The Orchards Residential Care Home

Updated 4 April 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

One 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 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 sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with five members of staff including the provider who is also the registered manager, one senior care worker, and three care workers. We also spoke to a visiting health professional.

We reviewed a range of records. This included four people’s care records and six medication records. We looked at three 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 looked at training data. We spoke with one health professional who had visited the service recently.

Updated 4 April 2020

About the service

The Orchards residential home provides accommodation and personal care to 13 people, some of whom may be living with dementia. At the time of the inspection, 13 people were living in the service.

The Orchards accommodates 13 people in one adapted building. There are two communal lounges, a dining area, and a garden people can access.

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

Risks had been assessed and those identified were safely managed; some improvements were however needed to ensure accurate guidance was in place for staff delivering care. The provider had recruitment checks in place to ensure staff were suitable to work in the service. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm. Medicines were managed safely.

Staffing levels required review to ensure they were meeting the changing needs of people using the service. Following the inspection, the registered manager confirmed they would increase staffing across the day.

People were supported by staff who had completed training to give them the skills and knowledge they needed to meet their needs. People were supported to have sufficient amounts to eat and drink and were protected against the risk of poor nutrition. However, improvement was required in how staff documented people’s dietary intake, particularly where people needed to gain weight.

Staff supported people to maintain their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, some care records did not contain a mental capacity assessment and best interests decision where applications to deprive people of their liberty had been made.

Staff treated people in a kind and caring way. People and relatives valued the service and the support the staff provided. Staff treated people with respect and helped them to maintain their independence and dignity.

Care records contained some inaccurate or contradictory information, but these were being reviewed promptly by the registered manager. People and relatives were confident to raise concerns and complaints, and these were listened to. Activity provision was provided by care staff, and people living in the service were satisfied with this.

There were governance systems in place which included quality audits, however, some had not identified the issues we found. More regular monitoring and auditing of people's care records was required by the registered manager, so they can assure themselves that people's needs are being met. People, relatives and staff were given the opportunity to feedback on their experience of the service.

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 30 January 2019).

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.