28 June 2023
During an inspection looking at part of the service
About the service
The Old Orchard is a residential care home registered to provide personal and nursing care for up to 5 people. The service provides support to people who have learning disabilities and/or autistic people. Nursing care was not being provided at this care home. At the time of our inspection there were 5 people using the service.
People’s experience of using this service and what we found
Right Support
Not enough staff were deployed to meet people’s assessed needs for 1:1 support or to support people to follow their interests and take part in activities outside of the care home. The service gave people care and support in a safe, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community.
People were not always supported to have maximum choice and control of their lives. Limitations in staffing levels prevented that. Within the care home, staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care
People’s care plans did not always accurately reflect their specific care needs in respect of modified diets, which were important to mitigate people’s risks of choking on food. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right Culture
The provider had not taken action to ensure people received the level of staff support they were assessed as requiring. Staff knew and understood people well, and wanted to enable people to live their life as they wished, but were limited by the provider’s staffing levels. The provider’s management arrangements also limited the registered manager’s ability to progress the improvements to the service which the provider had identified as being necessary. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 5 July 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Old Orchard on our website at www.cqc.org.uk.
Enforcement
We have identified breaches of regulations in relation to staffing levels, person-centred care, and the provider’s quality monitoring processes at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.