Orchard Nursing

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. For example, an initial assessment of each person’s needs was completed before they moved into the home to confirm the service could meet their requirements. The outcomes of these assessments were used to develop an individualised care plan tailored to each person. Assessment of people’s needs was ongoing, and care plans were reviewed and updated monthly, or sooner if there was a sudden or significant change in a person’s needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. For example, recognised assessment tools were used to help assess and evaluate people’s care needs. These included the Malnutrition Universal Screening Tool (MUST) to identify people at risk of malnutrition and dehydration, and the Waterlow score to assess the risk of pressure ulcers. Staff applied their training, skills and knowledge effectively and followed the guidance within these tools to determine when people required additional care or support from external professionals.

People’s nutritional and hydration needs were clearly detailed in their care plans, and staff were knowledgeable about these requirements. Kitchen staff also held up‑to‑date information to ensure they prepared the correct food and drinks for each person, including those requiring modified diets.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. For example, managers and staff worked effectively with other agencies to ensure people received the care and treatment they needed. People were supported to attend health and wellbeing appointments, and records were maintained detailing their attendance and any outcomes. Care plans were updated promptly following these appointments to reflect any changes, advice or guidance provided. Staff made timely referrals to external services when required, including mental health teams, dietitians and specialist nursing teams, ensuring people had access to appropriate and responsive support.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. For example, staff supported people’s emotional wellbeing through positive interactions. Designated staff were employed to help plan and deliver a varied programme of activities, including light exercise sessions, arts and crafts, and music‑based activities, all aimed at enhancing people’s overall wellbeing and quality of life. Menus were under review to promote healthy eating and to ensure they continued to reflect people’s preferences.

The provider routinely monitored people’s care and treatment to ensure outcomes were positive and consistent. For example, aspects of people’s care were monitored in line with their care plans. This included regular oversight of food and fluid intake and monitoring of skin integrity, which helped reduce associated risks and ensured these areas of care remained consistent and effective.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. For example, decisions made on behalf of people who lacked capacity were completed in line with the principles of the Mental Capacity Act (MCA) 2005. Relevant others, such as family members and external professionals, were involved in best‑interest decision‑making where appropriate. Applications for Deprivation of Liberty Safeguards (DoLS) were submitted in a timely manner and monitored to ensure authorisations remained current and continued to reflect people’s needs.