We inspected The Orchards on the 5, 8 and 9 December 2016. The Orchards comprises of two care homes owned by the Orchard Trust Limited. The Orchards provides residential care for up to six people with learning disability and physical disability needs. Offa’s Dyke provides residential care for up to 14 people living with a range of learning disability and physical disability needs. At the time of our visit four people were living at the Orchards and 14 people were living at Offa’s Dyke. This was an unannounced inspection.

We last inspected in October 2013 and found the provider was meeting all of the requirements of the regulations at that time.

There was a registered manager in post on the days of our inspection. The registered manager is also one of the providers of the service. 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 living at The Orchards were kept safe. Support workers ensured people were protected from the risks associated with their care. People were supported with their independence and to take positive risk. People received their medicines as prescribed.

People enjoyed living at the home. They were supported by a kind, caring and compassionate support team. Support workers clearly knew people’s needs, wishes and preferences. People enjoyed the time they spent with support workers and other people in their homes. They were supported by support workers to enjoy a range of activities and one to one stimulation.

People told us they felt safe with support workers and safe in the home. Staff had a good understanding of safeguarding and the service took appropriate action to deal with any concerns or allegations of abuse.

People's needs were assessed. Where any risks were identified, management plans were in place. They were supported in a way that recognised their rights to take risks. The care and support people received was personalised to their needs.

There was a positive caring culture, promoted by the registered manager. Support workers were passionate about providing high quality personalised care and support. They spoke confidently and positively about people.

Support workers were knowledgeable about the people they supported. They had access to professional development. Support workers received the training they required to support people with individual needs and had access to effective supervision (one to one meetings with their manager).

People and their relative’s views on the service sought. The registered manager ensured the views of people, their representatives and healthcare professionals views mattered. People and their relatives told us the management was approachable and felt confident in their ability to complain. Quality assurance systems were in place to enable the service to identify areas for improvement and ensure people received a good quality service.

People were respected as individuals. Staff worked closely with them and their representatives to make sure their preferences and needs were understood. Staff made sure people had the equipment they needed to maximise their comfort and independence. People had very good access to activities but some had less opportunity to spend time in the wider community. External health professionals were regularly involved in people’s care to make sure that their health needs were met. In feedback to the provider one relative said “I have always had concerns for ...’s health which he has dealt with very well thanks to the staff at Orchard Trust”.

Offas Dyke was a new, spacious, purpose built environment. The Orchards had been adapted to meet the needs of the people living there. Staff were highly thought of by relatives who said “As far as we can see they are doing an excellent job”. Staff demonstrated caring and knowledge in the way they interacted with people but had some training needs which had not been met. The provider had appropriate systems in place to monitor the quality of the service and was particularly strong on their approach to health and safety.

We carried out an inspection on 23 and 24 April 2013 and published a report setting out our judgements. We asked the provider to send us a report of the changes they would make to comply with the standard they were not meeting.

We have followed up to make sure that the necessary changes have been made and found the provider is now meeting the standard included within this report. This report should be read in conjunction with the full inspection report.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences in relation to the records the service held about them.

We found that care plans were detailed and accurately reflected the support needs and care provided to individual people who used the service. Care records were regularly updated and the systems in place meant that the right information was available to staff to assist them in meeting the needs of the people they supported.