Orchard Nursing

Updated 30 March 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 Care Act 2014.

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 1 inspector.

Service and service type

Orchard Nursing a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Orchard Nursing is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was no registered manager in post. The manager had applied to CQC to become the registered manager.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed all the information we held about the service since it registered with the Commission. We also obtained information about the service from the local authority and local safeguarding teams. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection visit

We spoke with 6 people and 6 family members about their experience of the care provided. We also spoke with the manager, deputy manager 4 care staff and the cook.

We reviewed a range of records. This included 8 people’s care records and a selection of people’s medication records. We looked at recruitment records for 4 staff members employed since the last inspection. A variety of other records relating to the management of the service, including audits and checks were reviewed.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect

Updated 30 March 2023

About the service

Orchard Nursing accommodates up to 31 people over three floors who require personal and nursing care. At the time of the inspection there were 30 people using the service.

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

Risks assessments were completed and included risk management plans. Staff monitored people’s health safety and wellbeing in line with their plans. Regular checks were carried out on the safety of the premises and equipment. There were effective systems in place to protect people from the risk of abuse and staff understood their responsibilities for keeping people safe.

People told us they were treated well and felt safe. People received their prescribed medicines at the right times by appropriately trained and competent staff. There were enough suitably skilled and experienced staff to meet people's needs and keep them safe and they were recruited safely. Most parts of the service were clean and hygienic although some areas and equipment were not cleaned as often as they should have been. There were some inconsistencies with staff around the use of PPE and disposal of clinical waste. These issues were addressed immediately by the manager.

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.

Improvements had been made following previous inspections. The manager and other senior staff had made good use of the providers systems and processes for assessing, monitoring, and improving the quality and safety of the service. The providers performance management systems were followed to promote improvement, learning and development.

People’s needs were met through good partnership working with others including families and other external professionals and agencies. Lessons were learnt when things went wrong and shared with the staff team for their learning. Relevant others were notified about incidents, events, and outcomes of investigations. The provider and manager acted in an open and transparent way with relevant others following incidents.

Rating at last inspection and update

The last rating for this service was requires improvement (published 24 February 2022).

Why we inspected

This was a planned inspection.

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.

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 requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Orchard Nursing on our website at www.cqc.org.uk.