Orchard Lea

Updated 13 August 2021

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 team was made up of two 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.

Service and service type

Orchard Lea 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We reviewed previous reports and notifications that are held on the CQC database. Notifications are important events that the service has to let the CQC know about by law. We also reviewed safeguarding alerts and information received from a local authority.

We used all of this information to plan our inspection.

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.

During the inspection

We met with most people using the service and spoke with seven people in person about their experience. We also spoke four relatives. We spoke with 10 staff members, including the registered manager, care staff and ancillary staff. We asked the registered manager to send a CQC poster to relatives and staff inviting them to feedback directly to us. One relative contacted us after the inspection.

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. This included four people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. Following the inspection, we sought feedback from four professionals; three responded.

Updated 13 August 2021

About the service

Orchard Lea is a care home registered to provide nursing and personal care for up to 37 people, some of which were living with dementia and/or a physical disability. The premises comprise of a two-storey building with a passenger lifts to access the second floor. At the time of the inspection, 21 people were living at the service. Although the service is registered to provide nursing care, no-one was in receipt of this regulated activity at the time of inspection. We were not able to inspect this regulated activity as a result.

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

Improvements had been made since the last inspection and two previous breaches had been met in relation to good governance and notifications required by CQC.

There were improved systems in place to check the quality and safety of the service. Effective quality assurance and monitoring systems had been embedded and were used to identify shortfalls and drive improvements.

At the last inspection some environmental risks had not been proactively managed in relation to hot water temperatures. We found improvements and action had been taken to address this risk. Personal emergency evacuation plans (PEEPS) had not been reviewed or updated at the last inspection to include all people living at the service. At this inspection PEEPs were all up to date with information to assist people when evacuating the building.

At the last inspection, some staff had not received core training to ensure they worked safely with people. At this inspection we found staff received training and support needed to carry out their role effectively.

Everyone we spoke with said they felt safe. Comments included, “It is very nice here. Everyone is very pleasant” and “Yes, I am safe and happy.” People were protected from harm and abuse as staff understood how to report any concerns. Risk assessments were completed and contained strategies to reduce potential harm. Medicines were safely managed.

Staff had enough time to deliver a good standard of care without rushing people. The registered manager followed safe recruitment processes to ensure staff recruited were suitable for their roles.

People’s needs were assessed prior to moving to the service to confirm their needs and preferences could be met. People enjoyed the food and there was always a choice.

The service worked well with health care professionals to provide timely care to people to ensure their health was maintained. These included GPs, speech and language therapists; occupational therapist and the mental health team. Feedback from professionals included, “This is one of the better homes we know…” and “We have no concerns whatsoever. They have been brilliant”.

The service promoted a positive and inclusive culture for people. People described a happy atmosphere. Comments included, “I think they look after you and accommodate you…I can’t think of anything to improve” and “It is first class. I have never seen anything to cause any concern at all”.

People using the service and relatives described the registered manager as approachable and all said they would feel confident to raise any issues or concerns. People and their relatives were asked for their views about the care and support provided. Where suggestions were made, action was being taken.

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

Rating at last inspection

The last rating for this service was requires improvement (published 24 December 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of safe, effective and well-led which contain those requirements. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Lea on our website at www.cqc.org.uk.

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.