Archived: Orby House

Orby House is a residential care home providing accommodation and personal care to six people at the at the time of the inspection. The service can support up to seven younger adults with a learning disability and/or autism. Each person had their own flat within one overall building, on a larger site accommodating a day centre and other facilities. There were office facilities and a sleep-in room within the building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were happy living at the service; they told us staff were like family members to them and always acted in their best interests. Services were delivered in a way that was flexible, provided choice and ensured continuity of care. People were truly placed at the centre of the service and were consulted and involved in decision making. Care was individualised and tailored to the needs and wishes of the people using the service.

People were protected from avoidable harm and abuse by staff who were alert to the signs of abuse and knowledgeable about the action to take if they identified a concern. Staffing levels were planned to take into account people’s planned and spontaneous activities. Medicines were managed safely and people told us they received their medicines regularly.

Staff were supported to deliver effective care and received training to gain and further develop their knowledge and skills. They received regular supervision and appraisal. Consent was gained for the care and support people required in line with the relevant legislation. People had access to healthcare and preventative services according to their needs.

People continued to be supported by staff who showed empathy and kindness toward them. They supported people physically and emotionally, to enable them to lead fulfilled lives. People’s privacy and dignity were respected.

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.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. This was illustrated by a person who told us of the progress they had made following admission to the service, moving from requiring one to one support initially, to preparing to move towards supported living. They said, “I have had a lot of support and they have helped me through it.”

Leaders were enthusiastic and committed to providing the high standards of care. They led by example. Processes were in place to monitor quality of the service provided and action was taken to bring about continuous improvement. People and staff felt listened to, valued and involved.

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

Rating at last inspection

The last rating for this service was good (published 28 February 2017). At this inspection the service remained good.

Why we inspected

This was a planned inspection based on the previous rating.

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.

People living at the home were of mixed ages. Some people required more assistance either because of mental health needs or because they were experiencing difficulties coping with everyday tasks.

There was a registered manager in post. 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.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection there was one person subject to such an authorisation.

We found that people’s health care needs were assessed and care was planned and delivered in a consistent way through the use of their care plans. People were involved in the planning of their care. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans were put in place to minimise risk in order to keep people safe.

People had been consulted about the development of the home and quality checks had been completed to ensure the home could meet people’s requirements. Lessons which had been learnt from audits had been passed on to staff at meetings and staff supervisions.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period. Each person had their own accommodation and were encouraged to take part in housekeeping tasks and cooking their own meals, with the help of staff. People were supported to maintain their independence and control over their lives and accessed a number of events in the local community.

People were treated with kindness and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. On-going training was available for all staff.

People knew staff kept records about them and had access to them. The care plans were person centred and reflected the needs of people who used the service. Staff had recorded when other health and social care professionals had been contacted. One person told us, "I can see my records, any time." Another said, "Staff ask me what I need, they know my problems and help me everyday."

Polices were in place to instruct staff on how to give medicines safely. The records showed people were receiving their prescribed medicines. The storage of medicines was safe.

People who used the service told us there were always sufficient staff available to meet their needs. One person told us, "When I want to go out or to the day centre, staff take me." Another person told us, "I have little road sense but staff are always available to escort me."

The provider had a complaints policy which was on display. Staff and people who used the service told us they had every confidence in the management team in dealing with concerns. One person said, "I speak up at group meetings and I can talk to the care staff." There were no formal complaints listed in the complaints log.