Background to this inspection
Updated
12 February 2020
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.
Inspection team
The inspection was carried out by one inspector.
Service and service type
The Orchard 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.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
The first day of our inspection visit was unannounced. We let the provider know when we would be returning for a second day to complete our inspection visit.
What we did before the inspection
Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority. This information helps support our inspections. We used all of this information to plan our inspection.
The provider completed 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.
During the inspection
We spoke with four people, two relatives and a community healthcare professional about their experiences of the care provided. We also spoke with the registered manager, three senior care staff, three care staff and an activities coordinator.
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 talk with us.
We reviewed a range of records. These included four people’s care records, medicines records, complaints records and three staff recruitment records. We also reviewed incident and accident records, selected policies and records relating to the safety of the premises and management of the service.
After the inspection
We spoke with two community health and social care professionals about their experiences of the care provided. We also reviewed additional information sent to us by the provider.
Updated
12 February 2020
About the service
The Orchard is a residential care home providing accommodation with personal care for up to 14 people, some of whom are living with dementia. The accommodation is split across two floors within a modern, purpose-built building. At the time of our inspection, there were 11 people living at the home.
People’s experience of using this service and what we found
People were supported by staff who received training in how to identify and report potential abuse. Procedures were in place to identify and manage the risks to people. Staffing arrangements at the home meant there were enough staff with the right skills to safely meet people's care needs. People had support to take their medicines safely and as prescribed. Measures were in place to protect people from the risk of infections. The provider sought to learn from any accidents or incidents involving people who lived at the home.
Staff received training and ongoing management support to enable them to work safely and effectively. People were supported to maintain a balanced diet and to enjoy mealtimes at the home. Staff liaised with community healthcare professionals to ensure people’s health needs were monitored and met. 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.
Staff treated people in a respectful and caring manner. People and their relatives’ views about the service were encouraged and taken on board.
People’s care reflected their individual needs and requirements. People’s care plans were individual to them and followed by staff. People had support to participate in a range of social and recreational activities, and to pursue their interests. People and their relatives knew how to raise any concerns or complaints about the care provided, and were confident these would be acted on. People’s wishes and choices regarding their end-of-life care were assessed, so these could be addressed at the appropriate time.
The provider promoted an open and inclusive culture within the service. People and their relatives benefited from good communication with the registered manager and staff. Staff were well-supported by the registered manager and enthusiastic about people’s care. The provider had quality assurance systems and processes in place to enable them to monitor the quality and safety of people’s care. Staff worked collaboratively with the community health and social care professionals involved in people’s care.
Rating at last inspection and update
The last rating for this service was Requires improvement (report published 24 January 2019) and there were two 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.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.