Background to this inspection
Updated
4 December 2020
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 Care Act 2014.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
Orchard House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced. However, due to the Covid-19 pandemic, we contacted the service half an hour prior to arrival to make sure it was safe for us to visit.
What we did before the inspection
We looked at the information we held about the service including notifications. A notification is information about events that the registered persons are required, by law, to tell us about. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We sought feedback from the local authority and other professionals who work with the service. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with seven staff members including the registered manager, a registered nurse, senior care workers, care workers and housekeeping staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection
Due to the Covid-19 pandemic the registered manager sent us records electronically. We looked at a range of records, including two people’s care records and three people’s medicine administration records. We looked at information about three staff files in relation to recruitment and a variety of management records, including audits. We also spoke with six staff members by telephone following the inspection.
Updated
4 December 2020
About the service
Orchard House is a care home providing personal and nursing care to 47 people aged 65 and over at the time of the inspection. The service can support up to 67 people.
People’s experience of using this service and what we found
There were not always enough staff working in one area of the home and this put people at risk of not receiving care when they needed it.
People were happy with the care home and the staff that provided their care.
People felt safe living at the home and staff knew how to report possible harm. Staff assessed and reduced risks as much as possible, and there was equipment in place to help people remain as independent as possible. The provider obtained key recruitment checks before new staff started work.
People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff used protective equipment, such as gloves and aprons.
Systems to monitor how well the home was running were carried out. Concerns were followed up to make sure action was taken to rectify any issues. Changes were made where issues had occurred elsewhere, so that the risk of a similar incident occurring again was reduced. People were asked their view of the home and action was taken to change any areas they were not happy with.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (report published 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection there had been improvement in previous areas of concern but there was a breach of regulation in another area.
Why we inspected
We carried out an unannounced comprehensive inspection of this service between 10 and 12 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 coronavirus and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Orchard House on our website at www.cqc.org.uk.
Enforcement
We have identified a breach in relation to staffing levels at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.