CQC report explained · a residential care home
What the CQC found at Orchard House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and managed, safety checks were recorded, medicines were handled safely and there were enough staff. Infection control arrangements and safeguarding systems were also found to be in place.
- Effective?
- Good
- This question was not inspected during this focused visit. The report says the previous ratings for questions not inspected were used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. The report does describe positive relationships and a warm, caring atmosphere.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report does not give a current finding for this question.
- Well-led?
- Good
- Inspectors found effective audits, action plans and provider oversight. People, relatives and staff were encouraged to share their views, and the provider had acted on problems found at the previous inspection.
What inspectors found, December 2022
Orchard House Care Home is rated Good; inspectors found safe, kind care and clear improvements since the previous inspection.
This was an unannounced, focused inspection on 21 November 2022. One inspector spoke with a person using the service, a relative, the manager and staff. They also toured the home and checked care, medicine, staffing and monitoring records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staffing levels met people's needs and recruitment checks had been completed. They also found a warm atmosphere and positive relationships between people, relatives and staff.
The inspection followed a previous Requires Improvement rating and a breach of Regulation 17. The report says the home had made enough improvement and was no longer in breach. The overall Good rating also uses ratings from the previous inspection for areas not covered this time.
Risks were managed
Risks had been identified and recorded, with management plans in place. Fire checks, drills and action after accidents were also recorded.
“Risks to people had been identified and recorded. Thorough management plans were in place to reduce risks wherever possible.” from the report
Safe staffing
Inspectors found enough staff to meet people's needs. Recruitment checks were completed before new staff started.
“There was enough staff on duty to meet people's needs.” from the report
Medicines were safer
Medicines were stored, given and recorded safely. Guidance had been added for medicines given only when needed.
“Medicines were stored, administered and recorded safely.” from the report
Positive atmosphere
Inspectors found a warm, relaxed and caring atmosphere. People and relatives spoke positively about staff.
“There was a positive culture at the service which created a warm, relaxed and caring atmosphere.” from the report
Better oversight
Regular audits and action plans were being used to find and address shortfalls. The provider was also receiving regular reports about the service.
“Effective quality assurance processes to monitor the quality and safety of the service were in place.” from the report
Manager registration was pending
minorThere was no registered manager in post when inspectors visited. The new manager had applied to register, but the application was still being assessed.
“At the time of our inspection there was not a registered manager in post.” from the report
Provider oversight was still being formalised
minorThe provider had recognised that its oversight needed better written evidence. Monthly meetings to review concerns and quality audits were still being introduced.
“The provider had recognised they needed a thoroughly recorded process to evidence effective provider oversight.” from the report
- 01Has the manager's application to become registered now been approved?
- 02Have the planned monthly provider oversight meetings been introduced, and what actions have come from them?
- 03How are changes in each person's risks recorded and reviewed?
- 04How do you check that staffing levels remain safe when people's needs change?
- 05How are as-and-when-required medicines reviewed and recorded?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 7 December 2022 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, December 2021
Requires Improvement; inspectors found kind, personalised care, but important safety records and quality checks were not reliable.
This was the home’s first inspection. It was unannounced and took place on 21 October 2021. Two inspectors spoke with people, a relative, staff and visiting professionals. They observed the home and checked care, medicine, recruitment, training and safety records.
People told inspectors they felt safe and were happy with their care. Staff were kind and caring, people’s independence was supported, and people received personalised care. The effective, caring and responsive parts of the service were rated Good.
The home was not always safe or well-led. Records about risks, accidents, fire checks, recruitment and medicines were incomplete. COVID-19 guidance was not always fully followed. Quality checks had failed to identify these problems.
The overall rating was Requires Improvement. This means the inspectors found some good care, but also shortfalls that need to be put right and monitored.
Kind and respectful staff
Staff treated people with kindness and compassion. People said staff knew them well and respected how they wanted to be supported.
“Staff treated people with compassion and kindness. They engaged in meaningful conversation with people and addressed people in their preferred way.” from the report
Personalised support
People’s likes, dislikes and preferences were included in care plans, and staff responded to their needs. People were supported to make choices and remain independent.
“People told us they received personalised care and support.” from the report
Good support from professionals
The home worked with health and social care professionals to support people’s care and treatment. Feedback from professionals was positive.
“Staff worked with other agencies to ensure people received appropriate care and treatment.” from the report
People felt safe and happy
People told inspectors they felt safe, were happy with the care and could raise concerns. Call bells were answered promptly.
“People told us they felt safe living at the service and were very happy with the care provided.” from the report
Incomplete safety records
seriousRecords about medical risks, accidents, incidents, fire checks and fire drills were not always complete. This meant there was limited assurance that safety risks were being properly recorded and reviewed.
“Risks to people were managed safely but had not always been appropriately recorded.” from the report
Weak quality checks
seriousThe home’s audits and quality checks did not identify the problems found during the inspection. This was a breach of Regulation 17.
“Failure to establish and operate robust systems to monitor and improve the service is a breach of regulation 17” from the report
Medicines and care plan records
needs fixingSome records for medicines prescribed when needed were not complete, and some care plans lacked important information. Inspectors recommended that the home improve both areas.
“Where people were prescribed 'as and when required' medicines, appropriate protocols were not always in place.” from the report
Infection control guidance
seriousThe home did not always follow government guidance for new admissions and testing during the COVID-19 pandemic. Inspectors also found that suitable areas for putting on and removing protective equipment were not in place.
“Government guidance in relation to new admissions and testing had not always been followed.” from the report
Recruitment records
needs fixingSafe recruitment processes were in place, but records did not always show that they had been followed. Interviews and gaps in employment were not always recorded or explored.
“Safe recruitment processes were in place, but records had not always been kept evidencing these processes had been followed.” from the report
- 01What action have you taken to make sure risks linked to conditions such as epilepsy are recorded and reviewed?
- 02How do you now check that accident, incident and fire safety records are complete?
- 03What changes have you made to medicines protocols for medicines prescribed as and when required?
- 04How do you check that care plans contain enough detail, including repositioning support?
- 05What evidence can you show that the Regulation 17 action plan has been completed and that quality audits now identify problems?
This was the first comprehensive inspection of the newly registered home and covered all five CQC questions, including infection prevention and control under Safe. This explanation was written from the published report of 16 December 2021 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 Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2019
Registered with the Care Quality Commission on 22 July 2019.
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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