CQC report explained · a residential care home
What the CQC found at The Orchard
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough suitably skilled staff, safe recruitment, safe medicines management, good infection control and systems for learning from incidents.
- Effective?
- Good
- Staff supported people with nutrition, specialist feeding needs, healthcare and activities. Staff were trained and supported, and the home followed the Mental Capacity Act and relevant DoLS arrangements.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People and relatives were involved in care decisions, with staff using different ways to understand people's wishes and reactions.
- Responsive?
- Good
- Care plans were person-centred and activities reflected people's interests. Staff understood individual communication needs, involved families and had arrangements for complaints and end of life care.
- Well-led?
- Good
- Management responsibilities were clear and records were described as up to date. The management team used audits, feedback and incident reviews to monitor and improve care.
What inspectors found, October 2019
The Orchard rated Good; inspectors found safe, kind and person-centred care, with well-led arrangements improved since the previous inspection.
This was a planned inspection on 19 September 2019. The inspector spoke with people living at the home, relatives and staff. Five people were away on holiday, so the inspector met them at their holiday destination. Records, medicines, staff training, audits and the building were also checked.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines systems, suitable support with health and nutrition, and care that respected people's choices, dignity and communication needs.
The home supported people with activities, holidays, healthcare and end of life care. The report says the home used positive behaviour support and no restraint, seclusion or segregation. The overall rating was unchanged from the previous inspection, while the Well-led rating improved from Requires Improvement to Good.
Communication support
Staff understood how people communicated without speech and used this knowledge when planning and delivering care.
“Staff had assessed people's specific communication needs and were familiar with the ways people communicated.” from the report
Choice and independence
The home supported people to make choices, develop skills and take part in activities while reducing unnecessary risks.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Kind and respectful care
Inspectors observed warm interactions and found that staff protected people's privacy, dignity and involvement in decisions.
“Staff were respectful of people's privacy, dignity and independence.” from the report
Activities and inclusion
People could take part in a wide range of social, leisure and community activities, including holidays.
“People were able to join in a range of social and leisure activities including sensory stories, light sessions, cooking, music, swimming, shopping, concerts and shows, gardening days out and holidays.” from the report
Improved management
Management arrangements and records had improved since the previous inspection, with clearer responsibilities and regular checks on quality.
“On this inspection management of the home was good.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and update my relative's individual communication needs if they cannot communicate using speech?
- 02How do you manage PEG feeding, soft or blended diets and any changes in nutritional needs?
- 03What medicine errors have occurred recently, and how do you check that staff remain competent to give medicines safely?
- 04How will you support my relative to take part in activities, holidays and community life that match their interests?
- 05What audits and checks are currently used to identify problems in care records or management arrangements?
This was a planned inspection covering all five CQC questions and both the care provided and the care home premises; five people were away but were met at their holiday destination. This explanation was written from the published report of 22 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.
What inspectors found, March 2017
Rated Good overall; inspectors found safe, kind and personalised care, but management oversight and records required improvement.
Inspectors visited without warning on 31 January and 1 February 2017. They met five people living at the home, spoke with one person, relatives and staff, observed care, and checked care, medicines, consent and management records.
People were found to be safe and supported by enough suitably checked staff. Staff understood people's needs, supported them with medicines, food and healthcare, and respected their choices, privacy and dignity. Care was tailored to people's communication needs, interests and preferences.
The main weakness was how the home was managed during a changeover between managers. Responsibilities were unclear, and some daily checks, care records and medicines information were incomplete or not easy to find. The provider and managers had started taking action during the inspection. The home was rated Good overall, with Well-led rated Requires Improvement.
Kind and respectful care
Inspectors saw warm relationships between staff and people. Staff used appropriate ways to communicate and respected people's privacy, dignity and choices.
“People were supported by staff in a kind and caring way and were involved as much as they were able to in the day to day choices and arrangements.” from the report
Individual communication
Staff understood how people communicated, including people who could not communicate verbally. The home used tailored approaches and support from speech and language therapists.
“There was an emphasis on supporting people to communicate to the best of their ability.” from the report
Safe staffing and medicines
There were enough staff to meet people's needs, and recruitment checks were completed. Medicines were stored safely and given by trained staff who had been assessed as competent.
“We saw there were sufficient numbers of staff deployed to meet people's needs and to keep them safe within the home.” from the report
Meaningful activities and relationships
People were supported to attend college or day opportunities, enjoy activities and maintain important relationships. Their choices helped shape their daily lives.
“People were supported to spend their time how they wanted to.” from the report
Unclear management responsibility
needs fixingDuring the management changeover, staff were not clear about who was responsible for running the home each day. This reduced the registered manager's oversight, although inspectors said it had not affected people or staff.
“We found staff were not clear on who was responsible for the day to day management of the home.” from the report
Incomplete daily checks
needs fixingDaily records did not always show that health and safety, medicines and petty cash checks had been completed. The provider had identified some of these issues and action had begun.
“During our visit we found that daily records were not always completed by staff.” from the report
Care information not always available
needs fixingSome care records were not available, up to date or complete. One person had very little information about their care needs and risks at the home, although staff knew how to support them safely.
“We also found care records were not always available, up to date or complete.” from the report
Missing medicines information
needs fixingInformation about some people's as-required medicines was missing from their medicines folders. Inspectors were told the information was being updated at head office, and staff knew what medicines people needed.
“People's health programmes, which contained information on people's 'as required' medicine, were missing from their medicines folder.” from the report
- 01Who is currently responsible for the home's day-to-day management, and how are staff told about their responsibilities?
- 02How do you check that daily health and safety, medicines and petty cash records are completed?
- 03Are each person's care records and risk assessments now complete and available at the home?
- 04How are as-required medicines recorded and kept available for staff?
- 05How will you make sure a suitably trained staff member is available when someone needs oxygen support?
This was an unannounced inspection of the overall service, covering all five CQC questions and providing an overall rating. This explanation was written from the published report of 25 March 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 The Orchard
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015
Registered with the Care Quality Commission on 12 August 2015.
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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