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Archived: Orchard End

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Reports


Inspection carried out on 13 May 2014

During a routine inspection

A single Inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. There were ten people living at Orchard End at the time of our inspection. Due to their complex needs they had limited ability to express their views about their care and treatment, or how they were involved in the service.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We found that the staff were aware of what to do if they witnessed abuse and had been trained with regard to safeguarding adults. One told us they felt there was a culture amongst staff where abuse would not be tolerated and said ''We are reminded at the start of every training session about whistleblowing.'' The manager was aware of what actions to take in response to abuse allegations and had previously taken action to move a person to a more appropriate service, in order to safeguard those who lived in the home.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The complex needs of the people living at Orchard End meant that they lacked the capacity to make the decision, or confirm that living at the home was what they wanted. We found that DoLS assessments had been carried out, or applied for, in respect of everybody who lived there. This ensured that their placement at the service was in their best interests.

We found that systems were in place to assess risks to people who lived in the home, visitors and staff. This meant that people benefited from safe care, treatment and support, due to effective management of risks to their health, welfare and safety.

Is the service effective?

We found that staff were trained and had received good support from the management team in order to carry out their role effectively. Staff demonstrated an awareness of people's needs and provided appropriate support. Health and social care professionals had been contacted and were involved in people's care. One care manager had commented at a person's review 'I think this is an excellent placement.'

We found that people were supported to access the local community. People were also able to access the home's communal areas and large gardens. This enabled them to experience a degree of social interaction and to find quiet, relaxing areas if needed. The people we met were not able to fully verbalise their feelings about the support they received; however two people responded ''yes'' when we asked if they liked the home.

Is the service caring?

We found that appropriate interventions were carried out that reduced the risk of harm to people and we saw that the staff were kind and supportive. For example; one person needed support in relation to a medical condition and the risks associated with it. Another person required an intervention to minimise risk. We found that the risks had been assessed and appropriate support and interventions had been provided in both cases.

Is the service responsive?

We found that the service took action in response to the findings of quality assurance audits, accident and incident reports and risk assessments. This protected people's welfare and enhanced practice.

Staff members we spoke with told us that they felt they were listened to and that the manager responded to any suggestions they had concerning people living at Orchard End. One told us ''He's pretty good at sorting things out.'

Is the service well-led?

We found that there were regular quality assurance processes in place to monitor the service provided to those living at the home. These were carried out by the manager and senior representatives of the registered provider.

The staff received regular supervision and support. They were positive about the manager and felt that they were able to speak with him at any time; one said ''Communication is good here, between everybody. '' Staff were supported to receive regular training and undertake further qualifications to enable them to meet the needs of those living at Orchard End.

Inspection carried out on 11 July 2013

During a routine inspection

We were unable to speak to people that used the service because of their complex communication needs. However, we did speak to staff, look at documents held by the service and saw the results from the �360 quality� project from Gloucestershire County Council. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People who used the service had complex communication needs. Staff used intensive interaction to engage with people and found new ways they had communicated effectively. This had given people the ability to make day to day decisions. We looked at the care plans for three people who used the service. This showed that each person had a �my profile� which gave specific information on each person. We found that they were person centred and in an easy read format. Support guidelines were in place. We found that these were individual to each person and reflected their needs.

Medicines were given safely by trained staff. We found no errors in the administration or recording of people's other medicines. However, we found some errors in the recording of a controlled drug. The manager however, provided suitable evidence following our inspection to account for the medicine. The provider had not received a complaint since June 2012. The provider had also ensured they had informed us of any notifiable incidents in a timely way.

Inspection carried out on 12 December 2012

During a routine inspection

This was an unannounced visit as part of our planned inspection schedule. We had not received any concerns prior to our visit.

We looked at the care files for four people who used the service and we found nothing that gave us cause for concern. Each person had received a deprivation of liberty screening assessment. We also found evidence where best interest decisions had taken place. As an example of this one person required staff to have a monitor in their room so staff could hear if the person needed additional support. A best interests meeting was held to agree this process.

We observed excellent interactions between staff and people using the service. We also found the home had good systems in place for safeguarding and for monitoring the quality of the service the provide to people. The home was in good order and had been refurbished within the last two years.

Reports under our old system of regulation (including those from before CQC was created)