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
- Inspectors found that staff understood safeguarding, risks were reviewed, medicines were managed safely and there were enough staff to meet people's needs. The home was also following infection control procedures.
- Effective?
- Good
- People's needs were assessed and care was based on recognised guidance. Staff were trained, people enjoyed meals and healthcare support was arranged when needed.
- Caring?
- Good
- Staff were kind, patient and respectful. People and relatives were involved in decisions, and inspectors saw that privacy, dignity and independence were supported.
- Responsive?
- Good
- Care plans included people's histories, preferences and communication needs. People had activities, outings and support for hobbies, and complaints were investigated.
- Well-led?
- Good
- The management team was described as open and approachable. Audits, feedback and incident reviews were used to identify improvements, and the registered manager had improved the culture of the home.
What inspectors found, October 2019
Orchard House was rated Good; inspectors found safe, kind and personalised care, with some decision-making records still being updated.
This was an unannounced inspection on 20 and 23 September 2019. One inspector spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough knowledgeable staff, safe medicines systems, suitable care plans, respectful care and activities that people enjoyed.
The home supported people to make choices and involved relatives in decisions. The management team was described as open and approachable, and inspectors found that the new registered manager had improved the culture of the home.
The overall Good rating means inspectors found the service consistently met the expected standards at this inspection. The previous inspection, published in October 2016, was also rated Good.
Safe care and medicines
Staff understood people's risks and safeguarding duties. Inspectors found that medicines were given as prescribed and managed safely.
“Staff administered medicines in a safe way, following appropriate guidance, and using an effective system to ensure people had their medicines as prescribed.” from the report
Kind and respectful staff
Inspectors saw staff treating people with patience, kindness and consideration. People's privacy and dignity were maintained.
“We saw examples of staff being kind and caring throughout the inspection.” from the report
Personalised support
Staff knew people's histories, preferences and communication needs. Care was adapted to the individual, including people staying for a short period.
“We saw staff were able to provide personalised care tailored to the needs and wishes of the individual.” from the report
Activities and community links
People had regular activities, outings, events and support for their hobbies. The management team was also developing community links.
“There was an activity program advertised around the home, with events planned regularly which people told us they enjoyed participating in.” from the report
Open management
People, relatives and staff said the management team listened and acted on feedback. Audits, complaints and incidents were used to improve care.
“All the staff we spoke with said the registered manager had created an open and positive culture at the home.” from the report
Short-stay decision records
needs fixingThe registered manager was reviewing the Mental Capacity Act process and updating records for people staying for short periods. Ask how this work was completed and checked after the inspection.
“The registered manager was reviewing the process to comply with the MCA for people staying at the home for short stays.” from the report
Recruitment and agency staffing
minorThe home was recruiting to fill vacancies and used regular agency staff to maintain staffing levels. Ask how this affects continuity and whether vacancies have since been filled.
“There was an on-going recruitment campaign to fill vacancies.” from the report
- 01Have the Mental Capacity Act records for people staying for short periods now been fully updated and checked?
- 02How many staff vacancies were there after the inspection, and how often are agency staff used now?
- 03How will you make sure activities remain suited to my relative's interests, abilities and wishes?
- 04How are relatives involved in care planning and kept updated about changes in their family member's care?
- 05What improvements have resulted from recent complaints, accidents and incident reviews?
This was an unannounced inspection covering all five CQC questions, with the previous Good ratings from October 2016 reviewed as part of the planned inspection. This explanation was written from the published report of 24 October 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.
What inspectors found, October 2016
Rated Good; inspectors found safe, kind and personalised care with clear leadership.
The inspection was unannounced and took place on 14 September 2016. One inspector and an expert in dementia care visited the home. They spoke with people living there, relatives, staff and health professionals. They also reviewed care records, audits and meeting notes.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training and support, and care that took account of people's choices and needs.
People were treated with kindness, dignity and respect. They were supported to maintain relationships, hobbies and independence. The home had systems for checking its work and learning from improvements, including more accurate completion of fluid charts.
Safety and staffing
Inspectors found that staff understood how to protect people from harm. Staffing levels were reviewed when people's needs changed or when staff were absent.
“People were supported by sufficient numbers of staff to keep them safe and meet their needs.” from the report
Kind and respectful care
People said staff were kind and caring. Inspectors saw staff speak calmly, respect privacy and give people time to do things at their own pace.
“The staff were friendly, polite and respectful when providing support to people.” from the report
Personalised support
Staff knew people's histories, preferences and abilities. People were supported to make choices, remain independent and take part in activities that suited them.
“People received individual care and support that was in line with their preferences.” from the report
Training and health support
Staff received training suited to the people they cared for, including dementia care and communication. People had access to healthcare professionals when needed.
“The registered manager supported staff by arranging training so staff developed the skills needed in order to provide care and support to people” from the report
Visible leadership
The manager was regularly present and staff felt supported. The home used audits and meetings to review people's experiences and improve practice.
“Clear and visible leadership meant people received good quality care to a good standard.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently decide staffing levels when people's care needs change or staff are absent?
- 02How do you check that medicines are given at the right time and that staff understand possible side effects?
- 03What dementia care and communication training do staff receive now, and how is new staff competence checked before they work alone?
- 04How do you monitor people's fluid intake and make sure fluid charts are completed accurately?
- 05How do you find out about each person's hobbies, preferences and choices, and how are activities adapted when their needs change?
This was an unannounced inspection of the overall service, covering all five CQC questions, using observations, conversations, records and provider checks. This explanation was written from the published report of 12 October 2016 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 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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11 live-in carers within about an hour of Herefordshire, County of
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 £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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.