Orangery Care Home

Updated 5 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 10 and 11 April 2018 and was unannounced. The inspection team included 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. The expert by experience had experience of caring for older people.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law.

Prior to the inspection, we requested and received written feedback on the service from a specialist nurse, a social worker, a social services team manager and the fire brigade. During the inspection, we spoke with 17 people and two relatives. We spoke with night and day staff, including three nurses, the clinical lead, seven care staff, two kitchen staff, one laundry assistant, the deputy manager, the regional manager and the registered manager.

We reviewed records which included four people’s care plans, four staff recruitment and supervision files and records relating to the management of the service.

The service was last inspected in March 2017 when it was rated as requires improvement overall.

Updated 5 May 2018

The inspection took place on 10 and 11 April 2018 and was unannounced. Manor Place Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 60 people in a three storey building, providing care on four designated units for people who require nursing and/ or dementia care. Communal areas were located on the ground floor, and the service was situated around an enclosed courtyard area and secure garden. At the time of the inspection there were 52 people living there.

The service had a registered manager. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Act 2008 and associated Regulations about how the service is run.

People had been safeguarded from the risk of abuse; staff understood both their role and duty to protect people and had access to relevant guidance. A range of risks to people had been assessed and care plans were in place to manage them. The required utility and equipment safety checks had been completed to ensure their safe use. People were safe as they were cared for by sufficient numbers of staff whose suitability for their role had been assessed. Processes were in place to ensure people received only the medicines they required, from trained staff. The service was clean and staff had undergone relevant training to enable them to understand how to protect people from the risk of infection. Processes were in place to ensure learning took place following incidents and improvements had been made to people’s care to reduce the risk of repetition.

People’s needs had been assessed prior to them being offered a service. The provision of people’s care reflected good practice guidance. Staff had received a suitable induction to their role, on-going training and supervision.

People’s nutritional and fluid intake needs had been identified and met. Processes were in place to ensure staff worked both across the organisation and with external professionals to ensure people’s health and social care needs were met. People were supported to access a range of healthcare professionals.

The service was in the process of being refurnished to ensure it met people’s needs. The garden was attractive, secure and accessible for people.

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.

People told us they liked the staff, whom they felt had promoted both their independence and their privacy and dignity, visitors were welcomed. Staff treated people kindly and ensured they were comfortable. Overall people were asked for their views about their care and offered choices about their care. The registered manager had taken action to ensure all staff consistently promoted the choices available to people at lunch.

Staff understood people’s needs and work was underway to ensure written care plans were fully centred on the individual. Staff had undertaken training in meeting the needs of those living with dementia, although some staff were more confident than others in their interactions with people. People’s needs for social and spiritual stimulation had been met. People’s complaints had been listened to, responded to and used to improve the service. People had been well supported at the end of their lives.

People were cared for within a positive culture where staff felt valued. Staff felt improvements had taken place to the quality of people’s care under the leadership of the registered manager. There was a clear management structure and oversight and support provided both from the provider and regional manager. The registered manager was visible and accessible to people within the service. Processes were in place such as audits, trackers, surveys and meetings to monitor the quality of the service and to drive improvements for people. Staff worked in partnership with other agencies.