A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions we always ask:
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you would like to see the evidence that supports the summary, please read the full report.
We used a number of different methods to help us understand the experiences of people using the service. We spoke with five people who lived at the home and the relative of another person. We observed staff interactions and care being provided. We also spoke with eight staff and the manager, reviewed five people's care records and looked at other documents relating to the management of the home.
Is the service safe?
There were effective systems in place to reduce the risk and spread of infection. We saw the home looked clean and smelled fresh. The people that lived at Orchard House, and a visiting relative, told us this was always the case. One person said, 'It is clean here, very clean.'
Is the service effective?
People told us that the felt their care needs were met by the staff at the home. They told us that when the need arose, staff supported them to access appropriate health care. We spoke to two health care professionals who have regular contact with the people who live at the home. Both health care professionals gave us positive feedback in relation to the way the staff at the home supported people to access health care. They told that the staff at the home acted on advice they gave in relation to meeting people's health care needs.
We found that records relating to the management of the home were accurate and fit for purpose. However, we found that this was not the case for some people's care records. We looked at the records of people who required their fluid intake to be monitored. Although staff assured us people were receiving sufficient fluids, none of the records we looked at showed this to be the case. In addition we found the record of one person who required their position to be changed at least two hourly to prevent pressure ulcers was incomplete and inaccurate.
Is the service caring?
People told us they were very happy with the care that they, or their family member, received. One person told us the staff 'look to make sure I'm comfortable. They're all nice. They're all good to me, anything I need doing I don't really have to ask.' Another person told us, 'The staff are good. They're just wonderful, smashing.' A relative we spoke with told us the staff were 'caring and sensitive in their approach.' They told us that staff didn't rush people and that they had 'seen a lot of kindness' at the home.
We found that people's care and support needs were assessed and care was planned and delivered in line with each person's individual care plan.
Is the service responsive?
People who used the service and their representatives were asked for their views about the care provided and these were acted on. People told us they felt confident any concerns they raised would be addressed. One person said, 'Any of the carers would help you. They're all very kind here.' A relative told us, 'The carers are fantastic. I have my groans but they always respond. When I've raised things it's tended to be because the carer is not very experienced. They always listen and address things quickly. I know they provided one carer with additional training after I mentioned something.'
Is the service well led?
A registered manager was in post at the service and had been so for several years. There was a comprehensive quality assurance system in place to audit and monitor the quality of the service provided. We saw that various checks were carried out regularly and that action plans were put in place and monitored where deficiencies were found. Staff told us that the manager was approachable and addressed any concerns that were raised.
We found that the provider was compliant with the regulations in four of the five areas we assessed. We have asked them to tell us what action they will take about the area where they were not compliant. If you wish to see the evidence supporting our summary please read the full report.