Archived: Orchard Cottage

Updated 21 October 2022

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 two inspectors.

Service and service type

Orchard Cottage 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 Cottage 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

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 and professionals who work with the service. We contacted Healthwatch to provide feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We observed the care provided within the communal areas. We spoke with three members of staff including the registered manager and two senior care workers.

We reviewed a range of records. This included three people's care records and three medication records. We looked at a variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

The provider told us during the inspection the service was no longer financially viable and made the decision to close the service. They worked with the local authority to find suitable alternative accommodation for all the people who were living at Orchard Cottage at the time of the inspection.

Updated 21 October 2022

About the service

Orchard Cottage is a residential care home providing personal to up to 10 people. The service provides support to older people who had varying care needs including, dementia, diabetes and mental health needs. At the time of our inspection there were 10 people using the service.

People’s experience of using this service and what we found

Individual risks were not effectively identified and managed to keep people safe. Lessons were not learnt from accidents and incidents to prevent future occurrences. People were not always protected from the risk of abuse as staff did not have a good knowledge of what action to take. Peoples medicines were not managed well or in a safe way. There were not sufficient staff on duty to effectively meet people’s needs and keep them safe.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People did not have a full assessment of their needs in order to develop care plans that were individual and reflected their health and care needs. People did not always have access to advice and treatment from the appropriate healthcare professional. The environment was not suitable for some people living at Orchard Cottage, such as people living with dementia.

Staff training was insufficient to meet staff needs. There were gaps in staff skills and knowledge which meant people did not always receive the help they needed.

The provider and registered manager did not have sufficient oversight of the service. Records did not reflect the changing needs of people. There was no process to monitor the quality and safety of the care provided to people to identify areas for improvement or take action when needed.

People received sufficient food and snacks and had a choice. People could request certain meals and their requests were acted upon.

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 good (published 5 May 2022).

Why we inspected

We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted due to concerns received about fire risks, staffing, response to incidents and access to healthcare. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with the assessment of individual risk and care needs, staff understanding of the Mental Capacity Act and the management and oversight of the service. We widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, medicines management, capacity and consent and monitoring and oversight of quality and safety at this inspection.

Please see the enforcement action at the end of this report.

Follow up

The provider told us during the inspection the service was no longer financially viable and made the decision to close the service. They worked with the local authority to find suitable alternative accommodation for all the people who were living at Orchard Cottage at the time of the inspection.