The Care Quality Commission
  • Care Home
  • Care home

Archived: Orchard House

Kinnersley, Severn Stoke, Worcester, Worcestershire, WR8 9JR (01905) 371445

Provided and run by:
Mr Anthony Gordon Williams and Mrs Susan Harris

All Inspections

17 June 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service caring?

' Is the service responsive?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on the people we spoke with who used the service, the staff who supported them and from looking at records.

At the time of our inspection 35 people lived at Orchard House. We spoke with seven people who lived in the home. We spoke with one district nurse and a healthcare assistant. We spoke with four members of staff and three people who worked in management.

Is the service safe?

People told us they felt safe with the staff that cared for them. Staff did not always understand what different types of abuse was. The staff that worked in a managerial role did not recognise all the types of abuse and failed to report incidents to the correct authorities.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberties Safeguards which applies to care homes. The provider had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards applications had been submitted inline with the providers policies and procedures. This meant that people would be safeguarded as required.

Is the service effective?

Staff we spoke with had a good understanding of the people's current care and support needs. However it was clear that staff did not know people's care history and this reflected in the care and support they received.

We found that the provider did not have systems in place to improve the service by learning from incidents or events.

We found the provider did not have an effective system in place to protect people from the risk of infection.

Is the service caring?

We asked people for their opinions about the staff that supported them. What people told us was positive, one person said, 'I can't grumble'. Another person told us, 'The food is lovely, really the best, always really very very good'.

People told us they were treated with respect and dignity by the staff. When we spoke with staff it was clear that they genuinely cared for the people they supported.

We found that some staff were focused on task based jobs and did not always respond to people's needs when they were required.

Is the service responsive?

Staff told us that the manager provided them with up-to date information. Staff told us they knew who they were providing care for.

Is the service well-led?

Staff told us the managers listened to them. Staff were clear about their roles and responsibilities.

The deputy manager told us that they had sent questionnaires to relatives and to people who used the service. This meant that the provider had taken appropriate steps to gather people's views of the running the home.

4 February 2014

During a routine inspection

We inspected Orchard House Care Home and spoke with three people who lived at the home. We spoke with the provider, the manager, the deputy manager, and four members of staff on duty. We also spoke with four staff and three relatives on the telephone. We spent time and observed the care and support people received.

People were positive about life at the home. One person said: "It's lovely here, like home from home. I'm happy here'. Another person told us: 'I think it is (the care) good' and 'Very happy with it here'.

During our inspection we saw that staff helped people to make simple everyday decisions such as, what they wanted to drink and what they wanted to do. There were systems in place to help people with the bigger decisions so that their best interests were maintained.

We saw that staff were aware of each person's needs and how to give care and support to meet those needs. We found that information had been kept up to date and that plans were in place to support staff to make sure they worked in a consistent way.

People were supported with access to additional medical services as necessary to make sure their health and social welfare was protected at all times.

There was a complaints procedure in place and on display at the home. The manager told us this procedure would be followed in the event any comments or complaints were received.

25 January 2013

During an inspection looking at part of the service

The home had last been inspected on 26 July 2012. We found that the registered provider was failing to meet some of the essential standards. During this inspection we checked what progress had been made towards those standards. We found that improvements had been made and the registered provider was meeting the required standards.

There were 35 people living in the home on the day of our inspection. We met all the people living there, spoke with three people, the acting manager, a senior care worker and one care worker to find out their knowledge and views about the service provided. Most people were unable to express their views verbally, so we spent time observing how staff supported them.

People made choices about what they did and what they ate and were supported to develop their independence skills. One person told us, 'We are treated as real people.'

Staff knew how to support people to meet their needs and had referred people to other health professionals. Staff followed advice from external professionals to ensure people's health and well being were promoted.

We found that the manager was regularly checking staff practices. This enabled them to offer effective care and support to the people who lived at the home. One person said, 'If I want help staff come quickly.'

The manager had introduced an effective system to monitor the standards of care that people received. It included audits of the premises to ensure they were fit for purpose.

30 July 2012

During a routine inspection

We inspected Orchard House and used a number of different methods to help us understand the experiences of people who used the service. We spent some time observing the care for five people. We spoke with members of staff on duty and other staff on the telephone, and spent some time with the registered managers.

We found that care and treatment had been planned and delivered in a way that met most people's needs but some care needs had not been fully met for the people whose records we looked at. The care plans we looked at were not easy to follow and contained too much information for staff to access easily.

We talked with some visitors about their view of the home. They were complimentary about the care and support that their relative received. We were told that 'staff are excellent, nothing is too much trouble', 'I cannot believe that X (person's name) has settled in here so quickly and seems so well'. 'Staff work hard and work long shifts here'.

We found that people who lived at Orchard House were protected from the risk of abuse. Visitors told us that they felt their relative was safe and they were aware of how to complain. Visiting relatives told us that they felt their relative received a good standard of care from the staff who worked at the home.

We found that staff had not always received appropriate support from the management team. Staff told us they had done some training but did not have regular supervision, appraisal or staff meetings. We found that although there was a system in place to regularly assess and monitor the quality of service that people received we found that regular reviews of the service had not been carried out.

8 November 2011

During an inspection looking at part of the service

We visited Orchard House so that we could check whether the home had made the improvements we required following a review in July 2011. We spent time observing how staff supported the people who live at the home. Many of the people who live at Orchard House have dementia and therefore not everyone was able to tell us about their experiences. To help us to understand people's experiences, we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. Some people using the service were able to tell us about their experiences and we also spoke with staff.

People told us 'I'm quite happy here', 'it's friendly' and 'we get some lovely food'. The home was providing care which met people's assessed needs. Risk assessments were not always being reviewed when people's needs changed.

There was a choice of nutritious and appetising food, and snacks were freely available. People's nutritional needs were being assessed and monitored, so that any concerns could be acted on promptly.

The home was providing a safe and homely environment for people. Some of the furniture did not promote people's comfort, for example some dining chairs had no cushioning.

11 July 2011

During a routine inspection

Because many of the people who live at Orchard House are not able to communicate verbally, we spent time watching how staff supported people. We observed staff providing care and support to people during the day, and saw that this was generally done in a kind and caring manner. Many of the people who live at Orchard House were not able to tell us much about their experience of living at the home, but those who could were happy with the support provided.

One person was able to tell us that the staff were 'kind, nice, I like them', and another smiled and gave a thumbs up sign when we asked if staff provided them with the support they needed.