Background to this inspection
Updated
21 May 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Orchard House Nursing Home provides accommodation with personal care and nursing for up to 31 adults. People who lived at the home had varied needs associated with old age and frailty, some people were living with dementia. People in care or nursing homes receive accommodation and personal care. CQC regulates both the premises and the care provided and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced.
What we did:
Before the inspection: We reviewed information available to us about this service. We checked the information that we held about the service and the service provider. This included previous inspection reports, the provider’s annual information return and statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events, which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.
During the inspection we looked at:
• Two staff files and one agency profile
• Two people’s care records and medicine records
• Audits, checks and studies outcomes
• People and visitors survey outcomes
• Records of accidents and incidents
• Other documents relating to the management of the service.
During the inspection we spoke to:
• Five members of staff (activities coordinator, one carer, one care lead, the chef and the Registered Manager)
• Three people
• Four relatives and a visitor
After the inspection;
We received feedback by email from a tissue viability nurse, a dietitian and a pharmacist. These health professionals gave us permission to quote them in this report.
Updated
21 May 2019
About the service: Orchard House Nursing Home provides residential and nursing care for up to 31 older adults who may have dementia and/or other health conditions. At the time of our inspection 31 people were living at the home.
Accommodation was provided over two floors and communal areas, including a conservatory, lounge, dining room, and a sensory room. People either had their own room or shared with another person. People had access to gardens at the rear of the home.
People’s experience of using this service:
People we spoke to were positive about the service. We saw friendly interactions between people and staff.
Staff treated people with respect, patience and kindness. There were sufficient staff to meet people’s needs, to give the support they needed and to spend quality time with them.
Orchard House Nursing Home is a founding member of the Namaste programme. The programme was developed for people living with dementia and anxiety. It is a sensory activity programme designed to promote wellbeing particularly for people who do not respond to structured activities.
People had access to a range of healthcare professionals and services.
External health professionals gave us positive feedback about the service, for example a pharmacist told us, “Orchard House are definitely one of the most organised, friendly, caring and resident knowledgeable homes we deal with. Whenever, I have been in the home, the staff have had a great mannerism with me, each other and most importantly the residents. I would be happy to have my mum looked after in this home. The residents always come first.”
People were supported to have maximum 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 were supported by staff whose suitability was checked through a robust recruitment process. People’s medicines were managed safely.
Care plans guided staff about people’s needs and how to meet them. Staff supported people to be involved in decisions about their care. People were supported to stay at Orchard House Nursing Home until the end of their lives.
People’s needs were fully assessed, before they came to live at the home, to ensure that staff could meet their needs appropriately. Staff completed relevant training to meet people’s needs and were supported to do additional training. Staff told us they felt supported, received regular supervisions and an annual appraisal.
Staff knew how to keep people safe in an emergency, such as a fire. People were supported by staff who were trained to recognise the signs of any potential abuse. Staff had been trained in safeguarding and knew what action to take if they had any concerns about people’s safety or welfare.
People’s risks were identified and assessed appropriately.
Arrangements were in place to assess and monitor the quality of the service, so that improvements could be made.
This service met the characteristics of Good. More information is in the ‘Detailed Findings’ below.
Rating at the last inspection: Good. The last inspection report was published on 24 November 2015.
Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care services.
Follow up: We will review the service in line with our methodology for 'Good' services.