The Orchards

Updated 18 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The Orchards is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Inspection site visit activity started and ended on 1 February 2018 and ended on 5 February 2018 and was unannounced. The inspection team consisted of one inspector, one nurse specialist advisor and an expert by experience who had experience of residential care settings. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed the information we held about the home and looked at the notifications they had sent us. Statutory notifications include information about important events which the provider is required to send us by law. The inspection considered information that was shared from the local authority and Clinical Commissioning Group (CCG) who are responsible for commissioning care.

During the inspection, we spoke with eight people who lived at the home and three visiting friends and relatives. We also spoke with six care staff, two nurses, the deputy manager, the home manager and a manager who had previously worked at the home.

We reviewed the risk assessments and plans of care for five people and looked at22 medicine records. We also looked at 16 provider audits for reviewing people’s care, the home environment and maintenance checks, Deprivation of Liberty authorisations, complaints records, an overview of the last two months incident and accident audits, the home improvement plan, staff meeting minutes and ‘residents’ meeting minutes.

Updated 18 April 2018

We carried out an unannounced comprehensive inspection of this service on 1 and 5 February 2018.

The Orchards is a home for people who receive accommodation and nursing care. A maximum of 72 people can live at the home. There were 55 people living at home on the day of the inspection. At the last inspection in November 2017, the service was rated Requires Improvement. This was because the provider had failed to ensure systems and processes were place to assess, monitor and mitigate risk to people living in the home. The provider had a condition placed on their registration to provide a monthly review to demonstrate how they were working towards making the required improvements. This was to ensure people living at the home remained safe while improvements were made. At this inspection we found the service had improved and was now Good overall.

People living in the home told us that staff assistance maintained their safety and made the home safe. People were able to minimise the risk to their safety and were supported by staff offering guidance or care that reduced those risks. Nursing and care staff understood their responsibilities in reporting any suspected risk of abuse and the expected action that would be taken. Staff were available for people who had their care needs met in a timely way. People’s medicines were managed and administered for them by the nursing staff in safe way to support their health needs.

Staff were knowledgeable about people’s support needs. Staff told us the training they received and guidance from managers maintained their skill and knowledge. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had a choice of where they ate their meals, and people enjoyed the food on offer. Where people needed support to eat and drink enough to keep them healthy, staff provided one to one assistance. People had access to other healthcare professionals from the point of admission and ongoing review which provided treatment, advice and guidance to support their health needs.

People were seen chatting and spending time with staff. Relatives we spoke with told us staff were kind and friendly. Staff told us they took time to get to know people and their families. Staff supported people, some of whom were on short visits to the home. People’s privacy and dignity was supported by staff when they needed personal care or assistance. People’s daily preferences were known by staff and those choices and decisions were respected. Staff promoted people’s independence and encouraged people to be involved in their care and support.

People’s care needs had been planned, with their relatives involvement where agreed, which had been recorded in care plans and had been reviewed and updated regularly. People also told us they enjoyed the social aspect of the home and the activities offered which had improved since our last inspection.

People and relatives knew how to make a complaint if needed. People also told us they would talk with staff if they had a question or concern. The provider had policies and processes in place to ensure that any complaints received were investigated and responded to.

Since the last inspection the manager had developed the existing quality assurance systems and people had the opportunity to state their views and opinions with surveys and meetings. Audits had been fully implemented to identify and record the required ongoing improvements. However, a registered manager will need to be in post and the provider to demonstrate consistent and sustainable good practice overtime.