What the CQC found at Little Orchard

People's needs, communication and sensory support were recorded in detailed care plans. Relatives were increasingly involved in developing them.

“The care plans at Little Orchard were extensive, detailed and informative.” from the report

People appeared at ease with staff, and inspectors saw mostly kind interactions. Personal care was delivered privately and relatives were positive about people's cleanliness and care.

“We saw kind and caring interactions by staff who were clearly fond of people they supported” from the report

People were supported to choose activities, make drinks, access the community and maintain important relationships. Staff adapted support around individual interests and communication.

“People were supported to participate in activities of daily living in a way that was relevant to them.” from the report

The manager had rewritten care plans, increased relatives' involvement and introduced regular staff meetings. Staff and relatives described improvements in the home's atmosphere and leadership.

“The registered manager had been in post for approximately eight months and had made a number of improvements to the service.” from the report

An epilepsy care plan was not consistently followed, seizure records were unclear, and an air mattress was not checked or set to the person's updated needs. This was a breach of Regulation 12.

“The failure to follow epilepsy care plans and review records of care delivery and to ensure the accurate setting of equipment was a breach of Regulation 12” from the report

Records showing unsafe fridge temperatures and some low food temperatures had not been audited. A changed swallowing instruction was also not transferred into the relevant care plans.

“The inspection identified a number of concerns that had not be identified through the provider's or managers own checks and audits.” from the report

Some medicines guidance did not match behaviour plans, and the home could not assure inspectors that medicines given with food remained effective. CQC recommended reviewing medicines records and procedures.

“We recommend a review of medicine records and procedures to ensure plans and practice are fully aligned.” from the report

Some staff could not demonstrate clear spoken English, which could affect communication with people. Inspectors also saw PPE not being changed between rooms and one visitor without a face mask.

“We were concerned that some staff were not able to demonstrate that they could communicate clearly in English.” from the report

Some activity planners were too general and one listed an activity that the person could not take part in. Inspectors said the planners needed to be more specific and personalised.

“We were concerned that not all activity planners were personalised as in one example, we saw an activity listed that the person would not have been able to participate in.” from the report