CQC report explained · a residential care home
What the CQC found at Orient St Adult Respite Unit
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust safeguarding systems, suitable risk assessments, enough staff and safe medicines processes. They also found infection prevention measures were in place.
- Effective?
- Good
- People had personalised care plans, suitable staff training and support with food, health needs, communication and decision-making. The home worked with relatives and health and social care professionals.
- Caring?
- Good
- This question was not inspected during this focused inspection.
- Responsive?
- Good
- This question was not inspected during this focused inspection.
- Well-led?
- Good
- Inspectors found stronger quality checks, regular audits, staff involvement and action taken in response to feedback. The previous breach relating to quality monitoring had been addressed.
What inspectors found, November 2022
Orient St Adult Respite Unit was rated Good after inspectors found safe, effective and well-led care, with clear improvements since the last inspection.
This was an unannounced focused inspection. Inspectors visited on several dates, spoke with people, relatives, staff and professionals, and checked care plans, medicines records, recruitment files, training records and management systems.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found people were protected from abuse, supported by enough trained staff, given their medicines safely and helped to make choices about their care and daily activities.
Care was personalised and people were supported with health needs, communication, food, activities and contact with professionals. Inspectors also found the home had made improvements to its quality checks and monitoring systems.
This report did not inspect Caring or Responsive. Their previous ratings were used when calculating the overall rating. The home had previously been rated Requires Improvement and had breached Regulation 17, but inspectors found it was no longer in breach.
Personalised support
Care plans reflected people's needs, communication styles, health needs and aspirations. People and relatives were involved in reviewing plans before respite stays.
“People had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations, including physical and mental health needs.” from the report
Safety and safeguarding
Staff knew how to identify and report abuse. Risk assessments were detailed and covered areas such as eating, drinking, mobility and safety in the community.
“Robust systems were in place to protect people from the risk of abuse and harm and promote their safety.” from the report
Skilled staff
Staff received training relevant to learning disability and autism support, including communication and positive behaviour support. Inspectors found enough staff on their visits.
“People with a learning disability and autistic people received care and support from staff who were provided with suitable evidence based training to effectively meet their needs.” from the report
Activities and independence
People were supported to choose activities, use local facilities and build everyday skills such as shopping, cooking and making drinks.
“People benefitted from the stimulating facilities at the service and were supported to take part in activities of their choice in the local area.” from the report
Improved management systems
The home had introduced regular checks covering areas such as medicines, training, policies and health and safety. It also used feedback from people and relatives.
“Robust systems to monitor and audit the quality of the service were now in place and an evident degree of progress had been achieved since the last inspection to implement and embed improvements.” from the report
No registered manager at the visit
minorThere was no registered manager in post when inspectors visited. The service manager was applying to CQC for registered manager status.
“At the time of our inspection there was no registered manager in post.” from the report
Staff vacancies and agency use
minorThe home had struggled to fill vacancies since the start of the COVID-19 pandemic and was using regular agency staff on short-term contracts. Inspectors still found enough staff during their visits.
“The manager informed us the service had struggled with filling staff vacancies since the onset of the COVID-19 pandemic and were actively working towards recruiting new permanent staff.” from the report
Incomplete employment histories
needs fixingTwo recruitment files did not initially contain full employment histories. The home corrected this quickly and said it would consistently obtain the information.
“We noted that although two staff recruitment files contained employment histories, the provider had not obtained a full employment history in line with legislation.” from the report
- 01Who is currently responsible for managing the home while the application for registered manager status is being considered?
- 02How many permanent staff vacancies are there now, and how often are regular agency staff used?
- 03How will you make sure temporary staff understand my relative's communication needs, routines and risk assessments?
- 04How are relatives asked about changes in health, medicines, food preferences and support needs before each respite stay?
- 05What activities and community visits could my relative choose during their stay, and how would you support their independence?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the overall rating also used previous ratings for the questions not inspected. This explanation was written from the published report of 5 November 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.
What inspectors found, December 2019
Rated Requires Improvement; care was safe, kind and responsive, but consent arrangements, staff training and quality checks needed improvement.
This was an unannounced planned inspection on 12 September 2019. One inspector reviewed care, medicines and staff records, spoke with five care workers and the manager, and later spoke with five relatives. Nobody was staying at the home during the visit.
The home was rated Good for Safe, Caring and Responsive. Inspectors found suitable risk assessments, safe medicines arrangements, clean premises, kind care, personalised support and activities that people enjoyed. Staffing arrangements had improved, and the home was no longer accepting emergency admissions.
The home was rated Requires Improvement for Effective and Well-led. Mental capacity assessments were not always completed correctly. Some staff training and supervision were overdue. The provider was not completing quality audits, so it could not show that it was identifying and fixing problems.
The overall rating remained Requires Improvement, as it had been at the previous inspection. The provider breached Regulation 17 on good governance. CQC said it would continue monitoring the home and check the action taken.
Improved staffing decisions
Staffing levels were judged appropriate, and the provider would not accept people when there were not enough staff. The home had also stopped accepting emergency referrals without proper assessment.
“If we don't have the staff, we're not going to accept people. Safety is the most important thing.” from the report
Safe medicines and clean premises
Medicines storage, temperature checks and records had improved since the previous inspection. Inspectors also found the home clean and staff trained in infection control.
“At this inspection we found these issues had been resolved and the provider had appropriate systems in place for the safe management of people's medicines.” from the report
Kind and respectful care
Relatives said people were treated well and appeared happy. Staff supported privacy, dignity and independence during care.
“People's privacy and dignity was respected and promoted.” from the report
Personalised respite support
Care plans recorded people's preferences, communication methods, dietary needs and interests. The home offered activities, including use of a sensory room and garden.
“We saw people's care plans were personalised and included details of their needs in a variety of different areas.” from the report
Mental capacity decisions
seriousThe provider did not always assess whether people could make particular decisions about their care. This meant it could not consistently show that decisions made for people were in their best interests and least restrictive.
“We found the provider was not always meeting the requirements of the MCA.” from the report
Overdue staff training
needs fixingSome refresher training was not completed on time, including safeguarding adults, catheter care and autism training. The provider said it was working to bring training up to date.
“We reviewed the provider's training data and found a number of staff required refresher training in various subjects.” from the report
Overdue supervision
needs fixingSome care workers had not had supervision for about five months, despite the expected interval being every three to four months. The manager said this was being addressed.
“We reviewed the provider's supervision data and found some care workers had not received a supervision for approximately five months, when they were required to complete these every three to four months.” from the report
No completed quality audits
seriousThe provider was not completing audits of areas such as care planning, safeguarding, risk assessments and restraint. This meant some risks might not be identified promptly and led to a breach of Regulation 17.
“Although we found no evidence of issues that caused harm within the service, the absence of completed audits meant there were areas of risk that had not yet been identified.” from the report
- 01How are mental capacity assessments and best-interests decisions now completed and recorded?
- 02Are all staff's refresher courses, including safeguarding, catheter care and autism training, now up to date?
- 03How often does each care worker receive supervision, and how is this checked?
- 04What quality audits are now completed for care planning, safeguarding, risk assessments and restraint?
- 05How will you decide whether there are enough trained staff before accepting a respite admission?
This was an unannounced planned inspection covering all five CQC questions; nobody was using the home during the visit, so inspectors also used records, staff discussions and relatives' feedback. This explanation was written from the published report of 12 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 Orient St Adult Respite Unit
4 rated inspections over 6 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Orient St Adult Respite Unit →
- December 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Orient St Adult Respite Unit →
- September 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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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