CQC report explained · a nursing home
What the CQC found at Orchard House
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks, medicines, staffing, recruitment and infection control were managed safely.
- Effective?
- Outstanding
- This question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Outstanding
- This question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership, an open culture, strong quality monitoring and a clear focus on improving people's outcomes.
What inspectors found, January 2024
Rated Outstanding; inspectors found safe care and exceptional leadership after checking concerns about medicines and staff conduct.
The inspection was unannounced and took place over five days in October 2023. Inspectors spoke with people living at the home, relatives and staff. They reviewed care, medicines, recruitment, complaints and management records.
The inspection was prompted partly by concerns about medicines and staff conduct. Inspectors found no evidence that people were at risk of harm from these concerns. Medicines were managed safely, risks were assessed, and there were enough suitably trained staff.
The home was rated Good for Safe and Outstanding for Well-led. The overall Outstanding rating also used ratings from the previous comprehensive inspection because this inspection only looked closely at Safe and Well-led.
Safe medicines and staffing
Medicines were safely received, stored, given and disposed of. Staff were trained and assessed before administering medicines, and the home had enough suitable staff.
“Safe protocols for the receipt, storage, administration and disposal of medicines were followed.” from the report
People's voices
People and staff helped shape the home through meetings, feedback and involvement in recruiting staff. This led to changes such as improved welcome packs and exercise equipment.
“New and innovative ways of gathering feedback from people had led to service improvements and ensured people's voice was heard.” from the report
Person-centred support
People were involved in their care plans and encouraged to work towards personal goals. Inspectors saw examples of support helping people progress with rehabilitation and return home.
“People were fully involved in developing their care plans and constantly encouraged by all staff to reach their goals however big or small.” from the report
Learning and improvement
The home reviewed accidents, incidents and complaints, and used what it learned to improve care and communication. It also developed new rehabilitation and health programmes.
“The provider had created an exceptional learning culture at the service which continuously improved the care people received.” from the report
Open management
Inspectors found an open, inclusive culture where people, relatives and staff could raise concerns and suggest improvements. Quality systems were used to identify and act on shortfalls.
“There was an exceptionally positive, open and inclusive culture at the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you make sure medicines remain safely managed, including medicines given only when needed?
- 02How are people with acquired brain injuries involved in setting and reviewing their rehabilitation goals?
- 03What changes have resulted from the Resident Voice meetings and feedback from families?
- 04How will families be involved in the planned family support group and in reviewing the service?
- 05How do daily safety meetings identify and act on accidents, complaints or safeguarding concerns?
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. This explanation was written from the published report of 24 January 2024 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 2019
Rated Outstanding; inspectors found exceptionally caring, effective and well-led support, with safe and responsive care rated Good.
This was an unannounced inspection on 22 and 23 October 2019. One inspector spoke with people living at the home, relatives, staff and visiting professionals. They also reviewed care plans, medicines records, recruitment files and management records.
The inspectors found that people received highly personalised care from staff who knew them well. People were supported to stay safe, take medicines correctly, access healthcare, build independence and work towards their own goals. The home was clean, well maintained and had enough suitably checked and trained staff.
The home was rated Outstanding overall. Effective, caring and well-led were rated Outstanding. Safe and responsive were rated Good. Since the previous Good rating, effective, caring and well-led had improved to Outstanding, while safe and responsive remained Good.
Personalised rehabilitation
Staff supported people to set goals, build skills and make progress towards greater independence. Activities included adapted cycling, work placements and practical tasks in the garden.
“Staff were passionate about providing high quality care and supporting people to make progress in their rehabilitation.” from the report
Kind and respectful care
People and relatives described staff as caring, approachable and respectful. Staff celebrated people's achievements and supported their dignity, privacy and relationships.
“People received an outstanding, personalised, caring service.” from the report
Strong staff skills
Staff received specialist training, regular supervision and support to develop their knowledge. The home kept agency use low and gave agency staff a thorough induction.
“The provider encouraged staff to pursue areas of special interest to improve outcomes for people who used the service.” from the report
Good safety systems
Risks were reviewed regularly and care plans explained how to reduce them. Medicines, recruitment, fire safety, equipment and infection control were all checked and managed.
“People were protected from risks by very detailed, regularly updated risk assessments.” from the report
Open leadership
Managers used audits, feedback, complaints and incidents to improve the service. Staff said they felt supported, valued and involved in developing the home.
“We found an open and transparent culture, where new ideas were encouraged.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and support my relative's specific brain injury, nursing and rehabilitation needs before they move in?
- 02What goals would you agree with my relative, and how would you measure and review their progress?
- 03How would staff support my relative's communication needs, including access to electronic or other assistive technology?
- 04How would you involve our family in care planning, reviews and decisions about health or rehabilitation?
- 05How do you balance encouraging independence with managing risks such as falls, medicines or reduced mental capacity?
This was an unannounced planned inspection covering all five key questions, including both the premises and the care provided; safe and responsive remained Good while effective, caring and well-led improved from Good to Outstanding. This explanation was written from the published report of 4 December 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 House
3 rated inspections over 7 years: the service has improved, from Good to Outstanding.
- January 2024Outstandingcurrent ratingstayed OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: GoodWell-led: Outstanding
- December 2019Outstandingup from GoodSafe: GoodWell-led: Outstanding
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016
Registered with the Care Quality Commission on 4 March 2016.
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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What to check when you visit
At least 100 live-in carers within about an hour of West Northamptonshire
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 £1,280 a week. 87 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
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.