CQC report explained · a residential care home
What the CQC found at Orchard View
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
HF Trust - Orchard View was rated Requires Improvement; inspectors found unsafe risk and medicine systems, limited person-centred activity, and weak oversight.
This was an unannounced focused inspection on 11 January 2023. Two inspectors visited, and another inspector spoke with relatives by telephone. They met all six people living in the home, spoke with staff and relatives, observed care, and checked care, medicine, staffing and quality records.
Inspectors found that risks were not always managed safely. Staff did not always follow guidance about choking, skin care and self-injurious behaviour. Medicine storage, records and as-required medicine guidance were also not always safe. People did not always receive the activities, community time or choice described in their care plans.
The home was rated Requires Improvement overall. Safe, responsive and well-led were also rated Requires Improvement. Effective and caring were not inspected during this visit, so their previous ratings were used when calculating the overall rating. The previous overall rating had been Good in October 2019.
Safeguarding awareness
Staff had safeguarding training and understood that they should report possible abuse or neglect.
“Staff received safeguarding training to help them recognise potential signs of abuse or neglect and understood their responsibility to report any concerns.” from the report
Safe recruitment
The recruitment file checked included references and Disclosure and Barring Service checks.
“Staff were recruited safely. Pre employment systems included reference and Disclosure and Barring Service (DBS) checks.” from the report
Infection control
Inspectors were assured that infection risks, protective equipment and possible outbreaks were being managed.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Immediate improvement steps
After the inspection, managers took some immediate steps to reduce risks and created an action plan covering care and social wellbeing.
“The interim agency manager had devised a robust action plan.” from the report
Choking risk
seriousStaff did not follow one person's instruction to remain upright for 30 minutes after eating. The person was tilted backwards shortly after a meal, increasing the risk of choking.
“During our visit the person was tilted backwards in their wheelchair a few minutes after their meal, putting them at increased risk of choking.” from the report
Medicine management
seriousSome as-required medicines lacked clear instructions and records did not show consistently why they were given or whether they worked. Some medicines were stored in an office without temperature control.
“Medicines were not always stored, administered or managed safely.” from the report
Management instability
needs fixingThere was no registered manager, several managers had left, and staff reported low morale. The provider was working on improvement, but longer-term stability was still needed.
“The provider was in the process of interviewing candidates for the registered manager role at the time of our visit.” from the report
- 01How are you now making sure the choking guidance and other health risk plans are clear, up to date and followed by every staff member?
- 02What changes have been made to medicine storage, as-required medicine instructions, medicine records and checks of their effectiveness?
- 03How will you provide and record each person's planned one-to-one activities, hobbies and time in the local community?
- 04How are people and their relatives now involved in care decisions and in setting personal goals and aspirations?
- 05Who is currently responsible for day-to-day management, and what is the timetable for appointing a registered manager?
This was an unannounced focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 11 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
HF Trust - Orchard View was rated Good overall; inspectors found safe, caring support but leadership and quality checks still required improvement.
Inspectors made an unannounced visit on 11 October 2019. They met all six residents, observed daily support, spoke with a resident, relatives, managers and staff, and reviewed care, medicines, incident and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were protected from abuse, received their medicines as prescribed, had personalised support and were treated with kindness and respect.
Well-led was rated Requires Improvement. There had been progress since the previous inspection, including recruiting more permanent staff and improving medicines storage. However, the new staff team still needed support, some records lacked detail, and internal checks had not identified an unlocked cupboard containing cleaning materials or prescribed thickener kept in a bedroom.
Protection from abuse
Staff had safeguarding training and were confident about recognising and reporting abuse. Risk assessments gave clear guidance for health conditions and emergencies.
“Staff had received training in safeguarding and were confident in their capability to identify and report any safeguarding issues.” from the report
Kind and respectful staff
Inspectors found that staff understood people's individual ways of communicating and treated them with dignity. Relatives also gave positive feedback about the caring approach.
“Staff demonstrated a person-centred approach for the people they supported and understood how each person required support to express their care needs.” from the report
More community activities
Recruiting permanent staff had increased opportunities for people to go out and take part in activities. Inspectors saw people attending a café, horse riding and a sensory morning.
“The recruitment of permanent staff meant people had more opportunities to engage within the local community.” from the report
Good partnership working
Staff worked with healthcare professionals and followed their recommendations. People had access to healthcare, dental care and hospital passports describing their needs.
“The registered manager and staff worked closely with other agencies to ensure people received effective care.” from the report
Safety checks missed hazards
seriousInspectors found prescribed thickener in a person's bedroom and an unlocked cupboard containing cleaning materials. Managers acted immediately, but these risks had not been found through the home's own checks.
“During our inspection we found a can of prescribed thickener, for drinks, in one person's bedroom.” from the report
Care records lacked detail
needs fixingSome mental capacity assessments did not explain enough about the help people had been given to make decisions. Protocols for giving medicines when needed also lacked sufficient detail.
“We found some improvements were still required with care records.” from the report
New staff team still settling
needs fixingThe home had recruited more permanent staff, but inspectors said the improvements needed to become part of the home's usual culture. Managers recognised that the new team needed further support with policies, procedures and safety.
“We have a new staff team who are very keen, but they will need a lot of support around policies, procedures and safety.” from the report
Outdoor areas needed attention
minorThe gardens and open spaces were available for people to use, but inspectors found them tired and not well cared for. Plans were in place for a sensory garden.
“There were gardens and open spaces for people to enjoy but these were very tired and not well cared for.” from the report
- 01What checks are now used to make sure cleaning products and prescribed thickener are stored safely?
- 02How have mental capacity assessments and as-needed medicines protocols been improved since this inspection?
- 03How are new staff supported and checked to make sure the improvements have become part of everyday practice?
- 04What progress has been made with improving the gardens and creating the planned sensory garden?
- 05How many permanent staff are now in place, and how often are agency staff used?
This was an unannounced planned inspection covering all five CQC questions; the previous overall rating was Requires Improvement, published on 3 November 2018. This explanation was written from the published report of 31 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Orchard View
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2019Goodup from Requires improvementSafe: GoodResponsive: GoodWell-led: Requires improvement
- November 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Registered with the Care Quality Commission on 22 September 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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