Orient St Adult Respite Unit

Updated 5 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can shared with other services.

Inspection Team

The inspection team consisted of two inspectors.

Service and service type

Orient St Adult Respite Unit is a 'care home' which operates as a respite service. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Orient St Adult Respite Unit is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was no registered manager in post. The manager of the service was in the process of applying to CQC for registered manager status.

Notice of inspection

We gave the service two days' notice of the inspection. This was because the service was small and people are often out with members of the staff team. We wanted to be sure there would be people and staff at the premises to speak with us. We visited the service on 28 July, 1 August and 5 August 2022.

What we did before the inspection

We reviewed information we held about the service which included any notifications the provider is required by law to send us and the last inspection report. We sought feedback from health care professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met and spoke with five people who used the service. One person was able to share their views about their experiences of staying at the service. We also spoke with eight members of the staff team, the deputy manager and the manager. We reviewed a range of records, which included the care and support plans for four people using the service. We looked at records for staff training and development, and supervision. A variety of documents relating to the management of the service including medicine administration records, quality assurance audits and policies and procedures were reviewed.

We visited the provider’s main office on 15 August 2022 to check five staff recruitment folders and spoke with a representative from the provider’s human resources team.

Following the site visits we continued to seek clarification from the provider to validate evidence found in relation to people’s care and support including the processes for infection prevention and control and quality assurance. We spoke by telephone with the relatives of five people who used the service. One person was supported by their relative to participate in a telephone discussion with us. We contacted professionals with knowledge of the service and received two written responses. Inspection activity concluded on 14 Septem

Updated 5 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the statutory guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Orient St Respite Service is a residential care home which operates as a respite service. It provides short stays and emergency accommodation where required for people with a learning disability and autistic people. The service is registered to accommodate up to four people at a time and we met six people during our three visits. Part of the premises provides services for children and is registered by Ofsted. The services for adults and children was clearly divided by locked doors internally and the rear garden has a fence and gate to ensure guests from each side do not have access.

People's experience of using this service and what we found

Right Support

People were provided with a clean and comfortable living environment that had been adapted to meet their individual needs. People told us they were happy at the service and relatives commented on how their family members were supported to have good outcomes and a good quality of life during their stays at the service. Staff supported people to achieve their aspirations and goals. People benefitted from the stimulating facilities at the service and were supported to take part in activities of their choice in the local area. People received care and support from safely recruited staff who had appropriate skills and backgrounds for their roles. People were supported by staff to communicate their wishes, preferences and choices. People were supported to meet their healthcare needs and the provider liaised well with relevant health and social care professionals to ensure people achieved good outcomes for their health. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

People were protected from abuse by staff who had appropriate training and knew how to apply it. The service deployed sufficient staff with suitable training and experience to safely meet people's needs. People's cultural needs were understood and supported by staff. People who had individual ways of communicating were supported by staff with training and guidance to enable them to understand and interact with individuals. People's care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. People were treated with kindness and respect by staff. One person told us, "It's fun here, it's good."

Right culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

People and those important to them, including advocates where applicable, were involved in planning their care. Staff knew and understood people well and were responsive to their choices and wishes for how they spent their time during their stays. Staff placed people's needs and aspirations at the centre of how the service operated. People’s quality of life was enhanced by the service’s culture of ongoing improvement and inclusivity, which included acting on the feedback from people and their relatives about the quality of care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

At the last inspection, the service was rated as requires improvement (report published 11 December 2019) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve systems for monitoring the quality of the service. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this unannounced focused inspection to check the provider had followed their action plan and to confirm that the service was applying the principles of right support, right care and right culture. This report only covers our findings in relation to the key questions Safe, Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from ‘requires Improvement’ to ‘good’ based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Orient St Adult Respite Unit on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.