Background to this inspection
Updated
20 February 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
This inspection was undertaken by two inspectors and an assistant inspector.
Service and service type
The Orchards 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 did not have a manager registered with the Care Quality Commission. This means that the provider is 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 they were registered. 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 spoke with five people who used the service and seven relatives by telephone about their experience of the care provided. We spoke with nine members of staff including, the area manager, senior care workers, care workers and a housekeeper.
We reviewed a range of records. This included two people’s care records and multiple 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 policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We received feedback from the local authority. We looked at training data and quality assurance records.
Updated
20 February 2021
About the service
The Orchards is a residential care home providing personal and nursing care to 25 people older people some who are living with dementia at the time of the inspection.
The Orchards accommodates up to 66 people across three separate floors, each of which has separate adapted facilities.
People’s experience of using this service and what we found
People who lived at The Orchards received care from a staff team who all cared about delivering an individual based service. Staff knew each person well. People’s views were respected, and they were involved in everything that happened in the service. People were happy living there and relatives trusted the staff team to look after their family members. One relative said, “I am incredibly relieved that [Family member] has landed at a place where I consistently feel all their emotional needs are being met and stimulation is more than being met.”
Staff understood the risks to people and the measures in place to keep them safe. Systems were in place to manage people's medicines safely and to reduce the risks associated with the spread of infection.
Sufficient numbers of staff were employed to meet people's needs. Staff received training which gave them the necessary skills and knowledge to carry out their roles and meet people’s needs.
Staff delivered care and support that was personalised. Staff were kind, caring and motivated and people, their relatives and external professionals were complimentary about the care provided. Staff respected people’s privacy, dignity and independence and encouraged people to lead their life in the way they wanted to.
People were supported to maintain their health. Staff made referrals to health professionals when required. Staff were kind and caring and had developed good relationships with people using the service. People were supported to have maximum choice and control over 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.
People had access to food and drink based on their individual choice and preferences. People had access to a range of activities that reflected their specific needs and interests.
Care plans were in place which guided staff to provide support that met people's needs which were in line with their preferences.
Systems ensured that people's risks were well managed, and lessons were learnt when things went wrong. There was an open culture within the service, where people and staff could approach the area manager who acted on concerns raised to make improvements to people's care. A relative told us, “We feel as a family we have done the right thing and [relative] are in exactly the right place. We have a great sense of security and they are exceptionally well cared for.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 9 August 2019 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about medication processes and a number of safeguarding incidents.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe sections of this full report.
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.