Archived: The Orchard

Updated 9 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This was a focused inspection to check whether the provider had made improvements as a result of warning notices which were served following our comprehensive inspection on the 07 and 09 October 2015.

The focused inspection took place on the 06, 07 and 08 January 2016 and was unannounced; this meant that the staff and provider did not know we were visiting. The inspection was carried out by one inspector.

We inspected the service against three of the five questions we ask about services; is the service safe, effective and well-led. This is because the service was not meeting legal requirements in relation to those questions and were the areas the warning notices were served against.

Before the inspection we reviewed information we held about the service, this included the provider’s action plan, which set out the action they had taken to meet the legal requirements which the warning notices referred to.

During the inspection we spoke with the four people living at The Orchard who were receiving care and support, two relatives; the registered manager, deputy manager and three care staff. We reviewed four staff files and three care plans within the service and cross referenced practice against the provider’s own policies and procedures.

We spent time observing interactions between staff and people who lived in the service.

Updated 9 March 2016

We carried out an unannounced comprehensive inspection of this service on 07 and 09 October 2015. We found breaches of a number of the regulations of the Health and Social Care Act 2008. This resulted in the Commission serving four warning notices on the provider. These warning notices were in relation to safe care, protection of people, quality monitoring and staffing. The timescale for meeting the warning notices was the 18 December 2015. In addition to the warning notices we asked the provider to take action to improve the running of the home.

The registered manager sent us an action plan detailing actions anticipated to ensure future compliance with the regulations. We undertook a focused inspection on 06 and 07 January 2016 to check that they were meeting the legal requirements which the warning notices related to. This report only covers our findings in relation to these breaches of regulations. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ‘The Orchard’ on our website at www.cqc.org.uk. We will follow up on the other breaches referred to in that report at a later stage.

The Orchard is a care home for older adults. It is registered to provide accommodation for 11 people. At the time of our inspection eight people lived at The Orchard. The Orchard is a family owned and run care home. It has a family home atmosphere and rooms are personalised.

The service had a registered manager 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.

At this focused inspection on 06 and 07 January 2016, we found that some improvements had been made to rectify issues identified at the previous inspection. However, we found a number of issues still of concern.

Medicine administration did not follow national guidelines. One person was not offered prescribed medicine for 11 days.

Staff had been offered training but failed to demonstrate that they had knowledge of this learning. We observed poor manual handling practice and disregard for respecting dignity.

The provider had responded to improvements required in fire safety. Door releases were now in place allowing doors to shut when the fire alarm was activated.

We found the provider had taken steps to improve its monitoring of the quality of the service provided. Questionnaires had been sent out to people, relatives and staff.

Staffing numbers had increased since our last visit. This meant that people’s safety at lunchtime had improved.

At the last comprehensive inspection this provider was placed into special measures by CQC. This inspection found that there was not enough improvement to take the provider out of special measures. We found a number of continued breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. CQC is now considering the appropriate regulatory response to resolve the problems we found.

We have made a recommendation about staff training on the subject of Safeguarding people from abuse.