The Care Quality Commission
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Archived: Orchard House

Overall: Requires improvement read more about inspection ratings

Green Lane, Wolverton, Milton Keynes, Buckinghamshire, MK12 5EZ (01908) 321359

Provided and run by:
Milton Keynes Council

All Inspections

24 August 2015

During an inspection looking at part of the service

Orchard House is registered to provide personal care for people over 55 years old in their own homes and within sheltered accommodation. The service provides rehabilitation and re-enablement care, within 18 individual on-site flats, as well as rapid response care for people in their own homes during the night. At the time of our inspection 15 of the flats were occupied.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

During our inspection on 2 February 2015, we found that the registered person did not have effective systems designed to enable them to regularly assess and monitor the quality of the services provided in the carrying on of the regulated activities. We found that the audit checks that had been completed were not always effective in identifying the issues that we found or detailing the action that needed to be taken to address them. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Following the inspection the provider sent us an action plan detailing the improvements they were going to make, and stating that improvements would be achieved by early August 2015.

This report only covers our findings in relation to the outstanding breaches of regulation. 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.

This follow up inspection took place on 24 August 2015 and was announced.

During this inspection, we found that improvements had been made to the audit systems in place within the service, to ensure that appropriate standards of record keeping and data management were in place, and overviewed and monitored on a regular basis. We found that the systems in place had been strengthened which meant that any issues could be identified and addressed in a timely manner.

While improvements had been made which means that the service is no longer in breach of regulations, we have not revised the rating for this key question. To improve the rating to ‘Good’ would require a longer term track record of consistent good practice. We will review our rating for well- led at the next comprehensive inspection.

02 February 2015

During a routine inspection

Orchard House is registered to provide personal care for people over 55 years old in their own homes and within sheltered accommodation. The service provide rehabilitation and re-enablement care for people over within 18 individual on-site flatlets, as well as rapid response care for people in their own homes during the night. At the time of our inspection 16 of the flatlets were occupied.

This inspection took place on 02 February 2015 and was announced.

There was no registered manager in post during our visit however the service has a manager who is in the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were protected from abuse and felt safe with the service being provided to them. Staff had a good awareness of abuse and the forms it could take, however the systems for reporting abuse were not always used effectively.

Staff were knowledgeable about risks of abuse however we found that reporting, tracking and following-up of incidents required some improvement.

There were sufficient staffing levels available to meet people’s individual needs, as well as regular access to an on-site multi-disciplinary team of professionals.

There were suitable arrangements for the safe storage, management and disposal of medication.

People were asked for consent before being supported by staff, however we did not find use of the Mental Capacity Act (MCA) 2005 or sufficient levels of training and understanding regarding this piece of legislation.

People were supported to prepare their own meals and drinks as they would in their own homes, following their stay at Orchard House.

People’s health needs were met and a set of rehabilitation goals were in place for each person to support their move back into the community. People felt they were treated with kindness, dignity and respect by staff.

The service listened to what people said about the care they received and took active steps to encourage feedback from each person and their families. Activities took place on a regular basis and there were books, music and games available for use at all times.

The manager had only been in post for approximately four weeks at the time of our visit which meant that not everybody was aware of who they were. Systems and processes in place for quality assurance were not embedded or used effectively.

The service shares a site with a provider of sheltered living which led to some confusion and lack of clarity in some areas.

3 February 2014

During a routine inspection

During this inspection we made ten telephone calls to people who used the service to obtain their views about the service. We also spoke directly with two people who were staying at Orchard House.

All of the people we spoke with told us staff explained their individual care needs to them and that they were asked for their consent before staff provided any care. One person said 'The staff always knock on the door to make sure it's alright for them to come in'. Another person told us 'They always involve me in decisions, they ask me how I want to be supported before they help me; they are very kind, nothing is too much trouble'.

People told us they were well cared for by the staff from Orchard House; they told us the staff knew the care they needed and how they wished to be supported. One person said 'I am very well looked after, I have no concerns at all, the staff are all lovely' and another person said 'The staff are very kind and I feel safe living here'. We also spoke with a person who had been cared for at Orchard House, they said 'I would recommend Orchard House to anyone, I loved it, they helped me all they could'.

People told us they were in contact with the management team and felt able to raise any concerns they might have. They also told us that when concerns had been raised the management had taken action to address them.

13 November 2012

During a routine inspection

We spoke with two people who used the service during the course of this inspection; both told us that the staff were respectful of their privacy and dignity. They also told us they were able to make decisions about the care and support that they received from the staff at Orchard House.

One person said 'I was so pleased to be taken on by the service, the support that I now receive has made a big difference to my quality if life'. Another person said 'the staff recognise that there are still some things I can do myself, they give me the time to be as independent as possible and are there to help with the things that I can't do'.

Both of the people we spoke with told us the staff knew how they needed to be supported and they felt safe with the staff. They told us that the staff were respectful, kind and caring. They also told us that they knew how to raise any concerns should they need to do so. One person said 'The staff are all very nice, I know the team leaders very well and would raise any concerns with them'. Another person said 'the staff are usually on time and I never feel as though I am being rushed'.

However one person told us there seemed to be a lot of agency staff working for the service and another person said that they did not always know which staff member was going to be providing their care at each visit.