CQC report explained · a nursing home
What the CQC found at Orchard Nursing
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Orchard Nursing is rated Good; inspectors found safe, caring support and clear improvements, but some cleaning and infection-control practice needed attention.
The inspection was unannounced and took place on 14 March 2023. One inspector spoke with six people, six family members and staff. They reviewed care, medicine and recruitment records, along with management checks.
The home was rated Good overall, with Safe and Well-led both rated Good. People said they felt safe and were treated well. Inspectors found medicines were given safely, staffing levels met people's needs, and risks were assessed and monitored.
Most areas were clean, but some rooms and equipment were not cleaned often enough. There were also inconsistencies in the use of protective equipment and disposal of clinical waste. The manager addressed these issues immediately.
The overall rating improved from Requires Improvement at the previous inspection, published on 24 February 2022. This inspection did not assess all five key questions, so some parts of the overall rating carried over from the previous inspection.
Risk management
Risks were assessed, with plans explaining how staff should manage them. Staff used the required equipment and monitoring records.
“Risk assessments relating to the health safety and welfare of people were completed and included plans for managing risk.” from the report
Medicines
Trained and competent staff gave medicines at the correct times and followed the provider's procedures.
“People received their prescribed medicines at the right times.” from the report
Improvement
Inspectors found that managers had made improvements since the previous inspection and used quality systems to monitor the home.
“Managers had worked consistently to make improvements to the service following previous inspections.” from the report
Partnership working
The home worked with health and social care professionals, and followed advice to meet people's needs.
“There was good partnership working with others to make sure people received the care they needed.” from the report
Cleaning
needs fixingSome areas and equipment, including a sluice room and wheelchairs, were not cleaned often enough. Inspectors said this could increase the likelihood of infection spreading.
“We found the likelihood of the spread of infection could be further reduced through better cleaning in between use of parts of the premises and equipment including a sluice room and wheelchairs.” from the report
Protective equipment
needs fixingOne staff member did not follow PPE guidance. The report says this was dealt with immediately.
“A member of staff did not follow effective PPE guidance. This was addressed immediately.” from the report
Registered manager
minorThere was no registered manager in post during the inspection. The manager had applied to become registered.
“At the time of our inspection there was no registered manager in post.” from the report
- 01What checks have been completed since the inspection to show that the sluice room and wheelchairs are now cleaned between uses?
- 02How do you make sure all staff use PPE correctly and dispose of clinical waste safely?
- 03Has the manager's application to become the registered manager been completed?
- 04What are the current ratings for Effective, Caring and Responsive, which were not inspected during this visit?
- 05How have you maintained the improvements made since the previous Requires Improvement rating?
This was a planned, unannounced inspection focused on Safe and Well-led, including infection prevention and control; the other key-question ratings were carried over from the previous inspection. This explanation was written from the published report of 30 March 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, February 2022
Rated Requires Improvement; inspectors found recent improvements in safety and management, but these had not yet been proven over time and special measures had ended.
Inspectors made an unannounced, focused visit on 9 February 2022. They spoke with three people, seven staff and five family members. They reviewed care records, medicines records, recruitment records, policies, audits and training records.
The home had improved since its previous inspection. Risks were assessed and monitored, medicines were managed more safely, infection control was effective, and staffing levels were suitable. People and families said they felt safe and were treated well.
Management and quality checks had also improved under a new manager. However, these changes were recent and needed to continue for longer. The home was no longer in breach of Regulations 12, 17 or 18, and was no longer in special measures.
The overall rating was Requires Improvement. Only Safe and Well-led were assessed during this visit. The ratings for Effective, Caring and Responsive came from the earlier comprehensive inspection.
Risk management
People's risks were assessed, monitored and managed with clear plans. Records included monitoring of diet, fluids and repositioning.
“Risks to people were now assessed, monitored and safely managed.” from the report
Infection control
The home followed infection control measures, kept the environment clean and had a good supply of protective equipment. Staff and agency staff were included in COVID-19 testing.
“Safe infection prevention and control (IPC) measures were followed to minimise the spread of infection including those related to COVID-19.” from the report
Staffing
Inspectors found enough suitably qualified and experienced staff. Recruiting permanent staff had reduced the use of agency staff.
“The manager had recently recruited a number of permanent staff at all levels which had led to a significant reduction in the deployment of agency staff.” from the report
People felt safe
People and families told inspectors that people felt safe and were treated well by staff.
“People told us they felt safe and were treated well by staff.” from the report
Improved management
A new manager had introduced better governance, communication and support for staff. Staff reported improved morale and a better atmosphere.
“The culture of the service had now improved which led to people receiving positive outcomes.” from the report
Improvements need to last
needs fixingThe main concern was that many improvements had only recently been made. The home needed to show that its new systems remained reliable over a longer period.
“However, many of the improvements were recent and needed to be embedded and sustained over a longer period to achieve a rating of good.” from the report
Training was not yet complete
needs fixingMore than 80% of staff had completed the required training, but further training was still planned.
“Plans were in place for staff to complete all the training required of them.” from the report
Safeguarding training still being completed
minorMost staff had completed safeguarding training, but not all staff had done so at the time of the inspection.
“The majority of staff have completed safeguarding training to date.” from the report
- 01What evidence can you show that the recent risk assessment and monitoring improvements have been sustained?
- 02How do you check that all required staff training, including safeguarding training, is completed?
- 03How are medicines records, including records for 'when required' medicines, checked for accuracy?
- 04How are the new audits and governance systems being kept effective over time?
- 05What is the current position on the application for a registered manager?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not reviewed and their previous ratings carried over. This explanation was written from the published report of 24 February 2022 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 Nursing
7 rated inspections over 8 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2022Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- November 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- December 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 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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