CQC report explained · a residential care home
What the CQC found at Orchard House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2018
Orchard House was rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
Inspectors visited without notice on 26 February 2018. They met everyone living there, spoke with people, relatives, staff and managers, and observed care. They reviewed six people's care plans, risk assessments and medicine records, along with staffing, training, accidents, maintenance and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, well-managed medicines, personalised care plans and support for people's health, choices, independence and community activities.
The previous inspection in December 2017 had found problems with staff recruitment checks and the provider's quality monitoring. Inspectors found these had been corrected. The home was described as fully compliant with the regulations at this inspection.
Safe staffing and recruitment
There were enough staff, and the records showed that required recruitment checks had been completed before staff started work.
“Improvements had been made and the staff files were in good order with all the relevant documentation in place.” from the report
Personalised support
Care plans included people's routines, preferences, communication needs and guidance about health and behaviour support.
“Care plans were personalised with people's life histories together with information about people who were important to them such as family and friends.” from the report
Kind and respectful care
Staff gave people time, respected their privacy and encouraged them to do as much as possible for themselves.
“Staff treated people with mutual respect and were attentive and caring.” from the report
Choice and community life
People chose activities and were supported to go out, attend appointments and take part in community life.
“People went bowling, to the cinema or visited places of interest regularly.” from the report
Improvements in management
The provider's monitoring and the home's own checks had improved since the previous inspection, and repairs were dealt with more promptly.
“At this inspection the registered manager had worked hard to ensure that improvements had been made to the service and the breaches of regulations had been met.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative's particular communication needs, and how will staff learn what they like and dislike?
- 02How often will my relative's care plan and risk assessments be reviewed, and how will the family be involved?
- 03What staffing levels and one-to-one support will be available for my relative's daily activities and community outings?
- 04What training do staff have for my relative's health conditions, autism, epilepsy or behaviour support needs?
- 05How will you involve my relative and our family in decisions, complaints and any end-of-life wishes?
This was an unannounced inspection of the whole service, including care and accommodation, with all five CQC questions rated. This explanation was written from the published report of 28 March 2018 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, January 2017
Rated Requires Improvement; inspectors found kind, responsive care but unsafe recruitment checks and weak provider oversight.
Inspectors visited on 15 and 16 December 2016. The first day was unannounced. They met everyone living at the home, spoke with people, relatives and professionals, observed care, and checked care plans, medicines, staff records, maintenance records and audits.
People generally received kind and personalised support. Inspectors found enough staff, safe medicines management, suitable activities, support with health needs, and respect for privacy and dignity. The ratings for Effective, Caring and Responsive were Good.
The home was not consistently safe or well-led. Recruitment files did not show that all required checks had been completed before staff started work. Provider-level checks also failed to identify recruitment problems and delays to some maintenance and fire safety work. The overall rating was Requires Improvement, and two legal breaches were found.
Kind and respectful care
People were calm and relaxed. Staff were attentive, patient and respectful, including when people were distressed or needed support with dignity.
“Staff showed kindness and patience in their interactions with people.” from the report
Personalised activities
People had activities based on their interests and abilities. They were supported to build independence through cooking, shopping, household tasks and personal goals.
“People were enabled to explore their potential for independence at a pace that suited their ability to absorb and learn new things.” from the report
Health and nutrition
Staff monitored people's health, arranged health appointments and supported specialist dietary needs. Meals were varied and took account of people's preferences.
“People ate a varied diet suited to their preferences and dietary requirements.” from the report
Medicines management
Only trained staff administered medicines, their competence was checked, and records and storage arrangements were found to be appropriate.
“Medicines were managed appropriately with only trained staff administering medicines, whose competency was routinely assessed” from the report
Incomplete recruitment checks
seriousThree recruitment files had missing information. This included identity evidence, health declarations, employment history, references and other records showing that recruitment had been thorough.
“The provider failed to ensure that a safe recruitment process for new staff was in place and this could place people at risk from staff that might be unsuitable.” from the report
Weak provider oversight
seriousThe provider's central audits did not identify recruitment problems or delays in maintenance and fire safety work. This was a breach of Regulation 17.
“People were not protected by organisational quality monitoring audits which had failed to identify shortfalls.” from the report
Delayed safety work
seriousSome fire safety improvements and other repairs had remained outstanding without a clear completion date. Not all staff had taken part in a fire drill during the previous year.
“These improvements related to measures that needed to be implemented to prevent fire spread and development.” from the report
Cold upstairs bedroom
needs fixingOne upstairs bedroom was colder than expected because a radiator was not working and was partly obscured. Inspectors recommended checks of all top-floor radiators and recorded temperature checks.
“We felt the temperature of the room was lower than we would expect if the radiator had been on and we have made a recommendation about this.” from the report
- 01Have all current staff recruitment files now been completed, including identity checks, employment histories, references, health declarations and interview records?
- 02What fire safety improvements identified in the previous risk assessment are still outstanding, and when will each one be completed?
- 03Have all staff taken part in a fire drill within the last 12 months?
- 04Has the radiator problem been fixed, and are room temperatures now recorded where needed?
- 05How does the provider now check that recruitment, maintenance and fire safety issues are identified and followed up promptly?
This was an unannounced inspection covering all five key questions, with detailed checks of three people's records and the home's staff, medicines, maintenance and quality monitoring records. This explanation was written from the published report of 24 January 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 House
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- March 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.