CQC report explained · a residential care home
What the CQC found at Quorn Orchards Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found incomplete records about skin damage, limited evacuation guidance, unlocked doors to high-risk areas, cleanliness problems, a risk of cross-infection and unsafe storage of some prescribed creams. They also found enough staff and safe medicines administration.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Audits and checks had not identified all the problems, and improvements to records and the environment were not yet consistent or lasting. People, relatives and staff nevertheless described the manager as supportive and approachable.
What inspectors found, July 2022
Quorn Orchards Care Home is rated Requires Improvement; inspectors found kind care and enough staff, but safety records, premises and management checks needed improvement.
This was an unannounced focused inspection on 24 May 2022. Two inspectors reviewed Safe and Well-led, spoke with people, staff and relatives, observed care, and checked records, medicines, staffing and safety documents.
The home had enough staff and people were treated kindly. Medicines were given safely, people were protected from abuse, and staff understood people's needs. However, records about skin damage were incomplete, some high-risk doors were left unlocked, and some areas were not clean or well organised.
Medicines were not always stored safely. The home's checks did not find all these problems, and improvements were not yet lasting. Safe and Well-led were both rated Requires Improvement, changing the overall rating from Good at the previous inspection in 2019.
Enough staff
Inspectors saw enough staff to meet people's needs without rushing. Staffing was based on the needs of the people living there.
“There were enough staff to meet people's needs. We observed staff had time to spend with people and provided care and support without rushing.” from the report
Kind and attentive care
Staff knew people well and were consistently kind and attentive during the inspection. People and relatives said they felt safe and well cared for.
“We observed consistently caring and attentive interactions between people and staff throughout our inspection visit and staff demonstrated they knew people well.” from the report
Safe medicines administration
Inspectors observed a medicines round and found that staff consulted people and gave medicines safely. Staff had medicines training and regular competency checks.
“Staff consulted with people about their medicines and administered them safely and in their preferred way.” from the report
People and relatives could share views
People could raise views in meetings and discussions. Relatives said they could speak directly with the manager and take part in care meetings.
“Relatives confirmed they could share their views directly with the registered manager who took these on board.” from the report
Incomplete skin-care records
seriousRecords did not always describe skin damage, wounds or their progress. This meant staff and managers did not have a reliable record of people's risks.
“Accurate and up to date records were not always kept in relation to people's skin integrity.” from the report
Unsafe areas and cleanliness
seriousDoors to high-risk rooms were left unlocked while work was under way. Inspectors also found mould, grime, a rusty support frame, food remains and clutter that affected access.
“At this inspection we found some internal doors to high risk areas had been left unlocked.” from the report
Infection-control risk
seriousThe same toileting sling was used for two people, creating a risk of cross-infection. The infection-control policy also needed updating.
“We observed staff using a toileting sling for one person, then using the same sling to support a second person to go to the toilet.” from the report
Creams not always stored safely
seriousSome prescribed creams containing flammable substances were left exposed, including one left on top of a radiator.
“Further improvements were needed to ensure safe storage of people's prescribed creams in line with best practice.” from the report
Management checks missed problems
needs fixingAudits and checks had not found all the concerns. The home had started improvement work, but inspectors could not see that changes were lasting.
“The registered manager completed a variety of audits and checks and these were used to drive improvements. However, the impact of these improvements, and evidence to support these were sustainable, was not evident at the time of our inspection.” from the report
- 01How have you improved records for skin damage, wounds and changes in people's skin?
- 02How do you now check that prescribed creams, especially flammable creams, are stored safely?
- 03What changes have been made to cleaning, clutter and infection-control practice, including the use of toileting slings?
- 04How do you make sure high-risk doors and fire arrangements remain safe while building or repair work is taking place?
- 05What evidence can you show that your audits now identify problems and that improvements are lasting?
This was a focused inspection of Safe and Well-led only; the other key-question ratings from the previous comprehensive inspection were carried forward into the overall rating. This explanation was written from the published report of 28 July 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, October 2019
Rated Good; inspectors found safe, kind care and improvements since the previous inspection, but activity provision needed strengthening.
The inspection was unannounced and took place on 30 September and 1 October 2019. One inspector and an Expert by Experience spoke with seven people, three relatives and nine staff. They also reviewed care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were safe, treated with kindness and supported by staff who knew them well. They also found that risks, medicines, infection control, staffing and care planning were managed well.
The home had improved from Requires Improvement at the previous inspection, when there were multiple breaches of regulation. At this inspection, the provider was no longer in breach. Inspectors noted that activities had been limited at first, but action was taken during the inspection to provide activities five days a week.
Kind, personal care
Staff knew people well and showed patience, warmth and compassion. People were involved in decisions about their care and daily lives.
“People were safe and well cared for. Staff provided support with empathy and compassion and knew people well.” from the report
Improved safety
The home had addressed earlier safety concerns. Risks were assessed and monitored, there were enough staff, and medicines and infection control were managed safely.
“The assessment and monitoring of risk promoted people's safety.” from the report
Good food and health support
Staff understood people's dietary needs and followed healthcare guidance. People's weights and health needs were monitored.
“People's nutritional needs were met, and their preferences considered.” from the report
Active management
The manager was visible, listened to concerns and introduced audits to identify and address shortfalls.
“There were robust systems in place to monitor the quality of the service.” from the report
Activities were initially limited
needs fixingPeople had little opportunity for activities during the day because of how activity staff were deployed. The home acted during the inspection and arranged activities five days a week.
“People had little opportunity for occupation or activity during the day with the current deployment of activity staff.” from the report
As-needed medicines records
needs fixingAn audit found that the reason for giving some as-needed medicines was not always recorded. The home introduced an extra check, and inspectors confirmed this was in place during the inspection.
“A recent audit had identified the reason for administering 'as and when required medication' was not always documented.” from the report
- 01How has the activities programme continued since the inspection, and how are people's individual interests included?
- 02How do you check that the reason for giving as-needed medicines is recorded every time?
- 03What further changes have been made to the home's décor and furnishings?
- 04How are relatives involved in reviewing care plans and discussing changes in health?
- 05How often are staff training, competency checks and supervision completed?
This was a planned inspection based on the previous rating, covering all five CQC questions and checking whether earlier improvements had been made. This explanation was written from the published report of 31 October 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 Quorn Orchards Care Home
5 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- July 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2019Requires improvementdown from GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 14 May 2012.
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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