CQC report explained · a nursing home
What the CQC found at Orchard House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Medicines, infection control, recruitment and responses to incidents were managed safely.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was carried forward to calculate the overall rating.
- Well-led?
- Requires improvement
- Some management and quality systems were not used to their full potential. Records contained old information, incidents were not analysed for patterns, and staffing needs were not formally assessed using a dependency tool.
What inspectors found, November 2023
Rated Good overall; inspectors found safe care, but the home was Requires Improvement for well-led.
This was an unannounced, focused inspection on 7 November 2023. Inspectors spoke with people, relatives and staff, and checked care records, staff records, medicines and how the home was managed.
The home was rated Good for Safe. Inspectors found people were protected from avoidable harm, medicines were managed safely, infection control was effective and there were enough suitable staff. A window safety issue was corrected after the inspection.
The home was rated Requires Improvement for Well-led. Records and quality checks were not always used effectively. Incidents were recorded but not analysed for patterns, some care information was old or difficult to find, and staffing needs were not formally assessed using a dependency tool. The overall rating stayed Good because the other areas were not inspected and their previous ratings were carried forward.
Safe care
People and relatives told inspectors they felt safe. Staff knew how to recognise and report abuse, and risks such as falls and pressure wounds were assessed and managed.
“People were safeguarded from abuse and avoidable harm.” from the report
Medicines
Medicines were administered, recorded and stored safely. A new electronic medicines system helped staff identify when time-critical medicines were due.
“People were supported to receive their medicines safely.” from the report
Clean environment
Inspectors found effective infection prevention and control arrangements and a clean, hygienic home.
“One person told us, the home was "scrupulously clean.” from the report
Open communication
People, relatives and staff said they could speak openly with the manager and felt listened to. Relatives said they were kept updated about changes in people's health.
“There was a positive and open culture at the service.” from the report
Learning and training
The home had a development plan and regular staff training. Staff were supported to refresh their skills and ask for further training.
“Staff were encouraged to learn and improve their skills.” from the report
Incidents not analysed
needs fixingThe home recorded incidents but did not analyse them to identify patterns that might help prevent problems or improve care.
“Data was collected about incidents, but this was not analysed to identify any potential patterns which may support prevention or further improvement.” from the report
Care records were hard to use
needs fixingSome records contained old information and current information was difficult to find. One person's repositioning chart was not completed correctly.
“People's care records contained a lot of old information and the way information was presented made it difficult to locate up to date current information.” from the report
Staffing review system
needs fixingManagers reviewed people's individual needs, but did not bring this information together in a formal tool to check that staffing levels responded to changing needs.
“This information was not collated in a formal dependency tool to ensure staffing levels were appropriate and responsive to changes in people's needs.” from the report
Window restrictors
minorThe window restrictors did not follow best practice guidance during the visit. Suitable restrictors were fitted after the inspection.
“Following our site visit the operations manager arranged for appropriate restrictors to be fitted” from the report
- 01How are you now analysing incidents and accidents for patterns and preventative action?
- 02How will the new electronic recording system make current care information easier for staff to find?
- 03How do you now check that repositioning charts and other daily records are completed correctly?
- 04What formal tool are you using to match staffing levels to changes in people's dependency needs?
- 05Have all the window restrictors now been fitted, and how do you check they remain safe?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the last inspection in 2018. This explanation was written from the published report of 29 November 2023 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, October 2020
Inspected but not rated; inspectors were assured about infection prevention and control during the COVID-19 pandemic.
This was an announced, targeted inspection on 21 October 2020. It looked only at infection prevention and control measures as part of a national review of care homes.
Inspectors were assured that the home was managing visitors, social distancing, admissions, personal protective equipment, testing, cleaning and possible outbreaks safely. The home had made all bedrooms single use and had prepared an isolation area if needed.
The home supported family visits for people nearing the end of life. Other people were offered video calls and could use communal areas while keeping their distance. Staff also provided activities in people's rooms.
The overall service and Safe question were inspected but not rated. This report does not provide ratings for Effective, Caring, Responsive or Well-led.
Single-use bedrooms
The home changed all bedrooms to single use, including rooms that had previously been shared, to reduce the risk of infection spreading.
“In response to the COVID-19 pandemic the provider had made all rooms single use to minimise the risk of cross infection.” from the report
Preparation for infection outbreaks
The home had set aside an area for isolation and had identified staff who could care for people with COVID-19 while using full PPE.
“The provider had allocated part of the service to be used as an isolation wing, should it be required.” from the report
Flexible family contact
The home allowed visits for people nearing the end of life and offered video calls and other alternatives for people who could not have face-to-face visits.
“Alternatives to face to face visiting were made available and people were supported to have regular video calls with their friends and family.” from the report
Activities and social contact
People could use communal areas while socially distancing, and staff provided one-to-one activities in people's rooms.
“Staff were able to provide one to one activities in people's rooms, and we observed this happening during our inspection, to ensure people were stimulated and engaged with.” from the report
Inspectors raised no specific concerns in this report.
- 01How are the infection control arrangements described in this 2020 report being applied now?
- 02What happens if a resident tests positive for an infection, and where would they be cared for?
- 03How can families visit someone who is nearing the end of life, and what alternatives are available at other times?
- 04How will you help a resident stay socially connected and occupied if they need to spend time in their room?
- 05What are the home's current ratings for Effective, Caring, Responsive and Well-led, which this inspection did not assess?
This was a targeted inspection of infection prevention and control only; the service and Safe question were inspected but not rated, and the other four questions were not assessed. This explanation was written from the published report of 30 October 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.
Every inspection of Orchard House Nursing Home
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- November 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2020Inspected but not ratedSafe: Inspected but not rated
- April 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodWell-led: Requires improvement
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementWell-led: Requires improvement
- February 2016Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 5 December 2012.
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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