Orchid Woodlands Healthcare Ltd

Updated 28 February 2023

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector, a medicines 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

Orchid Woodlands is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Orchid Woodlands is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced. Inspection activity started on 25 January 2023 and ended on 31 January 2023 by which time we had received and reviewed evidence provided after our visits to the home. We visited Orchid Woodlands on 25 and 26 January 2023.

What we did before the inspection

Prior to the inspection we reviewed information and evidence we already held about the home, which had been collected via our ongoing monitoring of care services. This included notifications sent to us by the home. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We also asked for feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 7 people, 2 relatives and a residents’ friend about the home and the care provided. We also spoke with 7 members of staff, which included the registered manager, care and auxiliary staff.

We reviewed a range of records and other documentation. This included 4 people’s care records, risk assessments, safety records, supplementary charts, audit and governance information. We also looked at medicines and associated records for 4 people.

After the inspection

We requested and reviewed additional evidence from the provider. This included monitoring data for 2 people, the provider’s dependency tool, training records, accident and incident data, complaints log, survey data and a selection of policies.

Updated 28 February 2023

About the service

Orchid Woodlands is a residential care home located in Atherton, Greater Manchester, who are registered to accommodate up to 38 people. They are registered to support older people, younger adults, people living with dementia, mental health needs, physical disability and sensory impairment. At the time of inspection 27 people were living at the home.

People’s experience of using this service and what we found

Improvements were required with medicines management, record keeping and the audit and governance process. Medicines were not managed safely, required safety checks had not been completed consistently, accidents and incident recording lacked detail and the audit and governance process was not robust, with auditing not completed consistently.

People told us they felt safe living at the home. People and relatives felt enough staff were deployed to keep people safe, although were concerned about the high use of agency staff. Staff had completed safeguarding training and knew how to report concerns; however, the home did not currently have a log onto which referrals were documented. The home was clean, with effective cleaning and infection control processes in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The home did not currently have a fully operational kitchen, with pre-made food being purchased and warmed up in the home. People told us they received enough to eat and drink and received a choice of meals. The environment was suitable for the people living at the home, with pictorial signage in place. However, the home required redecoration and updating throughout. A plan was in place to complete this work.

People and relatives told us they were happy with the care provided. They were complimentary about the staff who supported them, who they described as kind, patient and caring. People confirmed they were treated with dignity and respect and offered choices each day. Staff supported people to maintain their independence by only providing help and support where needed.

The quality and quantity of information in people’s care plans varied, although each one explained how they wanted to be supported. The home did not have an activity schedule and as a result, activity completion was inconsistent. People told us they would like to do more. People had communication care plans in place, to ensure staff knew the best way to communicate with them. People and relatives told us they knew how to complain but had not needed to.

Resident and relative meetings were not held regularly. However, people and relative’s views had been sought through planned annual surveys, with blank questionnaires left out in the home should anyone wish to provide additional feedback. People told us they liked living at the home and would recommend it.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 29 December 2021 and this is the first inspection under the current provider. The last rating for the service under the previous provider was good, published August 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to provide a rating.

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.

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 Orchid Woodlands Healthcare Ltd on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, record keeping and the home’s audit and governance process 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.