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
- People said they felt safe. Inspectors found detailed risk assessments, safe recruitment, suitable staffing, safe medicines systems and regular safety checks.
- Effective?
- Good
- Staff were trained to support complex health needs and worked closely with health professionals. People were supported with nutrition, communication, treatment and independence.
- Caring?
- Good
- Inspectors saw kind and respectful relationships. People were involved in choosing keyworkers and in decisions about their care, while their privacy and dignity were maintained.
- Responsive?
- Good
- Support plans were detailed and personalised. People were helped to communicate, pursue interests, maintain relationships and receive care that matched their wishes, including at the end of life.
- Well-led?
- Outstanding
- Leaders had created a positive, open and inclusive culture. People, relatives, staff and professionals were asked for their views, and the service used feedback and audits to improve.
What inspectors found, October 2019
Rated Good overall, with Outstanding leadership; inspectors found safe, kind and personalised care.
This was an unannounced inspection over three days. The inspector spoke with people, relatives, staff and outside professionals. They observed care and reviewed care plans, medicines records, recruitment files and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. People were supported by staff who knew them well, respected their choices and helped them stay healthy, independent and involved in activities and relationships.
The home was rated Outstanding for Well-led. Inspectors found an open culture where people helped choose staff, gave feedback and influenced improvements. The overall rating stayed Good, while the well-led rating improved from Good at the previous inspection.
Personalised support
Support plans reflected people's individual needs, preferences, communication methods and goals. Staff helped people build skills, make choices and live active lives.
“People's support plans were highly detailed and personalised to support their complex needs.” from the report
Kind relationships
People were supported by staff who knew them well and treated them with warmth, dignity and respect. Inspectors saw genuine enjoyment between people and staff.
“People were supported by staff who wanted the best for them and whose company brought them happiness.” from the report
Complex health needs
The staff team worked closely with specialist and mainstream health professionals. Inspectors found prompt referrals, detailed health guidance and action when people's health changed.
“Referrals to health care professionals were made very promptly, and their advice was acted upon.” from the report
Strong leadership
Inspectors found an open culture with clear values and active improvement work. Staff felt valued, and leaders worked transparently with families and outside agencies.
“The provider and registered manager had created a positive, caring, person-centred culture where innovation was encouraged and fostered.” from the report
Unexpected staff absence
minorOne person said they had sometimes missed activities that mattered to them because of unplanned staff sickness. Ask how the home protects important activities when staffing changes unexpectedly.
“One person identified specific times when they had not attended activities that were important to them, due to unplanned staff sickness.” from the report
Size of one home
minorOne part of the service was larger than current best practice guidance. Inspectors said its layout and design reduced the possible negative impact, but this is still worth discussing for someone who may prefer a smaller setting.
“This is larger than current best practice guidance.” from the report
- 01How would you make sure my relative does not miss important activities if staff are unexpectedly off sick?
- 02How would you support my relative's particular health needs, and which specialist professionals would be involved?
- 03How would my relative communicate choices, refusal, pain or distress, and how would staff respond?
- 04How would my relative be involved in choosing their keyworker and in reviewing their support plan?
- 05How would the size and layout of the service affect my relative's privacy, independence and daily life?
This was an unannounced, planned inspection covering all five CQC questions, the premises and the care provided; all five ratings were assessed, with Well-led improving from Good to Outstanding. This explanation was written from the published report of 4 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, January 2017
Rated Good; inspectors found safe, kind and personalised care, with one medicines error identified and dealt with promptly.
Inspectors made unannounced visits on 5, 8 and 9 December 2016. They spoke with people living in the homes, relatives, care workers and managers. They observed care and reviewed care plans, medicines records and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, personalised care, good support with health and food, meaningful activities, and systems for listening to people's views and improving the service.
One person did not receive one medicine as prescribed on the day of the inspection. Managers acted immediately, checked what should happen, gave the medicine where it was safe to do so, and discussed the cause with staff. The report says the home had met all requirements at the previous inspection in October 2013.
Kind and respectful care
Staff knew people well and treated them with dignity. Inspectors observed warm, friendly and calm interactions.
“Support workers treated people with dignity and kindness. People were supported to make choices.” from the report
Personalised support
Care plans included people's histories, relationships, preferences and health needs. Staff adapted support when people's needs changed.
“People's care and support plans were personalised and included information about what was important to them as individuals.” from the report
Safe staffing and risk support
Inspectors found enough staff and clear risk assessments for health needs, activities and equipment. People were supported to take positive risks and remain independent.
“There were enough support workers to meet the needs of people living at The Orchards and Offa's Dyke.” from the report
Good staff preparation
Staff had access to relevant training, supervision and professional development. Training was adapted when people's needs changed.
“People's needs were met by support workers who had access to the training they needed.” from the report
Activities and community life
People were supported to enjoy activities at home and trips into the community. Staff also helped people maintain personal relationships.
“People were supported with activities and were supported to access the local community.” from the report
One missed medicine
seriousInspectors found that one person had not received one medicine as prescribed. Staff took immediate action and investigated the reason, but this remains an important issue for families to ask about.
“For example, on the day of the inspection the inspector identified an individual error had been made and one person had not received one of their medicines as prescribed.” from the report
- 01What caused the medicines error found during the inspection, and what checks are now in place to prevent another missed dose?
- 02How would you assess and update my relative's care plan and risk assessments if their health or support needs changed?
- 03What activities and community access would be available for my relative, based on their interests and communication needs?
- 04How would my relative be supported to make choices and take positive risks while staying safe?
- 05How would you involve our family and healthcare professionals in decisions about my relative's care?
This was an unannounced comprehensive inspection covering both care homes operated as part of the service and all five key questions; the report's summary gives the visit dates as 2016, while one background section refers to 2015. This explanation was written from the published report of 24 January 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
38 live-in carers within about an hour of Gloucestershire
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 £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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.