CQC report explained · a residential care home
What the CQC found at Orchard Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The home had enough staff who knew people's needs. Inspectors found safe medicines systems, appropriate risk management and satisfactory infection control arrangements.
- Effective?
- Good
- Care plans reflected people's needs and communication preferences. People were supported with healthcare, activities, food choices, independence and decisions about their care.
- Caring?
- Good
- Staff were observed treating people with kindness, respect and patience. People and relatives said they were involved in care planning and that staff protected privacy and dignity.
- Responsive?
- Good
- Support was personalised and included activities, communication aids, advocacy and contact with relatives and friends. The home worked with other professionals to support admissions and reduce the risk of hospital readmission.
- Well-led?
- Good
- Leaders were described as approachable and staff felt supported to raise concerns and suggest improvements. Governance systems were now robust enough to show that safety was being managed effectively.
What inspectors found, October 2021
Rated Good; inspectors found safe, kind and person-centred care, but some care records did not fully reflect the support provided.
Inspectors visited the home on four dates, spoke with people, relatives and staff, observed care and reviewed care, medicines, recruitment and management records. They also checked infection control arrangements during the COVID-19 pandemic.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines practice, respectful care, meaningful activities and support that promoted choice, independence and human rights.
Some care records did not always show the person-centred support inspectors saw in practice. The manager knew about this and was working with staff to improve it. A previous breach about good governance had been addressed, and the home was no longer in breach.
Person-centred culture
Inspectors found that people's needs, quality of life and choices shaped the way the home worked.
“The needs and quality of life of people formed the basis of the culture at the service.” from the report
Kind and respectful care
Staff supported people at their own pace and respected their privacy, dignity and choices.
“People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person's individual needs.” from the report
Safe medicines
People received the right medicines at the right time, with medicines reviewed by their GP and safely administered, recorded and stored.
“People received the correct medicines at the right time.” from the report
Meaningful activities
People were offered activities based on their interests and were supported to develop independence and everyday living skills.
“People had access to a range of meaningful activities in line with their personal preferences.” from the report
Care records needed improvement
needs fixingSome records did not fully reflect the person-centred support inspectors saw being provided. The manager acknowledged this and said work was under way with staff to improve it.
“However, the care records did not always reflect the person-centred support we observed being offered to people.” from the report
- 01How do you check that each person's care records accurately reflect the person-centred support they receive?
- 02What progress has been made in improving care records since this inspection?
- 03How are people and their families involved in reviewing care plans and risk assessments?
- 04How do you reduce the use of restrictive practices and review whether they are still needed?
- 05How will the new outcome measurement tool affect each person's goals and progress?
This was a planned inspection covering all five key questions, including infection prevention and control under Safe; the report also checked whether the home was applying the principles of Right support, right care, right culture. This explanation was written from the published report of 6 October 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, February 2020
Orchard Lodge was rated Requires Improvement; inspectors found kind, person-centred care but weaknesses in safety checks, medicines systems and management oversight.
Inspectors visited without notice on 4 and 5 December 2019. They spoke with people, relatives, staff and other professionals. They also reviewed care plans, medicines records, staff files and management records.
People were treated kindly and supported to make choices, build independence and take part in activities. Care plans were detailed and daily records were up to date. The home worked with health professionals and people had access to suitable support.
However, health and safety checks were not always completed properly. Maintenance actions were delayed, environmental risk reviews lacked detail, and medicines audits and storage checks were inconsistent. Some training and care records also needed improvement.
The overall rating was Requires Improvement. Safe and Well-led were rated Requires Improvement. Effective, Caring and Responsive were rated Good. The home had no registered manager at the inspection, although a new manager was applying to register.
Kind and respectful care
Inspectors saw staff treating people warmly and responding sensitively to their communication and comfort needs.
“We saw a warm and caring approach by staff with positive and kind interactions between staff and people.” from the report
Personalised support
Care plans recorded people's preferences, needs and goals. Daily records showed that care was being delivered as planned.
“Care plans were detailed, person centred, and goal orientated with a focus on achieving outcomes.” from the report
Choice and independence
People were supported to make choices, use their preferred communication methods and work towards greater independence.
“There was a strong focus on building and maintaining people's independence.” from the report
Activities and community access
People could choose from activities inside the home and in the community, including trips, arts and crafts and day services.
“People had access to a range of activities including, day services, arts and crafts, shopping, theatre trips, cinema trips, wellbeing therapies, local attractions and live entertainment.” from the report
Staffing and safeguarding
Inspectors found enough staff during the visit, and staff knew how to recognise and report abuse. Recruitment records contained the required information.
“There were sufficient staff to meet people's needs and keep them safe.” from the report
Incomplete safety checks
seriousSome health and safety checks were not completed consistently. Maintenance actions, including reported concerns, had been delayed or were not fully recorded.
“Health and safety checks and actions were not always completed.” from the report
Weak risk monitoring
needs fixingEnvironmental audits sometimes showed that something had failed without explaining the risk or the action needed to correct it.
“We observed that the reviews for environmental risks lacked sufficient detail about the actions required to be taken and why.” from the report
Medicines systems
seriousPeople mostly received medicines safely, but auditing and storage systems were not consistently completed. This made it harder to demonstrate that medicines were always managed safely.
“The medicines systems in place for auditing and managing storage were not as effective as they could have been due to the inconsistency in completion.” from the report
Management oversight
needs fixingQuality checks and audits were not completed consistently. The new manager had identified the problems, but the planned action plan was not yet in place during the inspection.
“The action plan was not in place at the time of inspection.” from the report
Training records
needs fixingFour training courses had staff compliance below 67%, including fire safety and first aid. The manager was working to improve this.
“There were four training courses showing team compliance below 67%.” from the report
- 01What has been done to make sure all health and safety checks, maintenance actions and environmental risk reviews are completed and recorded?
- 02How are medicines storage checks and audits now completed consistently, and how are any errors followed up?
- 03What progress has been made with the action plan required by CQC for the Regulation 17 breach?
- 04Has the new manager completed the application to register with CQC, and who is overseeing the home until then?
- 05How are staff training gaps in fire safety and first aid being monitored and resolved?
This was an unannounced comprehensive inspection covering all five CQC questions; the home was a six-bedded care home supporting six people with learning disabilities, physical disabilities and/or autism. This explanation was written from the published report of 5 February 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 Lodge
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2020Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 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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