CQC report explained · a residential care home
What the CQC found at Orchard Gardens
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found enough staff, safe recruitment, regular risk checks and safe medicine administration, although records of remaining medicine quantities were inaccurate.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff had induction, supervision and training, and people were supported with food, fluids, healthcare and decision-making.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions and supported to remain as independent as possible.
- Responsive?
- Good
- Care plans reflected people's preferences, life histories and communication needs. There was a varied activities programme and complaints were investigated.
- Well-led?
- Good
- The home had an open culture, visible managers, regular audits and an ongoing improvement plan. It also worked with health and social care professionals.
What inspectors found, January 2020
Orchard Gardens was rated Good; inspectors found safe, kind and person-centred care, with some medicines records needing improvement.
This was an unannounced inspection over three days. Two inspectors spoke with nine people, one relative and nine staff. They also reviewed care records, medicines records, staff files and management records.
The home received Good ratings in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine administration, clean surroundings, suitable care planning and respectful support.
There were some smaller weaknesses. Medicine quantity records were not accurate, one person complained that meals were cold, the building had limited dementia-friendly features, and end of life plans were at different stages. The overall rating stayed Good, as the inspectors found these issues did not show poor overall care.
Staffing and recruitment
Inspectors found enough staff to meet people's needs and found that recruitment checks had been completed.
“There were sufficient staff deployed to meet the needs of people living at the location.” from the report
Respectful care
Staff knew people well, respected their privacy and supported their independence and choices.
“We heard staff and people having appropriate conversations. Staff knew people well and spoke about them with affection.” from the report
Personalised support
Care plans included people's preferences and life histories. Staff used this information to offer suitable choices and conversation.
“Peoples care plans were person-centred and based on how people wanted their care to be delivered.” from the report
Activities and relationships
People could take part in a wide range of social, creative and physical activities. Evening activities had been added after people raised this issue.
“There was a good range of activities to stimulate the mind and provide physical exercise for people.” from the report
Management and improvement
Managers were visible and approachable. Regular audits and an action plan were used to monitor and improve the service.
“There were regular audits of all aspects of the service and an area manager also completed an in-depth quarterly audit.” from the report
Medicine quantity records
needs fixingRecords showing how much medicine remained were inaccurate and could be misleading. Inspectors checked the medicines and were reassured that the correct medicines had been given.
“Records of remaining quantities of medicines on MAR's were not accurate, however the amount on site was as it should be.” from the report
Dementia-friendly design
minorThe modern building had few features to help people living with dementia find their way around. The manager had started adding landmarks and signage.
“The service was a modern building with little in the way of features that might enable people living with dementia to navigate the property.” from the report
Meal temperature
minorOne person said their porridge and lunch were cold. Inspectors did not see the same concern from anyone else.
“One person was less happy with the food, they told us their porridge was cold at breakfast time then at lunchtime we saw, when their lunch was served, that they complained again that it was cold.” from the report
End of life planning
needs fixingEnd of life plans were not all at the same stage of completion. Important documents were kept prominently in care records.
“End of life plans were at different stages however important documents such as advanced decisions or do not attempt resuscitation forms were in a prominent place in the records.” from the report
- 01How do you now check that medicine quantity records are accurate and not misleading?
- 02What changes have been made to help people living with dementia navigate the building?
- 03How do you check that meals are served at the right temperature, especially when someone has already raised a concern?
- 04How will you make sure each person's end of life plan is complete and regularly reviewed?
- 05What evening activities are currently available for residents?
This was an unannounced comprehensive inspection covering all five CQC questions, although the separate catering kitchen was not inspected because it was in another part of the wider site. This explanation was written from the published report of 1 January 2020 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, March 2017
Rated Good; inspectors found kind, safe and personalised care, with staffing vacancies and no registered manager in post.
This was an unannounced inspection on 16 February 2017. Inspectors spoke with people living at the home, relatives and staff. They observed care, reviewed care plans and checked staffing, medicines, complaints, incidents and quality records.
The inspectors found people were safe and treated with dignity and respect. Staff understood people's needs, supported their choices and kept care plans updated. People had access to healthcare, suitable food and a range of activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. A registered manager was not in post, but a new manager had been appointed and the deputy manager was running the home with extra support from the provider.
Personalised care
Care plans included people's routines, preferences, life histories and communication needs. Inspectors saw staff following individual guidance in practice.
“People's care plans were person centred to include information about their preferences and routines.” from the report
Kind and respectful staff
People and relatives spoke positively about staff. Staff supported independence, sought consent and protected privacy and dignity.
“People were cared for with kindness and compassion.” from the report
Medicine safety
The home had improved its medicine processes after errors. Inspectors found arrangements for ordering, storing, giving and disposing of medicines.
“These measures had resulted in a significant reduction in recording and administration errors.” from the report
Learning and oversight
The home used audits, meetings and reviews of incidents to identify improvements and reduce the risk of problems happening again.
“The provider analysed incidents and accidents to reduce risk of reoccurrence.” from the report
Activities and family contact
People had internal and external activities, and relatives were welcomed. There was also a private room for visits.
“There was a programme of internal and external activities.” from the report
No registered manager in post
needs fixingThe registered manager had left. A new manager had been appointed but was not yet in post, so the deputy manager was overseeing the home.
“A registered manager was not in post at the time of our inspection.” from the report
Permanent staffing vacancies
minorThe home had vacancies and used agency staff to supplement the permanent team. Staff reported that staffing could be difficult at weekends.
“There were currently vacancies for permanent staff members In the meantime, an agency provided staff to supplement the permanent staff team.” from the report
- 01Who is the registered manager now, and has the manager registered with CQC?
- 02How many permanent staff vacancies remain, and how often are agency staff used at weekends?
- 03What checks and training are completed before agency staff work in the home?
- 04How are medicine errors monitored now, and what changes were made after the errors mentioned in the report?
- 05How are people's care plans reviewed when their health, communication needs or routines change?
This was an unannounced inspection of the overall service, covering all five CQC questions, with observations, discussions and checks of care and management records. This explanation was written from the published report of 18 March 2017 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 Gardens
2 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015
Registered with the Care Quality Commission on 1 November 2015.
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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