CQC report explained · a residential care home
What the CQC found at Orsett House Retirement Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Risk assessments, medicines management, building checks and incident records had improved, although staff were sometimes busy with tasks and did not always have time to sit and chat.
- Effective?
- Good
- People's needs were assessed and reviewed, staff had appropriate training, and people received suitable food, drinks and healthcare support. Mental capacity assessments and applications for restrictions had been handled appropriately.
- Caring?
- Good
- People and relatives spoke positively about staff's kindness and attitude. Inspectors saw people being treated patiently, with dignity, privacy and support for independence.
- Responsive?
- Good
- Care plans reflected people's preferences and were updated when needs changed. People had choices about daily life, activities and food, and concerns were dealt with promptly.
- Well-led?
- Good
- The manager was visible and approachable, and staff felt able to raise concerns. Audits and other checks were more effective than at the previous inspection.
What inspectors found, March 2019
Rated Good; inspectors found kind, safe and personalised care, with some unpleasant odours and limited time for staff to chat.
This was an unannounced inspection on 12 February 2019. Inspectors spoke with six people, six relatives, staff and visiting professionals. They reviewed care records, medicines records, staff recruitment files and the home's checks and audits.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives gave consistently positive feedback. Inspectors found enough staff, safer medicines processes, improved care plans and good support with health needs, food and drinks.
This inspection followed an earlier Requires Improvement rating. The report says improvements to risk assessments, medicines, Mental Capacity Act processes and audits had been completed. No enforcement action was required.
Kind and respectful care
People and relatives spoke highly of the staff. Inspectors saw people being supported patiently and treated with dignity.
“People told us they were treated with kindness and were positive about the staff's caring attitude.” from the report
Personalised support
Care plans included people's preferences, such as clothing, oral care and food choices. Staff updated plans when people's needs changed.
“Care plans were reviewed and amended when peoples' needs changed.” from the report
Safer medicines
Medicines systems had improved since the previous inspection. People received medicines when they should and staff followed clearer processes.
“Medicines systems had improved and were better organised.” from the report
Good healthcare links
Staff made appropriate referrals and worked with a range of healthcare professionals when people's needs changed.
“One visiting healthcare professional told us, "The staff follow our instructions really well and their referrals are very appropriate and detailed.” from the report
Open management
The management team was visible and encouraged staff, people and relatives to share views. Audits were used to identify improvements.
“The management team had created an open culture where concerns could be raised and areas for improvement addressed.” from the report
Unpleasant odours
minorAlthough the home was clean, inspectors noticed unpleasant odours in some areas. The manager said some flooring and furniture would need replacing.
“Although all areas were clean, there were some unpleasant odours in some areas of the home.” from the report
Limited time to chat
minorStaff kept a presence in communal areas, but at some times they were busy with tasks and could not always sit and talk with people.
“However, there were times during the day when staff were busy with carrying out tasks and did not always have time to sit and chat with people.” from the report
- 01What action has been taken to replace the flooring and furniture linked to the unpleasant odours?
- 02How do you make sure staff have enough time to sit and chat with people, as well as complete care tasks?
- 03How are medicines given, recorded and reviewed, including medicines prescribed as needed?
- 04How are care plans updated when a person's needs, diet or preferences change?
- 05How do you involve relatives and people living here in decisions and improvements?
This inspection looked at the premises and care provided, covering all five CQC questions and following up concerns from the previous inspection. This explanation was written from the published report of 9 March 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, November 2017
Orsett House Retirement Home is rated Requires Improvement; inspectors found unsafe medicines and risk management, weak records, and gaps in consent and dignity.
This was an unannounced inspection on 6 September 2017. Inspectors spoke with people living at the home, visitors, health professionals, staff and managers. They observed care, reviewed six care records and checked medicine, staff and management records.
The home was not consistently safe. Medicines were stored safely, but an out-of-date medicine was being used, some as-required medicines lacked proper guidance, and records did not always match stock. Staff did not always follow risk assessments, investigate accidents or keep people protected when incidents happened.
All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. People said staff were kind, felt safe and could make choices, but inspectors found concerns about consent, health monitoring, privacy, meaningful activities, care plans and quality checks. The provider was in breach of Regulations 11, 12 and 17.
People felt safe
People and relatives said they felt safe at the home. Staff understood different types of abuse and knew how to report concerns, although some incidents were not escalated.
“People and their relatives told us they felt safe using the service.” from the report
Kind staff
People, relatives and health professionals described staff as caring and respectful. Staff had developed relationships with people and their families.
“People told us staff were caring and kind.” from the report
Choice and independence
People could choose their meals, where to spend time and how much support they received. Care plans encouraged people to do things independently where possible.
“People were supported to make choices about their care and support and retain their independence.” from the report
Medicines were not always safe
seriousAn out-of-date medicine was being used. Guidance and records for as-required medicines were incomplete, and medicine audits had not found these problems.
“This meant the provider could not be assured peoples medicines were being managed safely.” from the report
Risks and accidents were not managed properly
seriousStaff did not always follow risk assessments. Falls and other incidents were not always investigated, and care plans were not updated to reduce the chance of further harm.
“This meant people remained at risk of future falls.” from the report
Consent and liberty safeguards were incomplete
seriousThere was not always evidence that people had consented to decisions. Capacity assessments and records of best-interest decisions were missing, and some restrictions were not included in DoLS applications.
“This meant people were at risk of having their liberty restricted without the correct safeguards in place.” from the report
Care did not always protect dignity
needs fixingInspectors saw staff use undignified language and provide care without always considering people's feelings. Staff also missed opportunities to engage people.
“This showed people's dignity was not always promoted.” from the report
Care plans and activities were limited
needs fixingSome needs, including diabetes care, were not properly recorded. People sometimes had little interaction or meaningful activity unless staff were carrying out a care task.
“This showed people sometimes had limited opportunities for engaging in meaningful activity.” from the report
Quality checks did not find problems
seriousAudits and care plan reviews did not identify medicines, accident, consent or staffing concerns. There was also no system to decide staffing levels and deployment.
“The systems in place were not effective at identifying concerns.” from the report
- 01What has changed to make sure medicines are in date, as-required medicines have clear guidance, and medicine records match stock?
- 02How are falls, accidents and incidents now investigated, and how are care plans and risk assessments updated afterwards?
- 03How do you record capacity assessments, consent and best-interest decisions, including every restriction covered by a DoLS application?
- 04How do you check that staff use safe moving and handling techniques and follow people's dietary risk assessments?
- 05How many staff are planned for each shift, and how do you make sure people are not left waiting or unable to call for help?
This was an unannounced comprehensive inspection covering all five key questions for the home, with an overall rating and ratings for each question. This explanation was written from the published report of 14 November 2017 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 Orsett House Retirement Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Orsett House Retirement Home →
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Orsett House Retirement Home →
- October 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- August 2013
Registered with the Care Quality Commission on 8 August 2013.
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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