Orchard Nursing

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always treated with dignity and respect. For example, we observed people sitting in a communal lounge with the lights turned off. The lighting operated via a motion‑activated sensor on a timer, which only came on when movement was detected. As people were seated and not moving, the light timed out, leaving them in darkness. This did not support a dignified or comfortable environment. Managers took immediate action to ensure people’s dignity after we raised our concerns with them.

However, there were also examples of kind and compassionate care. Staff consistently knocked before entering people’s bedrooms and spoke to and about people warmly and respectfully.

People were not always treated as individuals in a way that consistently upheld their personal preferences and supported their dignity. We observed occasions where people were not provided with the support they needed to feel comfortable, respected or well attended to. For example, during our first site visit, we observed people waited for over an hour in the dining room before their meal was served, with limited interaction from staff and no drinks offered during this period.

However, the mealtime experience was significantly improved on day two, following the immediate actions taken by managers and staff in response to our feedback. People were assisted into the dining room shortly before their meals were served, and staff engaged with them in a warm and respectful manner. Staff demonstrated awareness of people’s personal histories, likes, dislikes and preferred routines, providing more personalised and attentive care.

The provider did not always promote people’s independence or ensure they had full choice and control over their care, treatment and day‑to‑day wellbeing. Although people’s levels of independence, preferences and choices were detailed within their care plans, this was not consistently reflected in practice. For example, during our first site visit we observed people were not routinely offered a choice of meal, as food was pre‑plated in the main kitchen before being served. During our observations, two people refused their lunchtime meal, explaining they did not like some of the food provided.

However, the mealtime experience was significantly improved on day two, following the immediate actions taken by managers and staff in response to our feedback. People were offered a choice at mealtime prior to their meal being served. following the immediate actions taken by managers and staff in response to our feedback. We observed staff encouraging people to mobilise independently by using their walking aids, which promoted confidence and supported their independence in daily activities.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. For example, staff responded promptly to call bells and assisted people with personal needs, such as support to use the bathroom. These interactions showed staff were attentive and aware of people’s immediate care requirements.

The provider and manager cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. For example, staff shared many positive examples of how their wellbeing had improved over recent months. They described a much better working environment and said they felt more confident and able to share their views and opinions. Comments from staff included, “There is much improved team morale,” “I now have a smile on my face coming to work,” and “I feel my opinions matter and are listened to.”