Archived: The Orchard

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The Orchard is a small house registered to provide accommodation and personal care for up to two people. The premises are also the family home of the provider. One person with a learning disability was being accommodated, who had lived with the family for over 40 years. The home is a domestic house situated close to local facilities and shops.

The home was operated by a sole provider who employed no staff. We found they had not maintained an up to date knowledge and understanding of the requirements of the regulations. They had not addressed shortcomings in their training or ensured they were following best practice guidance in the support of people with a learning disability. We have made a recommendation about this.

The provider did not have a sound understanding of safeguarding procedures. They had not completed safeguarding training in recent years and had not established effective systems to protect people from the risk of abuse. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

Suitable arrangements were not in place to ensure the premises were safe to use. A suitable and sufficient fire safety risk assessment had not been completed and fire safety procedures were not robust. The electrical equipment and systems had not been checked since 2001. The provider had not completed food hygiene training to help ensure they prepared, stored and handled food safely.

Contingency arrangements had not been made to ensure the person would experience a smooth transition if they needed to transfer to another service.

However, the person’s individual needs were being met in a highly personalised and caring way. The provider had sufficient time to meet the person’s needs. The person’s nutritional needs were met effectively and they were supported to access healthcare services.

The person’s rights and freedom were protected. They were encouraged to be as independent as possible and were involved in discussions about their care and support needs.

The person was supported to take part in a range of activities, including in the local community. They were encouraged to express their views and make choices about how they spent each day. Their privacy was protected at all times.

There was an appropriate complaints procedure in place. Medicines were managed safely and the provider knew how to access support if the person needed to receive end of life care.

The person was supported in promoting their independence and was able to make decisions about their daily routine. We spoke with the person using the service; they told us their favourite foods and said they 'like mum's food'.

The person said they were 'very happy' there. We found their needs were known and met. We also spoke with a care manager who had reviewed the care being provided. They told us the quality of care was 'lovely' and they had 'no concerns' about the service.

The person told us they could decide how to spend their money and showed us numerous personal items, including toys and music they had purchased. We saw they had their own bank account and there were suitable arrangement in place to protect the person from the risk of abuse.

The person's personal records, including medical records, were accurate and fit for purpose. Records were maintained of all relevant information relating to the person's care, treatment and any significant medical events. Records were kept securely and could be located promptly when needed.

We spoke to two members of the local LINK, who had visited the home to carry out some research into activities for adults with learning disabilities, and the promotion of service user dignity and respect. Their comments included, "the service user seems very contented. The home is very nice and comfy. It's excellent."

The service user told us about his plan of care and support. We found the care plan was developed with the service user and provided clear guidance to their ongoing support needs. There were also assessments of risk and regular reviews of the care plan.

We found the service user was supported to be fully engaged in all areas of daily living, including cooking and diet. The service user told us they were involved in the planning, shopping and preparation of food on a daily basis. We found the service user was being being supported and encouraged to be as independent as possible in this area of daily living.

The service user told us they felt safe and at home living at the Orchard. The service had arrangements in place to promote safety and safeguarding.

We found systems to assess and monitor quality and safety that were appropriate to the size and nature of the service.

The service user said he knew how to make a complaint if the need ever arose. The service had a clear procedure of complaints.