The Orchard Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed all quality statements in the well-led key question. Since the last assessment, there were now improved audits in place to oversee the service. However, there had been ineffective governance to ensure care planning and mental capacity documents were improved. We were therefore not assured that there was sufficient auditing in these areas. Staff understood their role and responsibilities. Staff spoke highly of the management team and culture at the service. Staff felt listened to and able to speak up if they had any concerns. People had access to the community and staff knew how to support people in the community. Staff understood people’s diverse needs and the service promoted a culture of equality.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff felt there was a positive culture in the care home, where care was arranged as much as possible around people’s choices.

While staff and leaders spoke of a person-centred approach to care, we found the application of the Mental Capacity Act had not yet improved at the service. This meant documentation did not always clearly describe how people’s freedom and liberty was supported and care plans lacked details. We reported this back to the management team, who began to take steps to improve the documentation at the service.

Staff told us that the leadership team was supportive. A staff member said “The manager is really efficient. If something needs doing, it is done there and then. They are supportive, caring, and only ever a phone call away.”

Staff were supported with regular supervision sessions. These one to one meetings with the management team, helped staff to provide good quality care.

Staff told us that they felt able to speak up if they had any concerns. A staff member said, “There are team meetings that we can talk about any concerns. But they (Managers) are really approachable before or after the meetings too.”

The provider had clear processes in place encouraging staff to speak up about any concerns. Staff had been given information on how to raise complaints, or speak to external professionals if needed.

Staff understood people’s diverse needs. They were able to explain people’s different religious beliefs and how staff would support these individuals.

The service had an equality policy in place. This was followed, to ensure all staff and people using the service were supported equally.

Staff told us that the management team made positive changes to the service. They felt the management team had good oversight to ensure the service was effective.

At the last inspection, we identified that mental capacity assessments and care planning was poor quality. At this assessment, we found the same concerns. Governance audits that were in place for these documents had not been effective. Other than care planning and mental capacity governance, there was effective audits at the service. This oversight ensured the building was safe and clean, and that there were suitable staff to support the people that lived at The Orchard.

People were unable to answer questions about the community and partnerships. However, we saw staff have clear conversations with people about what they would like to do that day. Staff then supported people to access community activities of their choice. Staff also knew what health professionals people needed to see, so conversations about this could also happen. We were assured people had positive experiences with the community and external health and social care professionals.

Staff and leaders were able to clearly explain what health and social care professionals supported people. They also knew what social activities were important to people.

We received no feedback from partners about this.

People’s care plans clearly documented their preferred activities and what people could be important to them. This helped staff understand what things people would like to do with their day. Care plans did not always include enough detail on what treatment people received from external health professionals. However, the management team and staff knew this information well and started to improve documentation before we left the assessment visit.

Staff and leaders told us about clear communication in the staff team. This communication helped staff stay aware of people’s changing needs and report concerns to family members and health professionals.

The last inspection identified multiple concerns with the service. There had been effective action to improve the service. This included creating thorough audits to improve the oversight of what care was happening. While a lot of improvement had occurred at the service, we remain concerned that effective action had not been taken to improve care planning and mental capacity documentation. The provider started taking action to improve this during the assessment.