, and responded well to them. Some people were able to use verbal communication skills, and responded positively to questions such as “Do you like living here?” with answers such as “Yes”, “I like it here”, and “I am very proud of the staff who work so hard for us.”

We saw that the service provided people with a wide variety of activities, and opportunities to develop their daily living skills and individual ambitions.

We found that the home emphasised the importance of person-centred care, and protected people’s dignity and encouraged their independence.

We found that quality audits were in place and people’s views were listened to, and action was taken in response to people’s ideas and concerns.

All five of the people we spoke with said they liked living in the home. One person told us “there is nothing I don’t like here.” People told us about their interests and what they liked to do, and how the service had supported them to do these things. One person told us that he had started training to do quality assurance inspections at other homes.

All the people we spoke with said they liked the staff. All five people we spoke with could name their key worker. One person told us “I’m proud of all the staff, they work hard here for the house.” People said they felt safe in the home, and would speak to the staff if they had a problem.

People told us they planned what they wanted to eat at a weekly menu planning meeting. Some people were also involved in cooking and cleaning the home, and said they enjoyed doing this.