CQC report explained · a nursing home
What the CQC found at The Orchards
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff understood how to identify and report abuse. Risks such as falls, choking and pressure damage were assessed and managed, medicines were given safely, and staffing levels were judged adequate.
- Effective?
- Good
- This question was not inspected during this focused visit, so no rating was given in this report.
- Caring?
- Good
- This question was not inspected during this focused visit, so no rating was given in this report.
- Responsive?
- Outstanding
- Care was highly personalised. Staff knew people's preferences well, supported individual routines and interests, involved families, provided varied activities and gave kind end of life care.
- Well-led?
- Good
- Leaders promoted an open, inclusive culture and used audits, feedback, complaints and incidents to improve care. Staff felt supported and quality monitoring was part of the home's daily running.
What inspectors found, December 2022
The Orchards: Rated Good; inspectors found safe, well-led and exceptionally responsive care.
This was an unannounced focused inspection on 3 and 8 November 2022. Two inspectors spoke with people living at the home, relatives and staff. They observed care and activities and checked care plans, recruitment records, audits and safety records.
The home was rated Good overall. Safe and well-led were rated Good. Responsive was rated Outstanding, which means inspectors found care was exceptionally tailored to people's needs, choices and interests. People were described as safe, well supported and treated as individuals.
The inspection was prompted by concerns about how risk was managed. Inspectors found no evidence that people were at risk of harm from this concern. A historical concern about an undignified practice was investigated, apologies were given and steps were taken to prevent it happening again.
Effective and caring were not inspected during this visit. Their ratings were not given in this report and were not used for the new inspection findings. The overall Good rating stayed the same as at the previous inspection, published on 7 April 2018.
Personalised care
Staff knew people very well and supported their routines, choices, hobbies and changing needs. People were not expected to fit around a fixed home routine.
“Care plans contained information about routines that were important to the person.” from the report
Activities and relationships
People had access to group and individual activities, family events and links with the local community. Staff made creative efforts to provide enjoyment and reduce isolation.
“Staff went the extra mile to create 'Golden moments' for people.” from the report
End of life care
Staff had relevant training and worked with the local hospice. People's wishes were recorded, families were supported and nurses were available to provide comfort and pain relief.
“People could be confident that at the end of their lives they would receive kind and compassionate care.” from the report
Safety and medicines
People felt safe, risks were reviewed and medicines were administered by trained staff whose competence had been checked. Call bells were usually answered within the five-minute target.
“People received their medicines safely from trained nurses and senior staff.” from the report
Leadership and improvement
The provider used feedback, audits, complaints and incidents to make changes. Staff described strong support and a positive working culture.
“Quality monitoring systems were fully embedded into the day to day running of the home.” from the report
Historical undignified practice
needs fixingA concern was raised during the inspection about a practice considered undignified. It was found to be historical, but the home investigated it, apologised and introduced measures to stop it happening again.
“A concern was raised with us on the first day of inspection about a practice that was felt to be undignified.” from the report
- 01What specific changes were made after the historical practice was found to be undignified?
- 02How will you assess and manage my relative's particular risks, such as falls, choking or pressure damage?
- 03How will you support my relative to continue their usual routines, interests and hobbies?
- 04How are families involved in decisions about care and kept informed about changes?
- 05What support and medicines would be available if my relative needed end of life care?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected during this visit, and the overall rating used the previous ratings for questions not inspected. This explanation was written from the published report of 21 December 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, April 2018
Rated Good; inspectors found safe, kind and personalised care, with some management processes still being improved.
This was an unannounced inspection on 12 and 13 March 2018. Inspectors spoke with people living at the home, relatives, staff and health professionals. They also observed care, checked the building and reviewed care plans, medicines, staff files, complaints, incidents and management records.
The home provides nursing care for up to 44 older people. There were 32 people living there during the inspection. Inspectors found people were safe, treated with kindness and given care that reflected their wishes. Staffing, medicines, cleanliness, food, healthcare and activities were all judged good.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The overall rating stayed Good from the previous inspection. The home had improved its leadership since 2015, when it was not always well-led.
People felt safe
People told inspectors they felt safe. Call bells were available and staff responded promptly when people used them.
“People had a call bell in their room. Staff responded promptly when people rang it.” from the report
Kind and respectful care
Inspectors saw a friendly and relaxed atmosphere. Staff showed empathy and supported people's independence and communication.
“Staff treated people with kindness, respect and compassion. The atmosphere was friendly and relaxed.” from the report
Personalised care plans
Care plans included people's wishes, routines, safety needs and personal information. Families and other people important to the person were included in reviews.
“Care plans were well organised, information was easy to find and they contained in-depth information relevant to the person.” from the report
Good activities and relationships
People were supported to take part in activities that suited their interests. The home also helped people keep in touch with family and practise their faith.
“Staff supported people to enjoy an active lifestyle according to their preferences.” from the report
Improved leadership
The report says leadership had improved since the previous inspection. Managers were visible, approachable and used audits and feedback to improve the home.
“At this inspection, we found the service had improved.” from the report
Learning from incidents
needs fixingStaff did not always receive information about the outcome of incidents unless they were involved in the investigation. The manager said a regular meeting would be introduced to share learning.
“Staff said they only received the outcome of an incident if they are involved in the investigation, which meant not all staff received learning from some of the incidents that occurred.” from the report
Staff supervision
needs fixingStaff said they had not received regular formal supervision during the previous year. The home had started a plan to improve supervision and appraisal arrangements.
“Staff told us they had not received regular supervision within the last 12 months but they felt supported in their role.” from the report
Contingency plan review
minorThe home's contingency plan covered several disruptions but did not have a review date. Families may wish to ask how often this is now checked.
“The plan did not have a review date but did include loss of bedrooms or accommodation plans, gas supply disruption, electricity supply disruption and a communication strategy.” from the report
- 01How do you now make sure all staff learn from accidents, incidents and safeguarding concerns?
- 02How often does each member of staff receive formal supervision and an appraisal?
- 03Has the contingency plan been given a review date, and when was it last checked?
- 04How will my relative and our family be involved in creating and reviewing their care plan?
- 05How would you support my relative's preferred activities, relationships, faith and end-of-life wishes?
This was an unannounced inspection of the overall service and all five CQC questions, including the building, care, medicines, staff records and management systems. This explanation was written from the published report of 7 April 2018 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 7 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- April 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 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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76 live-in carers within about two hours of Somerset
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Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
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