CQC report explained · a residential care home
What the CQC found at Orchard Lea
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risk assessments, fire safety, emergency evacuation plans and medicines management had improved, although crumbling plaster in the laundry presented an infection control risk.
- Effective?
- Good
- Staff had the training and support needed for their roles. People's needs, nutrition, healthcare and consent were managed in line with their preferences and assessed needs.
- Caring?
- Good
- This key question was not assessed during this focused inspection, so no rating was given in this report.
- Responsive?
- Good
- This key question was not assessed during this focused inspection, so no rating was given in this report.
- Well-led?
- Good
- The home had improved audits, monitoring and management support. People, relatives and professionals described the management as approachable, open and committed to improving care.
What inspectors found, August 2021
Orchard Lea was rated Good after inspectors found safer systems, better staff training and stronger management, with a few environmental issues still needing attention.
This was an unannounced focused inspection on 16 July 2021. Inspectors spoke with people living in the home, relatives, staff and health professionals. They also observed care and checked care, medicines, staff and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found improvements since the previous inspection. Risks were better managed, staff training had improved, medicines were safely handled and quality checks were being used to make changes.
People and relatives said they felt safe and were happy with the care. Inspectors also found good links with health professionals and a positive, person-centred culture. However, the inspection did not assess the nursing activity because nobody was receiving nursing care at the time.
The overall rating improved from Requires Improvement to Good. The previous breaches relating to management oversight and notifications had been addressed. This was a focused inspection, so the other areas were not reassessed during this visit.
Safer environment
Inspectors found that earlier problems with hot water temperatures and personal emergency evacuation plans had been addressed.
“People lived in a service which was safe and well maintained.” from the report
Medicines managed safely
Medicines were stored, administered and recorded safely. Staff explained medicines to people and stayed with them until they were taken.
“The Medicine Administration Records (MAR) were well completed which meant we were assured medicines had been administered.” from the report
Staff training
Staff had received training in areas including safeguarding, moving and handling, infection control and dementia care. New staff were supported through induction and shadowing.
“Staff received training and support needed to carry out their role effectively.” from the report
Good healthcare links
The home worked with GPs, therapists and mental health professionals. Inspectors were told that referrals were appropriate and recommendations were acted on.
“The service worked well with health care professionals to provide timely care to people to ensure their health was maintained.” from the report
Improved management checks
The home had embedded audits and monitoring systems. These were used to identify shortfalls and make improvements.
“Effective quality assurance and monitoring systems had been embedded and were used to identify shortfalls and drive improvements.” from the report
Laundry plaster
needs fixingPlaster on the laundry walls was crumbling and flaking. Inspectors said this posed an infection control risk, although refurbishment was included in the improvement plan.
“Plaster on the walls of the laundry was crumbling and flaking in some areas, which posed an infection control risk.” from the report
Limited staff presence in one lounge
minorInspectors noted a lack of staff presence in the lounge where some people ate lunch. Staff checked on people when passing through.
“We spoke with the registered manager about the lack of staff presence in the lounge, where some people chose to eat lunch.” from the report
Garden improvements pending
minorThere was little outdoor furniture, and the available furniture was in full sun. More work was planned to make the garden more usable.
“Although the garden was secure and potentially attractive, there was little furniture outside to encourage people to spend time there.” from the report
- 01Has the crumbling and flaking plaster in the laundry now been repaired, and how are infection risks being controlled until the work is complete?
- 02How many staff are available during the busiest parts of the day, including when people eat in the lounge?
- 03How quickly are call bells answered, especially at night and during busy periods?
- 04What improvements have been made to the garden, and can people use shaded and furnished areas?
- 05If my relative needs nursing care, how would the home provide it, given that nursing care was not being delivered or inspected at this visit?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed, and the nursing activity was not inspected because nobody was receiving it at the time. This explanation was written from the published report of 13 August 2021 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 Requires Improvement; inspectors found kind, personalised care but gaps in training, safety checks and management oversight.
This was the home's first inspection since it registered in October 2018. The visit was unannounced and took place on 14 and 18 October 2019. Inspectors spoke with people, relatives, staff and health professionals, observed care and checked records.
People were treated with kindness and respect. Inspectors found personalised care, good support from health professionals, safe medicines arrangements overall, good food and support at the end of life. People and relatives were generally positive about the home.
Some important improvements were needed. Not all staff had completed core training. Water temperatures had been too high, some evacuation plans were incomplete and creams records were not always filled in. Activities were limited, and staff were not always visible in the main sitting room.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good. The provider was required to send an action plan, and CQC said it would monitor progress and return for another inspection.
Kind and respectful staff
People, relatives and professionals consistently described staff as caring. Inspectors observed patience, kindness and positive interactions.
“Without exception, people and their relatives described a very caring and compassionate staff team.” from the report
Personalised care
Staff knew people's preferences and supported choices about daily routines, activities and care. Care records contained detailed information about each person.
“People benefited from personalised care that valued them as individuals.” from the report
Good health support
The home worked well with health and social care professionals. Referrals were made promptly and professionals said their recommendations were followed.
“Health professionals confirmed referrals were appropriate and their recommendations were always followed.” from the report
End of life support
People could remain in familiar surroundings when this was their wish. Staff worked with health professionals and supported relatives as well as the person.
“At the end of their lives people were supported to remain at the service (when this was their wish), in familiar surroundings, supported by their family and staff who knew them well.” from the report
Incomplete staff training
seriousSome staff had not completed core training in areas linked to safe care. The manager supplied updated training information after the inspection, but some training was still outstanding.
“Some staff had not received core training to ensure they worked safely with people.” from the report
Safety checks missed problems
seriousHot water had been recorded above the recommended temperature, but action was not taken until inspectors raised it. Some emergency evacuation plans had also not been updated for everyone.
“Although hot water temperatures had been recorded above the recommended temperature, action was not taken until we brought it to the attention of the registered manager.” from the report
Weak management oversight
seriousThe provider's checks did not identify several issues found during the inspection. Monitoring visits were not recorded, and the provider failed to notify CQC about reportable events without delay.
“The registered provider did not always consistently assess, monitor and improve the quality and safety of the services provided.” from the report
Limited activities
needs fixingPeople did not always receive regular, meaningful and person-centred activities. Inspectors recommended getting advice about activities, particularly for people living with dementia.
“Activities were not always person centred and records showed people were not offered regular meaningful activities.” from the report
Staffing pressures
needs fixingThe home had experienced staff turnover, sickness absence and recruitment difficulties. Inspectors also found limited staff presence in the main sitting room at times.
“The service had experienced staffing issues over the past months due to staff turnover and unplanned absence.” from the report
- 01How many staff currently have completed safeguarding, infection control, health and safety, and moving and handling training?
- 02What checks now make sure hot water temperatures remain safe, and how often are those checks reviewed?
- 03Are all residents' personal emergency evacuation plans complete and kept up to date?
- 04How do you make sure there are enough staff in communal areas throughout the day?
- 05What regular, meaningful activities are now available, especially for people living with dementia?
This was an unannounced planned inspection that looked at the overall quality of the care and the premises, and rated all five key questions; it was the home's first inspection. This explanation was written from the published report of 25 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 Lea
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2018
Registered with the Care Quality Commission on 18 October 2018.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
17 live-in carers within about an hour of Devon
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 £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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.