Orchard Lodge

The needs and quality of life of people formed the basis of the culture at the service. Staff undertook their role in making sure that people were always put first with enthusiasm. They provided care that was genuinely person centred and directed by each person.

The leadership of the service had worked hard to create a learning culture. Staff felt valued and empowered through inclusion in the development of people's care to suggest improvements and question poor practice. There was a transparent and open and honest culture between people, those important to them, staff and leaders. They all felt confident to raise concerns and complaints with a view to improving outcomes for people.

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.

• People's care and support was provided in a safe, clean, well equipped, well-furnished and well- maintained environment which met people's sensory and physical needs. • People were protected from abuse and poor care. The service had enough appropriately skilled staff to meet people's needs and keep them safe. • People were supported to be independent and had control over their own lives. Their human rights were upheld. • People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person's individual needs. People had their communication needs met and information was shared in a way that could be understood. • People's risks were assessed regularly in a person-centred way, people had opportunities for positive risk taking. People were involved in managing their own risks whenever possible. • People who had behaviours that could challenge themselves or others had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where

restrictive practices were used. • People made choices and took part in meaningful activities which were part of their planned care and support. Staff supported them to maintain independence and promote choice. • People's care, treatment and support plans, reflected their sensory, cognitive and functioning needs. • People received support that met their needs and aspirations. Support focused on people's quality of life and followed best practice. Staff regularly evaluated the quality of support given, involving the person, their families and other professionals as appropriate. • People received care, support and treatment from trained staff and specialists able to meet their needs and wishes. Managers ensured that staff had relevant training, regular supervision and appraisal. • People and those important to them, including advocates, were actively involved in planning their care. Where needed a multidisciplinary team worked well together to provide the planned care. • Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005. • Where people were at risk of placement breakdown, or had recently been discharged from hospital, there was clear support plans and reviews to try to prevent hospital admission. Staff worked well with other services and professionals to prevent readmission or admission to hospital. • People were supported by staff who understood best practice in relation to learning disability and/or autism. Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. People and those important to them, worked with leaders to develop and improve the service.

Our last inspection found a breach of regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities). This inspection found the provider had systems in place that were robust enough to demonstrate safety was effectively managed.