Archived: Orchard Court

Updated 1 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 March 2018 and was unannounced. The inspection team consisted of three inspectors 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.

We asked the provider to complete a Provider Information Return (PIR) prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR prior to our inspection to see if there were any areas in particular we needed to focus on during the day.

As part of our inspection we spoke with nine people and two relatives. We also observed the care that people received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not tell us about their experience directly. We spoke with the manager, the activities co-ordinator, chef and 13 care staff. We read care plans for eight people, medicines records and the records of accidents and incidents. We looked at mental capacity assessments and applications made to deprive people of their liberty.

We also looked at three staff recruitment files and records of staff training. We saw records of quality assurance audits. We looked at a selection of policies and procedures and health and safety audits. We also looked at minutes of meetings of staff, people and relatives.

Our last inspection of Orchard Court was in February 2016 where the service was rated ‘Good’ overall with no breaches of the legal requirements.

Updated 1 May 2018

This inspection took place on 14 March 2018 and was unannounced.

Orchard Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Orchard Court accommodates 63 people in one adapted building. At the time of our inspection there were 52 older people living at the home, some of whom were living with dementia.

There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager, who had previously been the registered manager at another of Anchor Trust’s services, had commenced in January 2018 and had applied to become registered manager. The new manager (manager) assisted us in our inspection.

Medicines management, infection control and safeguarding processes were not suitably robust. We also found at times staff were not always deployed across the service in a way which meant people received consistent attention. At the end of our inspection the manager and provider’s senior management told us an increase in staffing levels had been approved. Gaps in some people’s care records meant staff may not be using the most up to date information about a person.

People were supported by staff who knew them well and they got along with. Staff displayed kindness, care and empathy towards people and showed people respect. People were given attention by staff and staff adapted their approaches in response to individuals dependent on their need.

People had access to activities both in communal areas and within their individual living areas. Although no one was on palliative care there was evidence that staff discussed people’s end of life wishes with them.

People were cared for by staff who had gone through a good recruitment process and in the event of an emergency there was information and equipment in place for safe evacuation. People’s risks were identified and action taken in response to these. The manager reviewed accidents and incidents and as such had taken action to help reduce reoccurrence.

People’s legal rights were protected because staff were aware of the principals of the Mental Capacity Act (2005). The home environment was adapted for people living with dementia and people’s needs were assessed before moving into the home.

People had access to healthcare professionals where required and staff followed national and local guidance to provide effective care. People told us they liked the food that was prepared for them and their dietary needs were met. We also found that people were being cared for by staff who had access to a range of training to support them in their roles.

The manager had a clear vision for the service and had already started to make a positive impact on the care people received. However, this needed to be sustained and audits being carried out embedded to demonstrate continued improvement.

Staff felt supported by management and took part in staff meetings. There was a good culture within the staff team. People told us they liked the new manager and felt he was visible around the home. This was confirmed by our observations on the day.

People were involved in the running of the home and any complaints or suggestions were listened and acted on. Staff worked alongside other agencies to improve the quality of people’s care.

During our inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made a recommendation to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.