This unannounced inspection was carried out on 19 June 2017. The Old Orchard specialises in supporting people with a learning disability who have reached the age of 18 and leaving services run for children and young people to move into services for adults. The Old Orchard provides accommodation and personal care for up to six people. On the day of our inspection there were five people who were using the service.

At the last inspection, in November 2014, the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’.

The service is managed by the registered provider, so does not require a registered manager. Registered providers are ‘registered persons’ who have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to receive safe care. Most staff had received appropriate adult safeguarding training and were aware of their role and responsibilities to protect people from avoidable harm. Risks associated with people’s individual needs, including the environment and premises had been assessed and plans were in place to mitigate any risks. Procedures were in place to report any accidents and incidents and these were investigated and acted upon appropriately.

Staff underwent appropriate recruitment checks before they commenced their employment. Staffing levels were flexible and met people’s individual needs. People were supported to receive their medicines safely.

People continued to receive effective care and support. Staff received an appropriate induction, ongoing training and opportunities to discuss and review their work, development and training needs.

The principles of The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied where required. People were supported with any dietary and nutritional needs and meal preferences were known and respected. People were supported appropriately with their health care needs and the staff worked well with external healthcare professionals following any guidance and recommendations made.

People continued to receive good care. People had developed positive relationships with staff who understood their individual routines and preferences, and knew what was important to them. Staff were caring and treated people with respect, kindness and dignity. People influenced their care when they were able to do so.

People continued to receive a service that was responsive to their individual needs. Staff had information available to support them to provide an individualised service based on people’s needs, preferences and routines as well as anything else that was important to them. The provider had a complaints policy and procedure.

People continued to receive a service that was well-led. People who used the service were positive and said that the leadership and ethos of the service was good. The provider improved their quality assurance system when we identified it was not identifying some improvements that were needed.

We inspected the service on 12 November 2014. The Old Orchard specialises in supporting people with a learning disability who have reached the age of 18 and leaving services run for children and young people to move into services for adults. The Old Orchard provides accommodation and personal care for up to six people. On the day of our inspection there were three people who were using the service.     

The service is managed by the registered provider, so does not require a registered manager. Registered providers are ‘registered persons’ who have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.  

Staff supported people to remain safe and knew how to raise any concerns they had if someone was at risk of harm or abuse. People were able to be as independent as they could be and follow their interests as safely as possible. There were sufficient staff to provide people with the support they needed to live as full a life as possible with the support they needed to do so. Medicines were managed safely and people received their medication in an individual manner that best suited their needs.  

Staff received training and supervision to ensure they had the knowledge and skills to provide safe and appropriate care and support.  

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS is part of the Mental Capacity Act, which is in place to protect people who lack capacity to make certain decisions because of illness or disability. DoLS protects the rights of such people by ensuring that if there are restrictions on their freedom these are assessed by professionals who are trained to decide if the restriction is needed.     

People had sufficient food and drink to maintain their health and staff promoted the importance of a healthy diet. People were supported with their healthcare needs.

We observed people being treated with dignity and respect and enjoy interacting with staff. Staff joined in with people’s hobbies and interests as a way of providing them with support they needed to follow these. People’s individual beliefs were respected and recognised.    

People received the care they required in a manner that suited them. People were supported to increase their independence and encouraged to be involved in the local community. People were able to influence how the service ran and to treat it as their home. People who used the service, their relatives and staff were encouraged to express their views which were listened to and considered.

The service has been registered since July 2013 and one person has used the service. We used a number of different methods to help us understand the experiences of the person who used the service, because they had complex needs which meant they were not able to tell us their experiences.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two care workers and the registered manager (who is also the provider). We also looked at some of the records held in the service including the care files for one person. We observed the support provided by care workers and carried out a brief tour of the building.

We found appropriate care and support was provided. We found the staff team were supported through training and the provider assessed and monitored the quality of the service.