The Orchards

Updated 22 December 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 checked 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.

Inspection activity started on 2 November and ended on 12 November 2018. The inspection was announced. The provider was given 48 hours’ notice because the registered manager and staff are often out of the office supporting people and we needed to be sure they would be available.

The inspection was carried out by one adult social care inspector. Following the inspection site visit on 2 November 2018, an Expert by Experience contacted people who used the service and relatives to gain their views on the service provided. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. The inspector contacted staff employed by the service via telephone following the site visit.

As part of planning our inspection, we contacted the local Healthwatch and the local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England. We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.

The provider sent us their Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

We reviewed a range of documentation. These included three people's care planning documentation and daily records and four people’s medicine administration records. We looked at five staff files relating to their recruitment, supervision, appraisal and training. We reviewed records relating to the management of the service and a wide variety of policies and procedures.

During the inspection we spoke with nine people who used the service and two relatives to gain their views on the service provided. We also spoke with six members of staff including the registered manager.

Updated 22 December 2018

This inspection took place between 2 and 12 November 2018 and was announced. This was the first inspection of the service since it was registered in December 2017.

The Orchards Extra Care Housing is a domiciliary care agency. It provides personal care to people living in their own houses and flats to predominantly older people.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

People at The Orchards Extra Care Housing lived in apartments or in bungalows that were situated in the grounds. People had access to a restaurant, communal areas and a garden.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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 Care Act 2008 and associated Regulations about how the service is run.

Some risk assessments were in place although we found when people had specific medical conditions, risks associated with these conditions had not been recorded. We have made a recommendation regarding risk assessments.

Established recruitment procedures were in place which meant staff had been recruited safely. They received a thorough induction when they joined the service and received continuous support through regular one to one supervisions and training.

Medicines had been managed and administered safely. Staff had received medicines training and had their competencies in this area assessed by management.

Staff received safeguarding training and knew how to raise concerns. They were confident the management team would deal with any concerns raised appropriately.

There were enough staff available to meet people’s needs and attend planned care visits. People were supported by a consistent team of staff who were familiar with their likes, dislikes and preferences.

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. Consent to care and treatment was clearly recorded and staff respected people’s choices. People told us they were actively involved in the development of their care and support plans.

People were supported to access health professionals when needed and to maintain a healthy balanced diet of their choice.

People we spoke with told us staff treated them with dignity and respect and respected the choices they made. Staff were knowledgeable about peoples likes, dislikes and preferences ad positive relationships had been developed.

People’s independence was promoted by staff. Care plans had been developed to ensure they contained person-centred information and provided clear guidance of the level of support that people required. These had been regularly reviewed to ensure they remained up to date.

A complaints policy and procedure was in place. People told us they knew how to raise any concerns. Feedback from people had been sought on a regular basis to encourage continuous improvement. People told us they could contact the service at any time and were confident any feedback they provided would be listened to.

People, relatives and staff spoke highly of the management team. The registered manager completed checks to monitor and improve the service. When shortfalls had been found, action plans were in place to ensure improvements were made. Whilst we were told the provider completed audits on the service these were not recorded and there was no evidence to show these audits had been effective in recognising shortfalls. We have made a recommendation about effective quality assurance.