This inspection visit took place on 2 October 2018 and was unannounced.

Orchard View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Orchard View accommodates up to six people with learning disabilities in one purpose built building. There were six people living at the service at the time of our inspection visit. The home is in a rural area and all the accommodation is on one floor.

The care service had 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.

There was a registered manager in post at the service. 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.

At the last inspection in March 2016 the service was rated as Good. At this inspection we found people continued to receive a service that was caring and effective. However, we found a lack of permanent staff and people's differing needs meant staff could not always be responsive to the needs of those people who benefitted from more involvement and engagement in the local community. It also meant some health and safety checks had not been carried out in accordance with the provider’s policies. We identified one breach of the regulations. The service is now rated 'Requires Improvement'.

There were enough staff to keep people safe, but the provider was reliant on agency staff to maintain safe staffing levels. The provider was actively recruiting new staff, but a lack of permanent staff had impacted on the ability of staff to respond to people’s emotional and social needs.

There was a procedure for staff to follow to identify and manage risks associated with people’s care. Staff had a good understanding of how to safeguard people from harm and report any concerns to the registered manager.

People were supported to access health services when needed and staff regularly worked in conjunction with other health and social care professionals to ensure people received effective care. People received their medicines as prescribed and their nutritional and hydration needs were met.

Staff worked within the principles of the Mental Capacity Act 2005. People were supported to have choice and their decisions and choices were respected. The registered manager understood their responsibilities under the Act. They had applied to the supervisory authority for the right to deprive people of their liberty when their care and support included restrictions in the person's best interests.

Staff received training to ensure they had the skills to meet people’s needs. Some refresher training was overdue, but the provider had plans in place to deliver the required training to the whole staff team.

People continued to receive care that was kind and staff members treated them with dignity and respect. Staff ensured people’s voices were heard and any concerns were addressed.

The service had recently been through a challenging and unsettling period. As a result, changes had been made to the registered manager’s responsibilities within the provider group and they now only had managerial responsibility for Orchard View. Relatives had confidence in the registered manager and provider and said improvements had already been made within the home. The registered manager completed regular audits and had an improvement plan which they assured us would improve the safet

We inspected Orchard View on 16 March 2016. Our inspection visit was unannounced.

The service provides accommodation and personal care for up to six people with learning disabilities or autistic spectrum disorder. There were six ladies living there at the time of our visit.

A requirement of the service’s registration is that they have a registered manager. 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 and associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection.

There was a homely, friendly and open culture within the home and people and staff appeared to be happy. Interactions between staff and the people who lived there were warm and friendly. Staff demonstrated a good understanding of the importance of supporting people as individuals, protecting their dignity and spending time with them. People were supported to maintain relationships with those who were important to them.

There were enough staff to provide the support and stimulation people required to promote their wellbeing and to keep them safe. Risk management plans ensured people were safe both in the home and when in the community. Staff had a good understanding of their responsibilities in relation to safeguarding in order to protect people from the risk of abuse. The provider checked that staff were suitable to support people before they began working in the service.

Staff received training and support so they could carry out their roles effectively and safely. Staff had an understanding of the Mental Capacity Act 2005 and were watchful of people’s body language, gestures and facial expressions to ensure they were respecting their choices. The registered manager had considered where people’s liberty may need to be restricted to keep them safe and made appropriate applications to the authorising body.

Care plans gave staff information about people so they could ensure they were at the centre of the care and support they received. People had regular access to health care appointments and were referred to health professionals when sudden or unexpected changes in their health occurred. People were supported with their nutritional needs and staff were aware of any risks to people when eating or drinking. People received their medicines as prescribed.

The registered manager was aware of their responsibilities as a registered manager and was aware of the achievements and the challenges which faced the service. Staff found the registered manager approachable and receptive to new ideas. Regular checks were carried out by the registered manager to monitor the quality and safety of the service.