The Orchard

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.

At our last assessment we rated this key question good. At this assessment the rating has remained 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. Person-centred risk assessments were completed. Care records included guidance for staff to follow when people showed signs of distress. Assessments considered a wide range of needs, including personal care, skin integrity, nutrition, hydration and mobility. Care records reflected people’s current needs and how they preferred to be supported. Staff’s feedback confirmed this. Care records were regularly reviewed and updated to ensure they remained accurate and care continued to meet people’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. People’s care records included guidance for staff to support them. The service worked in partnership with external healthcare professionals, including GPs, and healthcare specialists, to ensure people received appropriate and timely support. People were supported with positive behaviour support plans. These described strategies to reduce people’s anxiety. For example, ensuring support was provided by trained staff and using people’s preferred communication methods such as known signs and gestures. Staff told us they followed guidance from speech and language therapists (SaLT) when supporting people with their specific dietary needs. The registered manager told us they sought advice from the relevant health and social care professionals when supporting people.

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. Staff we observed worked effectively together as a team to deliver coordinated and consistent care and there was a collaborative approach to meeting people’s needs. There were clear communication systems in place, including shift handovers and regular staff meetings. The registered manager and staff supported each other and worked cohesively to ensure care was delivered in a timely and responsive way. Staff worked in partnership with a range of external professionals, such as speech and language therapists and other healthcare specialists, to support people’s health and wellbeing. A health and social care professional told us the manager and staff worked closely with them when supporting a person within the service.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People were provided with a healthy and varied diet with choices for mealtimes. People could visit the on-site café for their meals. Staff we observed provided encouragement to people and supported them in a person-centred way. People’s lunchtime experience was relaxed, and they were supported to maintain and improve their health and well-being. Staff confirmed they always had time to support people. We observed the registered manager had planned and communicated in advance with their staff when supporting a person with a medical appointment. Relatives told us people’s health had not deteriorated, they were doing “amazing” and were “beautifully looked after.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Systems were in place to support regular reviews of care plans and risk assessments to ensure they remained up to date and reflective of people’s current needs. Staff recorded and reported changes in people’s health and well-being, enabling timely action to be taken where concerns were identified, for example, during shift handovers. Outcomes were monitored through a range of methods, including completing daily notes. Staff told us they recorded information, for example, in relation to people’s nutrition and hydration and this was reviewed by the registered manager. Relatives told us people’s health was supported well and monitored. For example, benefitting from the input of healthcare professionals.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. We observed people moving freely around their homes and choosing where they wanted to spend their time, which was respected by staff. The provider completed decision specific mental capacity assessments and best interest’s decisions when required. The provider was in the process of strengthening their processes and procedures when recording information within mental capacity assessments and best interest decisions. Staff had been trained about the principles of the Mental Capacity Act 2005 and understood the importance of respecting people’s wishes. Staff we observed requested consent from people when administering medicines and moving people safely. Staff told us they always assumed capacity and asked for consent when supporting people. Staff spoke to us about supporting people in the least restrictive way possible.