The Orchard Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed all quality statements in the safe key question. Safety risks to people were not always managed well. This is because care plan documentation did not provide enough guidance on how to support people safely. While documentation needed improvement, staff knew people well. People were supported to raise concerns when they didn’t feel safe. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk. The environment was managed safely. The management team had made improvements to water temperature. There were processes to ensure legionella bacteria did not build up in the water system. This protected people from getting legionnaires disease. Medicines were managed safely. People received medicines when prescribed, and staff had guidance on how to provide these medicines. There were enough staff to support people with their needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet the range of people’s needs at the service. Managers made sure recruitment checks were undertaken on all staff to ensure only those individuals that were deemed suitable and fit, would be employed to support people at the service.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were unable to explain how the learning culture effected their experience in the care home. However, due to effective processes and good staff knowledge, we assessed that people had a positive experience.

Staff told us that they had regular reflective supervision sessions to review what was working well, and what could be improved at the service.

When incidents happened, staff took time to document what happened and learn from it. This meant incidents were less likely to reoccur. There were clear processes to review incidents and then make improvements. There were handover processes, to ensure staff were kept up to date on incidents that had occurred. Staff were provided with the opportunity to reflect after incidents, to ensure learning and improvement could occur. Staff meetings allowed staff to reflect on what was working well, and what could be improved at the service.

People were unable to explain how systems between health and social care systems affected them. However, documentation and feedback from staff showed that people had good quality transitions between the care home and other health and social care services.

Managers and staff had good knowledge of which health and social care professionals supported which people. Staff were able to explain when these professionals visited, and what type of support they offered.

Partners had no specific feedback on this area.

People’s health needs were not always clearly recorded in care plans. For example a person was prone to episodes of ill health and had regular reviews with a health professional. There was a lack of detail on how often the person was likely to show episodes of ill health, and when professional advice should be sought. However, this lack of written documentation had not impacted people receiving the care they required. It had also not impacted staff’s good knowledge of people’s health needs.

People were able to answer ‘yes’ to whether they felt safe in the care home. They were not able to further expand on these answers. It was therefore not clear they understood the details of this question, however we observed positive interactions between people and staff and concluded that people had a positive experience.

Staff understood how to respond to allegations of abuse. Staff told us that they had no concerns. If they did, they were confident the management team would act appropriately. Staff were confident in using whistleblowing processes if they felt concerns were not being responded to. The management team understood how to respond to allegations of abuse. They had a clear process of how to investigate and keep people safe.

There was an open culture of communication and we saw no evidence that people were at risk or fearful of the staff team. We saw people and staff had positive relationships.

If an allegation of abuse was made, there were appropriate policies in place to guide the staff team. Records showed that any allegations were quickly investigated and referred to the local authority safeguarding team to investigate if needed.

People were unable to answer our questions about management of risk. However, staff worked closely with people to plan their care and knew their unique communication styles. This ensured, risks were reduced as much as possible and we were assured people had a positive experience.

Staff understood how to support people’s needs safely. Staff told us examples of how people would be supported to stay safe both in the care home and when they went out of the care home environment.

During the assessment, people were actively engaging in activities outside of the care home. This meant our observations of people’s care was limited. Whilst we did not observe these external activities, we were assured that staff were encouraging people to engage in social activities which they would have found difficult to complete safely without support.

People’s health needs were not clearly documented in their care plans. This meant staff did not have clear written guidance on how to keep people safe. This is an ongoing concern from the last assessment and specific care plan examples given at the last assessment had not been improved upon. It is concerning that more timely action had not been taken to improve care plan guidance for staff. Staff had received training on how to support people.

People experienced a safe environment. The building was safe to walk around and facilities were safe to use. There were plans were in place for an emergency evacuation procedure if needed.

Staff knew how to monitor the safety of the environment, and where to report any maintenance concerns to. Staff knew how to respond in the event of an emergency evacuation. For example, if a fire alarm sounded, staff could explain how people would be supported to move into a safe space. They practiced regular fire evacuation procedures.

We saw the environment in the care home was managed safely.

Staff wrote down when they checked the maintenance of the building (for example, regularly checking the fire alarm systems.) Systems were in place to ensure the water quality was maintained to reduce the risk of water-borne bacteria (like legionella.) Water was restricted to a safe temperature, to reduce the risk of scalding when people were bathing.

People told us there were enough staff. They were unable to give further details on staffing levels. We saw people had a good experience from the amount of staff deployed.

Staff felt there were enough staff to support people. They spoke highly of the training provided to them. They explained how it had supported them to be more effective in their roles. Staff told us that if they had any questions, they could always approach their management team for advice.

While people were in the building, we saw staff were deployed effectively around the building, to provide timely support to people. Some people wanted to leave the care home, and there were sufficient numbers of staff to support people to do this safely.

There were clear management processes to ensure there were enough staff. Staff had received suitable training to do their role. The management team ensured there was always suitably skilled staff working. Safe recruitment processes were followed. For example, previous employers were contacted to give references on the staff member. Staff had also had regular Disclosure and Barring Service (DBS) checks. These check the police database for convictions or warnings that may impact the staff members safety to work with people.

People were unable to tell us whether they felt the home was sufficiently clean. However, we saw people’s bedrooms and communal areas were kept clean. This meant people experienced care in a hygienic environment.

Staff knew what personal protective equipment they should wear and when. Staff knew how to put on and remove this equipment. This protected people from the spread of infection.

The home was clean and hygienic. We saw that staff had access to personal protective equipment (like gloves) throughout the home. This allowed them to support people in a hygienic way. We saw any dirt or spillages in the home were quickly resolved. We saw the kitchen was managed in a hygienic way to ensure food was stored appropriately and people did not get food borne infections.

There were clear processes and policies, to ensure the environment was kept clean and hygienic. For example, cleaning rota’s specified which area of the care home had been cleaned each day. This protected people from the spread of infection.

People were unable to answer questions about their medicines. However, we saw they received good quality support to take their medicine safely.

Staff were able to explain how they supported people to take their medicines safely. Staff explained that their received good quality training on how to support people’s medicine needs. Staff knew who to report medicine concerns to. For example, if they felt a person’s medicine was no longer effective, they understood where to document this, and which health professionals to contact.

Staff kept clear records of when they had given prescribed medicines. We saw medicines were given as prescribed. Staff did regular checks of the amount of medicine in stock. This ensured that suitable stock levels were always in place, and more medicine could be ordered from the pharmacist as needed. Some people required ‘as needed’ medicine and staff had clear written guidance on when and how this should be administered. Staff had received training on how to administer medicines safely. The management team had regularly assessed the staff’s competency, to ensure they were following best practice. Once person required suncream to be applied due to the side effects of their medication however, there were no records to demonstrate this. This was raised at the last inspection and action had not been taken.