HF Trust - Orchard View

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems and processes ensured people received safe care and treatment. Managers understood local processes and procedures for ensuring continuity of care as people moved between services. Records of people’s referrals and healthcare appointments were well organised. Rotas demonstrated staffing levels were maintained to ensure people received their allocated support hours and there were staff with the necessary skills to support people safely and meet their individual needs. Processes were in place to ensure regular checks on the safety of equipment and the environment. The provider had processes to learn from accidents and incidents to ensure people’s experiences were improved. Learning was shared with staff at staffing meetings, individual supervision and through a communication book and emails.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives told us learning had been taken from previous inspections to improve people’s experience of living at Orchard View. They described a more consistent staff team and told us people were being given more opportunities to engage in activities that were important to them. Relatives described good communication to support learning and improve outcomes for people. One relative told us, "I cannot say I have any complaints and if I did, I discuss them, and we move forward. Problems I did have previously, have been addressed and I feel we have moved past that now.” Another relative told us, "They (managers) are always happy to talk through problems. They always want to know my ideas and I've noticed they always ask my opinion.”

Staff told us they were able to raise concerns knowing they would be listened to and described a culture of shared learning to ensure people received safe and effective support. One staff member told us, "One of us will have an idea and then other people will say that would be great. The ideas we have will blossom.” Another staff member told us, "I feel I am listened to because if I come forward with an idea, they will see if it is something we can do.” The deputy manager explained the importance of gathering staff feedback and commented, “In team meetings we do discuss if there are lessons to be learned and I do discuss it with staff in their supervisions. I always involve the staff because they are the ones working closely with the people we support. They need to be empowered to say because it is a whole team approach.”

The provider had processes to learn from accidents and incidents to ensure people’s experiences were improved. Learning was shared with staff at staffing meetings, individual supervision and through a communication book and emails. Where accidents or incidents had occurred, action was taken to reduce the chance of re-occurrence. Managers then monitored these to identify possible learning and ensure action had been taken to mitigate individual and service level risks.

People experienced continuity of care when they moved between healthcare services. For example, when people were admitted to hospital, staff from Orchard View continued to provide 1 to 1 support within the hospital setting. This meant people were supported by staff who understood their individual needs, communication requirements, preferences and routines. This consistency was important to people because it helped minimise the impact on their emotional health and mental well-being. The importance of this continuity of care for people moving between services was expressed by 1 relative when they told us, "The only issue we had was when [Name] went into hospital in covid times without staff. The staff couldn’t go, and hospital staff just didn’t understand [Person].”

Staff ensured continuity of care when people moved between services. They described robust systems to ensure people did not miss important medical appointments and ensured other healthcare professionals had all the information they needed to provide effective care. One staff member told us their role at healthcare appointments was, “To make sure I have as much information as I can about the person I am supporting and to get as much information to bring back to the service. We do speak up for them because we work closely with people, and we can see what their needs are.” Another staff member described contacting healthcare professionals before an appointment to ensure people's needs were known. They went on to say, "We know people so during the appointments we can do things around them to help make them feel comfortable. When you take [name of person] you know what will calm her down, a busy environment is her worst nightmare.”

Records of people’s referrals and healthcare appointments were clear and well organised. Each person had their own hospital passport which clearly set out important information for hospital staff to understand how to care for the person. People also had individual health action plans to support the sharing of information between healthcare professionals involved in people’s care. Managers understood local processes and procedures for ensuring continuity of care as people moved between services. The deputy manager explained, “We have had people admitted to hospital and we contact the learning disability liaison nurse. We can send the hospital passport, but they need someone who knows them. The learning disability liaison nurse sorts out the funding for that." Whilst nobody had moved to Orchard View in the 3 years prior to our assessment, managers assured us any move to the service would be carefully managed with the input of social workers, healthcare professionals and other people involved in the person's care.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

People benefited from living in a safe but homely environment where they had space to move around. Where people needed specialist equipment to help them transfer and mobilise, this had been serviced to ensure it was safe to use. People had individual plans to ensure their safe evacuation in an emergency and were involved in any fire drills, so they were aware of the evacuation process. One relative mentioned the garden could do with a bit of care but commented, "Inside has had some attention and feels more homely.”

Staff confirmed they had received fire safety training and understood the evacuation process. Staff had received training in using equipment to transfer people safely and knew the process for raising any concerns about the environment.

The home generally looked well maintained and in good order. Areas that needed repair or repainting had been identified in the weekly health and safety checks. People’s individual evacuation plans were easily accessible for staff and emergency services. Doors to areas which could have exposed people to risk such as the cleaning chemicals cupboard and laundry were locked to ensure people’s safety.

Processes were in place to ensure regular checks on the safety of equipment and the environment. Where issues were identified, these were escalated through the provider’s systems to be addressed. The provider retained oversight of health and safety within the service to ensure the safety of the premises was maintained.

Relatives told us people’s experience of living at Orchard View had improved because of better staffing levels and a more consistent team. One relative told us, "There is a more stable staff team now. We had a period of a lot of agency but there is now a core group of staff that know people well." Another relative told us, “The staff team now is cohesive and staff seem a lot happier." Relatives told us people now received their allocated hours of 1 to 1 staff support which meant they were being encouraged to engage in more meaningful activity both inside and outside the home. Relatives felt staff had the necessary knowledge and skills to support their family member’s emotional and physical care needs.

Staff spoke of improved staffing levels which meant people received their allocated 121 support hours and were able to do the things they wanted to. One staff member told us, "Staffing levels are quite balanced at the minute. There are consistent staff, and we are quite a good staff team. If we are using agency staff, we are having the same, so it is continuity as well.” Another staff member told us, "We went through a spell when we were really short on staff, but that has gone and staffing is back to normal and people are getting out and doing things." Staff spoke positively about the training and support they received to enable them to carry out their role safely and effectively. One staff member told us, “The training is brilliant and consistent. There is a lot of face to face as well on the on-line training. If there is any training we feel we need, there are extra training modules.” One staff member explained how the training gave them confidence and said, "When we know the correct ways to help someone, we make sure it is safe.” Staff had regular supervision meetings with their manager and 1 staff member told us, “We had our 121s last week with [deputy manager]. We can raise any concerns we have got, and we can discuss any support we want. Personally, I feel really comfortable here because we have got a good support network for us and for the [people] as well.”

Staff were available to immediately respond to people and people with allocated 121 support had that level of support in place. A staff presence was maintained in communal areas and there were enough staff to take people on planned trips out. Staffing levels were sufficient to enable staff with delegated health and safety responsibilities to carry those out.

Rota's demonstrated staffing levels were maintained to ensure people received their allocated support hours and there were staff with the necessary skills to support people safely and meet their individual needs. For example, the deputy manager ensured rota's were planned so people had their preferred gender of staff to support them with personal care. Records showed staff received regular training to manage people’s risks and overall, training rates were good. The deputy manager was addressing any overdue training with staff in their 1 to 1 supervision meetings. Agency staff were being used in the service. The provider ensured agency staff had the right skills and had processes to share essential information about people’s needs. Staff files evidenced safe recruitment checks had been carried out to ensure the suitability of staff for their role.

People were encouraged to be involved in tidying and cleaning their bedrooms. People and relatives did not raise any concerns about the cleanliness of the home.

Staff had received training in infection control practices and good food hygiene. Staff described the actions they followed which reduced risks to people’s health and the spread of infection. This included checking the temperature of food to ensure it was cooked properly and safe for people to eat. The deputy manager explained, “We support people to do as much as they can, but it is overseen by the staff. They each have a day for their bedrooms, and we get them involved as much as possible.” Staff encouraged people to follow good hygiene practices and supported them to have recommended vaccines where appropriate.

The home was clean and tidy throughout and personal protective equipment was readily available for staff. However, we did note some areas where infection control practices could be improved. For example, in the kitchen there was a bin without a lid, a person’s toothbrush and personal toiletries had been left in a communal bathroom and another person’s mobility chair waiting repair had been left in the staff bathroom.

The provider had an up-to-date infection prevention and control policy which guided staff in good infection control practices. This included guidance on how to manage any infection outbreaks in the home. Schedule were in place for each person’s bedroom have a thorough clean each week and communal areas were cleaned daily. Cleaning responsibilities were shared between both day and night staff.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.