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Orchard House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 October 2019

About the service

Orchard House is a residential care home providing personal care to 15 people mainly living with Huntingdon’s disease at the time of the inspection. The service can support up to 15 people in one adapted building and a bungalow in the grounds.

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

People told us or indicated they felt safe living at the service. However, potential risks to people’s health, welfare and safety had not been consistently assessed. Staff did not have guidance to mitigate risk and keep people safe.

Incidents and accidents had been recorded but had not been analysed to identify patterns and trends. Incidents involving behaviour that may be challenging had not been discussed with the local safeguarding authority. The registered manager had not notified the Care Quality Commission of incidents within the service as required.

Medicines had not been managed safely. Staff had not followed guidelines when administering medicines. People’s health needs had not been assessed using recognised tools and following good practice guidance. Care plans did not always reflect the care being given.

Checks and audits had been completed. However, they were not robust and effective in identifying the shortfalls found at this inspection. People and staff had been asked their opinions on the service. The actions taken in response to any concerns or suggestions had not been clearly recorded, this is an area for improvement.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, improvements in the recording of decisions was required.

People were given a choice of meals and snacks to keep them as healthy as possible. Staff knew people’s choices and preferences and people told us they were supported in the way they preferred.

People were treated with dignity and respect, staff supported them to remain as independent as possible. People’s health was monitored, and they were referred to health professionals as required. People‘s end of life wishes were recorded, staff worked with other health professionals to support people at the end of their lives.

People were supported by staff who were recruited safely, were appropriately trained and received supervision to continue their development. People were protected from the risk of infection.

The registered manager had recorded and investigated complaints following the provider’s policy. People and relatives told us that the registered manager was approachable, and staff told us they felt supported.

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 Good (Published 25 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 22 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 22 October 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 22 October 2019

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 22 October 2019

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 22 October 2019

The service was not always well-led.

Details are in our well-Led findings below.