Orla House

We carried out this assessment on 22 to 24 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence, and good access to local communities that most people take for granted.

People were supported by warm and compassionate staff who had the right skills, values and training to safely support them even during periods of distress. There were enough staff available both day and night and people had the right level of support to ensure they could do the things that were important to them and for them. One staff member said, “It’s a home from home, none of us wear uniform so they (people supported) don’t feel like we’re on a different level from them, we take them out and do things that any family member or friend would do, we try to be that person for them, it’s their home and that’s what we want them to feel like.”

There were effective systems in place to safeguard people from abuse. Risk was assessed and actions were put in place to reduce risks which was discussed with the people themselves where appropriate to do so, relatives and professionals. The staff team had a good knowledge of safeguarding, signs to be aware of that may indicate a concern and how to escalate concerns externally if required.

Throughout the assessment the registered manager, care manager and team were responsive to any issues highlighted and put measures in place to address them immediately. We identified some issues in the environment including a toilet frame that was rusty at the feet, but this was replaced immediately by a spare that was available in the home. We found freestanding wardrobes were not secured in place however there was no risk related to this at the home and the registered manager had included this in an environmental risk assessment. While the home was kept clean and there were systems in place to maintain this, we identified some infection prevention and control matters. The registered manager was responsive to feedback about this and input from the NHS infection prevention and control team. The prior arrangements had been in place to support a more homely environment for people, but the registered manager fully understood the reasons for the improvements and provided assurance that this would be addressed. The entire team demonstrated a strong desire to learn and improve from feedback and regularly sought feedback from relatives and people living at Orla House. The care manager told us the home’s minibuses no longer had the home’s name on and why, “We used to have 2 white minibuses with the names of home on. We had a residents meeting and one of the residents said we don’t want the name on the bus, we don’t want people to know it’s from a home.” This evidenced people had a voice and their opinions and wishes were respected.

Care plans were thorough and included person-centred detail, all documentation was regularly reviewed by the management team, and we saw evidence of updates being made when people’s needs changed. Care plans included details on what people could do independently, and what they required support with. We saw numerous examples of where the team had engaged external professionals to ensure people’s care and support needs were fully met. They took a holistic approach to people’s care and considered the whole person, physical and mental wellbeing.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the home. We found that staff and management worked within the MCA. Authorisations were appropriately applied for and overseen. Where decisions had been made in people’s best interests this was clearly recorded and evidence of those involved in the decision-making process was recorded. People were not subject to unlawful or excessive restrictions, they had choice, control and freedom over their lives.

Staff discussed people’s care in a respectful and caring way and were passionate about adopting a person-led approach. One staff member told us, “It’s in the little details and the things important to them should be important to us to and if they see you have paid attention it’s kind of like a gateway into building a relationship and a trust.”

Medicines were managed safely and effectively, and people received their medicines consistently. ‘As required’ medicines had supporting documentation to guide staff on how to safely administer these and when. All medicines were appropriately stored and recorded and we saw evidence of stock management and auditing processes. Where people had prescribed rescue medicines this was safely managed, staff received the right training and were able to confidently describe the actions they would take if this medicine was required. Some people used over the counter medicines, but this was clearly documented and had been authorised by the GP.

People were supported by kind and compassionate staff who provided genuine caring support, respected people’s dignity, privacy and autonomy. Staff spoke with and about people with warmth and described people in terms of what they valued about them which was also reflected in the “about me” section in their care plans. The registered manager and team also treated colleagues with kindness and valued everyone’s individual skills and knowledge that they brought to the team. Equality and diversity was respected including people’s individual spirituality and people were given autonomy to celebrate their faith in a way that was comfortable for them. People’s rooms also reflected this and their individual interests and hobbies.

People’s independence was supported and they were encouraged to maintain their skills, for example cooking and maintaining the cleanliness of their home. People were given choice which was communicated in a way that met their needs including using easy read documentation and pictures.

People experienced a variety of activities both in the home and in the local, and wider, community and enjoyed holidays away which they chose to do as a group. Orla House is a family owned and run home. The registered manager told us about the history of the home, “It’s quite unique, we have grown up with people [living at Orla House], we opened in 1987 and they [people supported] are still here.”

Leaders modelled a positive culture and open approach, and staff were reflective of this. People were supported by a consistent, well established, caring staff team and leaders who knew them well and responded appropriately when concerns were raised or people’s care and health needs changed.