CQC report explained · a residential care home
What the CQC found at The Orchards Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2022
Rated Good overall; inspectors found safe care and good leadership, with staffing concerns checked and medicines managed safely.
This was an unannounced targeted inspection on 24 March 2022. Inspectors looked at concerns about staffing, recruitment, staff knowledge of people's needs and management. They spoke with people, staff, relatives and health professionals, and checked care records, medicines records, recruitment files and management audits.
The home was rated Good for Safe and Well-led. Inspectors found enough staff in place, safe recruitment checks, suitable risk assessments and safe medicines procedures. Staff understood safeguarding and people's needs. Infection control arrangements were also found to be effective.
The overall rating stayed Good. The previous inspection in 2019 had rated Safe as Requires Improvement, so this rating improved to Good. The inspection did not reassess Effective, Caring or Responsive, so their previous ratings were carried forward.
Safe medicines
People received their medicines as prescribed. Records, storage and staff training were found to be safe.
“Medicines were managed safely, and people received their medicines as prescribed.” from the report
Risk management
Staff knew people's needs and followed risk plans covering areas such as nutrition, choking and pressure care.
“Staff regularly assessed risks associated with people's care and well-being and took appropriate action to ensure these risks were managed and that people were safe.” from the report
Recruitment checks
The provider used appropriate recruitment checks, including Disclosure and Barring Service checks, to help prevent unsuitable staff being employed.
“Appropriate recruitment checks were carried out as standard practice including Disclosure and Barring Service (DBS) checks.” from the report
Supportive leadership
The manager had been in post for four years and had created a clear management and staffing structure. Staff said they felt supported and understood their responsibilities.
“Staff understood their roles and responsibilities, were motivated, and had confidence in the management team.” from the report
Using feedback
People and relatives could give feedback through surveys, suggestion boxes and care reviews. The home used this feedback to make changes.
“The service involved people, their families and friends in a meaningful way.” from the report
Short-notice staff absences
minorPlanned staffing levels were often met, but there were exceptions when staff were absent at short notice. The manager was actively recruiting and said the home was then fully staffed.
“planned staffing levels were often met apart from when there were short notice staff absences.” from the report
Delays to environmental changes
needs fixingSome environmental improvements took longer than necessary because approval of different quotes was delayed by the provider.
“approvals for environmental changes took longer than necessary pending approval of different quotes for the work required.” from the report
Disrupted professional visits
minorDuring the pandemic, some professionals stopped visiting, which disrupted people's care. The report says this was beginning to improve.
“The home had faced challenges during the pandemic when some professionals had stopped visiting the home resulting in disruption of people's care.” from the report
- 01How do you cover shifts when there are short-notice staff absences?
- 02What staff skills and qualifications are now available for the people living here?
- 03Which environmental improvements were delayed, and have they now been completed?
- 04How do you make sure visits and input from health and social care professionals continue when there are disruptions?
- 05What were the previous concerns about medicines and staffing, and how are the improvements being maintained?
This was a targeted inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 26 April 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, September 2019
The Orchards Residential Home is rated Good overall, but inspectors found medicines were not always managed safely.
This was an unannounced inspection on 11 and 18 September 2019. Inspectors spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, medicine records, recruitment files and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement because some medicines records and instructions were not complete. The manager took action during the inspection and said the identified issues had been addressed.
Inspectors found enough staff, clean surroundings, suitable risk assessments and good infection control. People described kind and respectful care. They also found personalised care plans, enjoyable activities, good support with food and access to health professionals.
The previous overall rating was Requires Improvement, published on 13 September 2019. Effective, Responsive and Well-led improved to Good. Caring stayed Good, while Safe remained Requires Improvement.
Kind and respectful care
People described staff as kind and compassionate. Inspectors saw staff supporting people with dignity and encouraging independence.
“People told us staff were kind, caring and compassionate.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Call bells were answered promptly and staff responded in good time.
“Throughout the inspection we saw staff responded to people's needs in a timely manner. Call bells were answered promptly.” from the report
Personalised support
Care plans included people's histories, likes, dislikes and communication needs. Staff knew people well and adapted support when needs changed.
“Care plans were person-centred and include information about people's histories, likes and dislikes.” from the report
Activities and social life
People had a wide choice of activities, including arts and crafts, ball games and musical entertainment. Relatives were welcomed and supported to maintain relationships.
“People had access to a wide range of activities.” from the report
Improving leadership
Inspectors found effective checks and action plans to improve the home. The report says there had been significant improvements since the previous inspection.
“There had been significant improvements in the service and feedback showed the improvements had been driven by the management team.” from the report
Medicine instructions were incomplete
seriousSome as-required medicines did not have protocols explaining when staff should give them. Some topical medicines did not have guidance about where and when to apply them.
“Where people were prescribed 'as required' medicines there was not always protocols in place to guide staff when the medicines were required.” from the report
Medicine records were not always complete
seriousMedicine administration records were not always fully completed. Inspectors said medicine balances showed people had received their medicines, but the recording shortfall reduced assurance about safe medicines management.
“Medicine administration records (MAR) were not always fully completed. However, balances of medicines showed people had received their medicines.” from the report
End of life plans were still being developed
needs fixingNo one was receiving end of life care during the inspection. Advance care planning documents were still being completed with people and their families.
“The service was in the process of completing, 'Advance care planning' documents with people and their families.” from the report
- 01What changes were made to the medicines system after the inspection, and how do you check that these changes are still being followed?
- 02How do you make sure there are clear instructions for every as-required and topical medicine?
- 03How do you check that medicine administration records are completed accurately every time?
- 04How will you involve my relative and our family in completing advance care planning documents?
- 05How are care plans reviewed when a person's needs or risks change?
This was an unannounced planned inspection covering all five key questions, the premises and the care provided; the previous rating for Safe remained Requires Improvement while other areas improved or stayed the same. This explanation was written from the published report of 26 September 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 The Orchards Residential Home
7 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- April 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Orchards Residential Home →
- September 2019Goodup from Requires improvementSafe: Requires improvementWell-led: Good
Read what inspectors found at The Orchards Residential Home →
- September 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2018Inadequatestayed InadequateSafe: Inadequate
- July 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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44 live-in carers within about an hour of Swindon
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 £990 to £1,280 a week. 34 can care for a couple. 12 years' experience on average.
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“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.