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 that risks were assessed and reviewed, medicines were managed safely, infection controls were in place and there were enough staff. One moving and handling lapse was identified, but no harm occurred and immediate action was taken.
- Effective?
- Good
- This area was not assessed in this focused inspection.
- Caring?
- Good
- This area was not assessed in this focused inspection.
- Responsive?
- Good
- This area was not assessed in this focused inspection.
- Well-led?
- Good
- Inspectors found effective audits, clear staff responsibilities and systems for learning from incidents. People, relatives and staff spoke positively about the home and its management.
What inspectors found, February 2023
Rated Good; inspectors found people were safe and well supported, with one moving and handling lapse dealt with immediately.
This was an unannounced inspection on 18 January 2023. Inspectors spoke with people, relatives, staff and managers. They reviewed seven care records, recruitment records, audits and other information.
The inspection looked only at Safe and Well-led. Both areas were rated Good. Inspectors found that risks were assessed, medicines were managed safely, infection controls were in place and there were enough staff.
Inspectors saw staff supporting people safely with moving and handling on several occasions. On one occasion, a person was not supported in line with their care plan, but came to no harm and the manager took immediate action.
The overall rating remained Good, the same as at the previous inspection published on 30 August 2019. The inspection was prompted partly by a reported incident involving a death, but the circumstances of that incident were not examined in this inspection.
Safe staffing
Inspectors found enough staff to support people safely. Staffing levels were reviewed regularly and relatives did not raise concerns.
“There were enough staff available to support people. We saw staff were available for people when they needed support.” from the report
Medicines
People received their medicines when needed. Staff had training and regular checks of their ability to administer medicines safely.
“People received their medicines when needed. Records we reviewed confirmed this.” from the report
Risk management
Individual risks were assessed, monitored and reviewed. Care plans were updated when incidents or changes occurred.
“Individual risks to people were assessed, monitored and reviewed. This included any health needs.” from the report
Management oversight
Audits covered medicines, infection control and equipment. The home could show what action had been taken when improvements were identified.
“The audits that were completed in the home were effective.” from the report
Communication with families
Relatives said they were kept informed and could speak with staff when they had questions or concerns.
“They communicate well. I can go in the office anytime to ask questions” from the report
Moving and handling lapse
needs fixingInspectors saw one person was not supported in line with their care plan during moving and handling. The person came to no harm and the manager took immediate action.
“On one occasion we saw one person was not supported in line with their care plan, they came to no harm due to this.” from the report
- 01What new moving and handling training and observations were introduced after the incident?
- 02How do you check that each person is supported in line with their moving and handling care plan?
- 03What actions were taken after the one moving and handling lapse found during the inspection?
- 04How are medicines audits and staff competency checks kept up to date?
- 05What information can you share about the further CQC investigation into the reported incident?
This was a focused inspection of Safe and Well-led only; the other three key questions were not assessed and no ratings were given for them. This explanation was written from the published report of 1 February 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, September 2019
Rated Good; inspectors found safe, kind and personalised care, with some concerns about the lounge layout and activities.
This was an unannounced inspection on 26 and 27 June 2019. Inspectors spoke with people using the home, staff and managers. They reviewed care, medicines, complaints, recruitment, safety and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training and care that reflected people's needs and choices.
There were some areas to improve. The layout of the main lounge could make people feel uncomfortable, hourly wellbeing checks felt intrusive to one person, and one loud activity caused distress. Managers responded to these concerns during the inspection.
Enough staff
Inspectors found sufficient staff to meet people's care and support needs, including one-to-one support at certain times.
“There were sufficient numbers of staff to meet people's care and support needs.” from the report
Kind and respectful care
People spoke positively about staff, and inspectors saw staff supporting people patiently and respectfully.
“We saw staff supported people with patience and ensured people were comfortable when they assisted them to move around.” from the report
Personalised support
Care records included people's histories, preferences and communication needs. Staff adjusted support to the individual.
“People received care that was personalised to meet their individual needs.” from the report
Learning and oversight
Managers used audits, feedback and incident information to plan improvements and monitor whether actions were completed.
“The registered manager used a range of audits to identify any shortfalls in the quality of the service.” from the report
Main lounge layout
needs fixingThe main lounge arrangement and the busy walkway behind seated people could leave some people feeling uncomfortable or uneasy.
“There was a busy walk way behind a long row of chairs meaning people were constantly walking behind seated residents which may have left them with a feeling of being uncomfortable.” from the report
Noisy activity
needs fixingOne external activity involved loud noise and shouting, which distressed some people. Managers took immediate action after inspectors raised this.
“The activity was loud and involved a lot of shouting, which caused some people distress.” from the report
Hourly wellbeing checks
minorOne person felt that hourly checks in their room were intrusive. Staff said they would discuss whether the checks could be done in a way that was more acceptable to the person.
“However, one person we spoke with felt well-being checks were intrusive, as these were completed hourly.” from the report
- 01What changes have been made to the main lounge layout since the inspection?
- 02How do you check that activities are suitable for people who may find noise or shouting distressing?
- 03How are hourly wellbeing checks agreed with each person and carried out in a way that respects privacy?
- 04How do you make sure there are enough staff for one-to-one support and group activities?
- 05How are people's communication needs and personal preferences recorded and shared with staff?
This was an unannounced planned inspection covering the whole service and all five CQC questions, including the premises and the care provided. This explanation was written from the published report of 3 September 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 Nursing Home
4 rated inspections over 8 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2019Goodstayed GoodSafe: GoodWell-led: Good
- June 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 31 December 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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