Archived: Orchard Residential

Updated 1 March 2022

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 prevention and control measures in place. This was conducted so we could 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 two inspectors.

Service and service type

Orchard Residential is a ‘care home’. People in care homes receive accommodation, nursing and / or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission at the time of the inspection. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A manager had been recruited and had submitted all necessary registration application forms to CQC.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We also sought feedback from the local authority who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with the five people who lived at the home, four relatives about their experiences of care their loved ones received, interim manager, regional manager, one deputy manager and five members of staff.

We reviewed a range of records including three people’s care records, multiple medication administration records, and four staff personnel files in relation to recruitment. We also reviewed a variety of records relating to the management and governance of the service, including policies and procedures.

After the inspection

Due to the impact of the COVID-19 pandemic we limited the amount of time we spent on site. A variety of records and documentation was sent to us electronically, these were reviewed remotely following the inspection visit. We looked at policies and procedures, quality monitoring and staff training records.

We continued to seek clarification from the provider to validate evidence found.

Updated 1 March 2022

About the service

Orchard Residential is a ‘care home’ providing accommodation, nursing and / or personal care for up to 26 older adults; some of whom lived with dementia. At the time of the inspection 18 people were living at the home.

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

Management of risk and safety monitoring had improved. People received safe, timely and effective care that was centred around their support needs. Care records contained up to date, consistent and relevant information that staff needed to know and risks were regularly reviewed, evaluated and followed up on when needed.

Improved medicine management processes had been identified. Medicines were safely stored and temperature checks were routinely taken, PRN (‘as and when required’ medicines) protocols had improved and controlled drugs were safely managed and administered in accordance with medication administration policy.

Infection prevention and control (IPC) measures, procedures and processes had improved. Staff were engaged in the required COVID-19 testing regime, all visitors were screened for symptoms of COVID-19 and Government guidance and best practice in relation to PPE was followed.

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.

Staffing levels and the deployment of staff was closely monitored. People received support from a consistent staff team who were skilled, experienced and competent to provide the level of care they needed. Staff received regular supervision and were supported with the necessary learning and development opportunities.

Recruitment procedures had improved and new processes had been implemented. Pre-employment recruitment checks were carried out and people received care and support from staff who had been appropriately vetted.

Overall quality assurance and governance measures had improved. The quality and safety of care was routinely monitored, the provision of care was assessed and improvements were being identified. A new manager had been appointed following the last inspection. They were aware of their regulatory roles and responsibilities and understood the importance of delivering safe, high-quality, person-centred care. We received positive comments about the improved provision of care people received.

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

Rating at last inspection and update

The last rating for this service was ‘inadequate’ (published 4 November 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in special measures since November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as ‘inadequate’ overall or in any of the key questions. Therefore, this service is no longer in special measures.

Why we inspected

We undertook this focused inspection to check whether the breaches of regulations and warning notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, had been met.

The focused inspection reviewed the key questions of safe, effective and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We looked at IPC 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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has improved to ‘requires improvement’. This is based on the findings at this inspection.

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

Follow up

We will work alongside the provider and local authority to monitor progress and continue to monitor information we receive about the service until we return as per inspection programme. If we receive any concerning information we may inspect sooner.