CQC report explained · a residential care home
What the CQC found at The Orchards
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that staff understood safeguarding, assessed risks and managed medicines safely. They also found enough staff and suitable infection control arrangements.
- Effective?
- Good
- This area was not assessed during this inspection. Its rating carried over from the previous inspection.
- Caring?
- Good
- This area was not assessed during this inspection. The report's overall findings said people received kind and compassionate care and that staff respected privacy and dignity.
- Responsive?
- Good
- This area was not assessed during this inspection. The report's overall findings said staff responded to individual needs and supported people's interests, goals and communication.
- Well-led?
- Good
- Inspectors found effective quality checks, clear staff roles and an open, person-centred culture. People, relatives and staff were involved in developing the service.
What inspectors found, June 2023
The Orchards was rated Good; inspectors found safe, caring support and strong management.
This was a focused inspection on 19 May 2023. One inspector visited the home, spoke with two people, three staff members and four relatives, and contacted other professionals. They also reviewed care, medicine, recruitment and management records.
The home supports up to four men with learning disabilities or other complex needs. Inspectors found that people were protected from abuse, risks were assessed, medicines were managed safely and there were enough staff. Infection control arrangements were also found to be suitable.
People received kind and respectful care. Staff supported choice, independence, activities and personal goals. The home was rated Good for Safe and Well-led.
The ratings for the other three areas were not assessed during this visit. They carried over from the previous comprehensive inspection in 2017, when the service was also rated Good. The overall rating therefore remained Good.
Choice and independence
Staff supported people to make choices, develop skills, pursue interests and take part in activities in the local community.
“Staff supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives.” from the report
Kind and respectful care
Inspectors observed caring and supportive interactions. Staff understood people's individual communication methods and respected their privacy and dignity.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Safe staffing and medicines
There were enough staff to provide one-to-one support and help people with activities. Medicines were administered, recorded and stored safely.
“There were sufficient staff to keep people safe, provide one-to-one support for people and to take part in activities and engage in tasks they wanted.” from the report
Positive management
The home had regular checks and audits, and management used people's views and incidents to improve support.
“The registered manager and provider understood the importance of continuous learning and had effective quality assurance systems in place to monitor care and drive improvement.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and review my relative's individual risks, including risks linked to health, activities and relationships?
- 02What one-to-one support would my relative receive, and how would this be arranged if their needs changed?
- 03How would staff communicate with my relative if they do not use speech or communicate in a usual way?
- 04How are medicines reviewed, including checks that medicines are not being used to control behaviour inappropriately?
- 05How would my relative be involved in choosing activities, meals and goals for their support?
This was a focused inspection of Safe and Well-led; the ratings for Effective, Caring and Responsive carried over from the 2017 comprehensive inspection. This explanation was written from the published report of 3 June 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, November 2017
The Orchards was rated Good; inspectors found safe, kind and personalised care, with a few records and medicines points to keep under review.
Inspectors visited on 25 October 2017 with 24 hours' notice. They spoke with all four people living at the home, staff, the regional manager and two family members. They reviewed care plans, risk assessments, medicine records, staffing files and other records, and looked around the building and grounds.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably recruited staff, well-managed risks, safe medicines support and good healthcare arrangements. People were supported to make choices, build skills and take part in activities they enjoyed.
Staff were described as patient, respectful and knowledgeable about people's needs. The home had systems for complaints, feedback, audits and improvement. Inspectors noted that some support plans had not been fully reviewed recently, and that some prescribed medicines needed clarification from the person's GP.
Kind and respectful staff
Inspectors saw staff being patient, respectful and attentive. People were included in conversations and supported in ways that suited them.
“We saw examples of people being supported and guided with patience and kindness.” from the report
Personalised activities
People chose activities, outings, holidays and work opportunities based on their interests and goals. Inspectors saw people taking part in activities on the inspection day.
“People were supported to follow activities of their choice.” from the report
Good risk management
The home assessed risks linked to health, behaviour, independence and the building. It used these assessments to help people gain skills and have new experiences safely.
“Risks to people's health or well-being were robustly assessed and managed, including risks from the environment or in relation to people's healthcare.” from the report
Strong oversight
Managers and provider teams carried out audits and recorded actions with dates and named responsibility. Feedback from people, families, staff and professionals was used to improve the home.
“The Orchards had clear systems for governance.” from the report
Support for communication
Staff worked to understand how people communicated, including supported communication. One staff member was learning a person's communication method and the person helped teach staff new signs.
“People's communication was understood, and staff worked hard to develop this further.” from the report
Some support plans were overdue for review
needs fixingSome plans had not had a full recent review. The home said its support-planning system and records were due to be replaced, and that the existing plans were still accurate.
“Some plans had not received a full review recently” from the report
Some medicine instructions needed clarification
needs fixingInspectors found that one prescription needed clarification from the GP. They also found medicines prescribed at set times were being given only when requested, so the instructions were referred back for review.
“One person's prescription needed clarification by the prescribing GP and senior staff agreed to request this.” from the report
- 01How often are each person's support plans now fully reviewed, and how are changes recorded?
- 02What was the outcome of the GP review of medicines prescribed at set times but given only when needed?
- 03How is the decision to have one waking staff member overnight kept under review if people's needs change?
- 04How will staff learn and maintain the communication methods used by each person?
- 05How are families updated about what people are doing and about actions taken after their feedback?
This was a comprehensive inspection covering all five CQC questions, including all four people's support plans, records, staffing, medicines and the building. This explanation was written from the published report of 22 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 The Orchards
3 rated inspections over 8 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Goodstayed GoodSafe: GoodWell-led: Good
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Registered with the Care Quality Commission on 14 April 2014.
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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28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.