Archived: Orchard Lodge

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found;

Is the service safe?

People were cared for safely. Risk assessments were in place and regularly reviewed. People's needs were assessed and reflected in the care plans.

There were arrangements in place to deal with foreseeable emergencies. There was emergency lighting and plans for managing the person's needs in the event of a power failure. Care records held an emergency evacuation plan for use in the event of a fire.

Appropriate arrangements were in place for obtaining and disposing of medicines safely. Medicines were delivered to the home monthly and where possible supplied in monitored dosage systems (MDS). Medicines were stored safely in a locked cupboard, a metal dispensing trolley which was secured to the wall and a wall mounted cupboard for controlled medication. We saw evidence that care workers had recently received management of medicines training by the pharmacy who supplied medication to the home. Suitable records were kept regarding medication administration. The home had appropriate systems in place to account for the amount of medicines given and for those left in stock. We saw that the amount of medication documented as being in stock on in the controlled drugs chart corresponded with the actual amount of medication in stock. This meant that medicines were handled safely and securely.

Systems were in place to make sure that managers and care workers learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service to continually improve.

The provider understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made the manager was able to describe the circumstances when an application should be made.

Is the service effective?

Peoples' care was effective. People all had an individual care plan which set out their care needs. People's needs were assessed and people told us they were involved in their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

People told us that care workers escorted them to healthcare appointments if needed. On the day of our visit we observed that a person was going to the hospital for some tests. The provider had arranged for an extra care worker to be on duty to ensure that this person could be accompanied. Any visiting health professionals to the home recorded any action or advice in the persons care record. This ensured continuity and a team approach to care delivery.

Care workers told us they felt supported in their role. One care worker told us "I love working here' and 'I am very supported". Most care workers had achieved a National Vocational Qualification (NVQ) in care whilst working at the home. Care Workers received regular supervision which provided them with the opportunity to discuss their areas of responsibility and identify training needs. This meant care workers were appropriately trained and supported to care for people living at Orchard Lodge.

Is the service caring?

The home was caring. People we spoke with were complementary about the home. One person told us, 'Staff are lovely and the care is a very good standard'. Another person told us 'It's good and friendly here, I would recommend it'. We spent some time in the lounge conducting a SOFI. We noted people were engaged in activities or tasks and had good interactions with care workers. The atmosphere in the home was pleasant and we observed interactions between care workers and people that were caring, relaxed and friendly.

Is the service responsive?

The home was responsive in meeting people's needs. People benefitted from meaningful activities and engagement with staff. Care records included people's spiritual wellbeing and detailed their religious beliefs. We saw people were supported to take part in religious services if they wanted to. One person told us 'there is a fellowship service here once a week that I like to attend'. We saw in one person's activity plan that they enjoyed 'forties music'. Over lunch time a CD of music from this era was played and both care workers and staff sang along. We saw people who were unable to join in the singing were smiling and seemed to be enjoying the music.

People we spoke with confirmed they would know how to raise concerns, but this was rare as they were pleased with the service provided. We looked at the provider's compliments and complaints file. We noted that there had had been a number of compliments but no written complaints since our last inspection. We saw that historical written complaints or verbal comments were recorded and responded to in a timely manner.

Is the service well-led?

The home was well led. The home worked with other agencies and services to make sure people received their care in a joined up way.

The manager was clearly passionate about the health and wellbeing of people living at Orchard lodge. Care workers spoke positively about the service they provided for people, the manager and each other. Care workers told us they felt able to raise any concerns with the manager. One care worker told us ''you can speak to the manager anytime. I have rung them in the middle of the night and they didn't mind'. This meant that care workers felt confident that they would be listened to and that any concerns they had would be taken seriously.

During our inspection we looked at the quality assurance systems that were in place. The information reviewed demonstrated that the service was monitored on a consistent basis to ensure that people experienced safe and appropriate support, care and treatment.

Staff had a good understanding of people's dietary needs. People who use the service ate meals which were healthy and balanced. They told us the food they liked was available and well prepared.

People who use the service benefited from equipment and mobility aids used in order to meet their needs for example hoists and walking frames. People were protected from risk of harm because equipment was used correctly and safely, and was properly maintained.

Staff were knowledgeable regarding their roles and responsibilities. People we spoke with felt there were enough staff on duty to care for them and provide support they needed.

There was a process and written complaints procedure to respond and resolve complaints. The people and/or their family members we spoke with told us they were aware of who to speak to if they had any complaints or concerns. The complaints procedure was accessible and clearly displayed in the home.

Care plans were person centred and written from the perspective of the person. People were involved in the development of their plans, which showed both needs and preferences in relation to how those needs were to be met. Relevant risk assessments were completed including falls, moving and handling and nutrition.

The staff we spoke with were able to give examples of what abuse is and tell us what they would do if they had concerns. They described the manager as approachable and confirmed that they believed he would act on any safeguarding issues they raised.

Staff told us, and we saw from records, that they had good access to training including moving and handling, infection control, safeguarding, the mental capacity act and deprivation of liberties safeguards.

People told us that they were asked for their views about the service they received. For example, one person told us 'we have residents meetings and talk about things like what food we would like to have on the menu'.

We saw that the provider had sought the views of a key stakeholder in relation to the new care planning system. The response from the stakeholder was very positive. This told us that the provider actively sought the views of other professionals.