CQC report explained · a residential care home
What the CQC found at Orchard House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Inspectors found safe staffing levels, recruitment, safeguarding, risk management, medicine systems and infection-control arrangements, although they were only somewhat assured about the effective and safe use of personal protective equipment.
- Effective?
- Good
- This key question was not inspected during this visit. The previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. The previous rating was used to calculate the overall rating.
- Responsive?
- Outstanding
- This key question was not inspected during this visit. The previous rating was used to calculate the overall rating.
- Well-led?
- Good
- Inspectors found clear management oversight, action plans and a positive, person-centred culture. Staffing pressures reduced the manager's time for management tasks, but the assistant manager helped the home remain effective.
What inspectors found, April 2023
Orchard House rated Good; inspectors found safe, kind and person-centred care, with some staffing and infection-control pressures.
This was a focused inspection of safe and well-led care. The inspection visits took place on 31 March, 4 April, 5 April and 12 April 2023. One inspector met five people, contacted five relatives, spoke with staff and managers, and reviewed care, medicine, staff and management records.
The home was rated Good overall, and Good for Safe and Well-led. Inspectors found enough staff to meet people's needs, safe medicine systems, appropriate safeguarding, kind care and strong support for choice, independence and personal goals.
There were some pressures. The home had experienced difficulty filling vacancies, and inspectors were only somewhat assured that personal protective equipment was being used effectively and safely. The manager was also spending more time providing care in another service, leaving less time for management tasks.
The other three key questions were not inspected during this visit. Their previous ratings were carried forward from the last inspection, published on 11 October 2017, when the service was also rated Good.
Choice and independence
Staff supported people to make decisions, develop their strengths and work towards their goals. Care was built around people's wishes and abilities.
“People were supported to have maximum possible choice, control and independence.” from the report
Kind and respectful care
Inspectors found that staff treated people with kindness, protected their privacy and dignity, and understood their individual needs.
“People received kind and compassionate care.” from the report
Safe medicines
Medicines were received, stored, given and disposed of safely. Staff also followed principles intended to prevent unnecessary over-medication.
“People's medicines were appropriately managed.” from the report
Open management
The management team used audits, action plans and incident reviews to identify issues and improve the service.
“The management team maintained clear oversight of the service and had created a robust governance system, which rapidly identified any issues.” from the report
Use of protective equipment
needs fixingInspectors were not fully assured that protective equipment was being used effectively and safely. Families should ask what has been improved since the inspection.
“We were somewhat assured that the provider was using PPE effectively and safely.” from the report
Staffing vacancies
needs fixingThe home had experienced difficulty filling vacancies because of recruitment pressures. Inspectors found staffing levels met people's needs at the time, but families may want to ask about current staffing.
“Due to pressures caused by the COVID 19 pandemic and recruitment difficulties, the service had experienced issues filling vacancies.” from the report
Management capacity
needs fixingThe manager oversaw two services and was spending more time providing care in the other service. This reduced the time available for management work.
“The staffing pressures had led to them needing to provide more time delivering care in Garden Lodge and less opportunity to attend to managerial tasks.” from the report
- 01How many staff vacancies are there now, and how do you make sure there are enough skilled staff on each shift?
- 02What has changed since the inspection to make sure personal protective equipment is used effectively and safely?
- 03How is management cover arranged when the manager is working across two services?
- 04What evaluation has been completed on the new care record templates?
- 05How are people's goals, choices and independence recorded and reviewed?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the last inspection in 2017. This explanation was written from the published report of 27 April 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 2017
Rated Good overall, with Outstanding responsive care and inspectors finding people received safe, kind and highly personalised support.
This was an unannounced comprehensive inspection. Inspectors visited on 7 August 2017, observed people and staff, spoke with staff, relatives and professionals, and checked care records, medicines, staffing, recruitment, cleanliness and safety checks.
The home supported five people with autism and could accommodate six. Inspectors found detailed information about people's histories, needs, preferences and possible distress triggers. Care plans were regularly reviewed and matched what inspectors observed. People were supported to make choices, take positive risks and take part in activities and community life.
All five areas were rated Good except Responsive, which was rated Outstanding. The overall Good rating means the home met the relevant standards at the time of this inspection. It had remained Good since the previous inspection in January 2015.
Detailed personal care
The home gathered extensive information before people moved in. Care records covered personal histories, preferences, communication and situations that could cause distress.
“We found this information to be highly detailed.” from the report
Choice and activities
People were supported to choose activities, continue hobbies, go out and take carefully assessed positive risks. Staff aimed to help people build confidence and avoid social isolation.
“This meant people were able to live their lives as they chose.” from the report
Respectful support
Staff noticed people's body language and respected privacy and dignity. They knocked before entering bedrooms and asked permission before showing rooms.
“Throughout the inspection staff showed their respect for people.” from the report
Safe medicines
Medicines were stored securely and records had no gaps. Staff had guidance for medicines needed on an as-needed basis.
“We found medicines were stored in locked cupboards.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are on duty during the day and night now, and has the night staffing arrangement changed since this inspection?
- 02How will you make sure my relative's care plans reflect their current needs, preferences and communication?
- 03How do you plan and support transitions, such as healthcare appointments, holidays, changes in family life or moving home?
- 04What activities and community opportunities could my relative choose, and how would you assess and support any positive risks?
- 05How can my relative or our family raise a concern or complaint, and how would it be followed up?
This was a comprehensive inspection covering all five key questions, with an unannounced visit on 7 August and follow-up telephone calls to relatives and professionals on 9, 14 and 18 August 2017. This explanation was written from the published report of 12 October 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 8 years: the service has held its Good rating throughout.
- April 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- October 2017Goodstayed GoodSafe: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
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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47 live-in carers within about an hour of County Durham
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 £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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.