Background to this inspection
Updated
28 April 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 2 inspectors.
Service and service type
Orchard Views is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Orchard Views is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 1 month. The manager was in the process of submitting an application to register themselves as the new manager of Orchard Views. We are currently assessing this application.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 3 April 2023 and ended on 5 April 2023. We visited the service on 3 April 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
We spoke with 5 people who used the service and 3 relatives about their experience of the care provided. We spoke with 2 visiting health professionals. We spoke with 10 members of staff including the manager, care workers, ancillary staff and the providers nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We observed staff interacting with people who used the service, to help us understand their experience. We reviewed a range of records. This included 3 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service.
Updated
28 April 2023
About the service
Orchard Views is a residential care home that provides accommodation and personal care for older people. The home can accommodate up to 40 people in one adapted building. At the time of this inspection there were 33 people using the service.
People’s experience of using this service and what we found
Since the last inspection there had been changes in the management team and the service had a new manager. The previous registered manager had left the service 2 months ago and the provider had recently appointed a new manager to oversee improvements at the service.
The new manager was in the process of submitting an application to register themselves as the new manager of Orchard Views. We are currently assessing this application.
The service had improved since the previous inspection. The nominated individual and manager gave assurance these improvements would continue and be further embedded, to ensure there was a continuous approach to improving care, quality assurance systems and the environment.
There had been improvements to ensure risks identified with people's health, medical and care needs had been assessed and documented. The provider’s governance systems had improved to ensure people continued to receive good quality and safe care. Improvements had been made to ensure medicines were managed safely although some staff’s competency checks needed updating. Appropriate health and safety checks to the buildings and premises were carried out and people were protected against the risk and spread of infection.
Some actions recommended in the services fire risk assessment, which was completed in March 2023 had not been completed and required attention.
The home was clean, but areas of the home looked ‘tired’ and required refurbishment and redecoration.
People were safeguarded from the risk of abuse. Risks in relation to people's care were identified and detailed information about how risks could be mitigated. People were protected from the risk and spread of infections. Accidents and incidents were recorded and analysed to identify any trends or patterns. This helped to mitigate future risks and ensured lessons were learned. The provider had a safe recruitment process which assisted them in recruiting suitable staff.
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.
Throughout the inspection we observed staff interacting with people in a caring and considerate way. We saw staff gaining people's consent prior to carrying out care tasks. People we spoke with were complimentary about the care and support they received.
Recommendation
We have made a recommendation about the provider implementing a more structured system to gather feedback from people and relatives on how the service was being run or what could be done better to drive improvements.
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 requires improvement (published 18 February 2022). Although we saw improvements had been made, the service remains rated requires improvement.
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take in the full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Orchard Views on our website at www.cqc.org.uk.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.