Orchid House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We reviewed 1 quality statement for this key question. During our assessment of this key question, we found concerns around people’s independence choice and control which resulted in a breach of Regulation 10 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. You can find more details of our concerns in the evidence category findings below.

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.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

Relatives told us they felt people were treated with respect and that staff listened to people's choices and preferences.

Staff were able to talk about how they supported people and appeared to know people well, but their responses were not always consistent with information in care plans. For example, we reviewed care plans where staff told us that a person “was not allowed to eat with other people living at the house as they 'distract' people and causes a choking risk." The care plan identified that the person should eat with no distractions to minimise choking and they will choose where they would like to sit to eat their meals, they will usually choose to eat in their private space with a staff member. The registered manager told us that the person “has a choice of where they would like to eat, if [person] is not happy we encourage [person] to eat in their annexe." They also told us that there was a risk of choking which needs to be managed. The information provided by the staff member was inconsistent with the care plan, choking risk assessment and registered manager’s comments. The registered manager told us that people had access to advocacy should they need it.

The culture of the service did not reflect the principles of the guidance Right Support, Right Care, Right Culture. We observed that some staff did not always listen and respond to people’s choices. Some staff did not always ask people their preferences on what they would like to do. Where people were able to express their preferences, staff did not always listen and act on these. People were not always treated with dignity and respect. Some staff interactions were not respectful towards people. For example we observed two people sat in the lounge and staff supporting these people regularly changed. When staff changed, they changed the television channel several times without asking people their preference. One person communicated they would like the door closed, as was their preference, they also indicated this was because of the noise of the vacuum cleaner outside the door that was too loud. However, staff kept coming in and out of the room and leaving the door open. During another site visit, this person again indicated that they would prefer the door shut, the staff member working with the person kept saying, 'the door is fine'. During a tour of the house, a staff member guided the inspector into a person’s room, the inspector did not enter suggesting that we should ask permission to enter as the person was in bed, the staff member stated 'it's fine [person's] fine', the inspector asked again and the member of staff repeated this, the staff member did not ask permission or acknowledge the person when we entered the room. We observed staff talking about people as if they were not in the room, staff saying they had 'done' people and were going to 'do' other people when referring to personal care. We observed two occasions where staff appeared to make fun of a person, however the person did not appear distressed by this. We also observed staff talking about personal things as if people weren't there.

Daily notes showed a wide range of activities inside and outside the home. They included helping prepare food, cleaning, access to the sensory room, relaxing with friends, car journeys, walking, visiting shops and bowling. Information showed that people were supported to access family and friends.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.