Orchard House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to dignity and respect.

This service scored 50 (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 did not treat people with kindness, empathy and compassion, or respect their privacy and dignity. Whilst we observed some kind and compassionate interactions between staff and people they supported, we also noted some terms used to describe people that were not respectful or reflected people being supported as adults. This included references to people as wearing “nappies” or referring to people with autism as “having a problem”. One member of staff we spoke to stated “It is easier to give people personal care at night, as they are half asleep”.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The service did not always have appropriate guidance and measures in place to support people’s health and support needs in an individualised manner, with risk assessments in place often being generic rather than bespoke to each person. Because restrictions were put in place without due consultation with people’s representatives, we could not be assured these decisions truly reflected people’s needs and choices. However, each person at the service had a key worker in place, and would meet with them monthly to review the care they were receiving, and planned activities and goals together that were person centred. There were detailed plans in place on how people could be supported to achieve what matters to them. For example, one person enjoyed baking, and staff had worked with this person to support them in their wish of baking a cake for Valentine’s Day. A relative told us “Staff support my relative to go out walking which he enjoys very much”. People were supported to make choices and to take part in activities personalised to their interests in a way that works for them.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. We saw some examples of people’s independence being supported by the service, including encouraging people to undertake actions for themselves to maintain dignity and privacy. One family member told us “Staff know how to communicate with (relative name), and support him in making choices for himself as well as supporting him to do tasks independently. Such as prompting to have a shower, and enabling him to go to the toilet by himself”. However, restrictions on the way people lived their daily lives had sometimes been made without an appropriate person representing them.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. We observed that there were sufficient staff to ensure people were supported where required, however staff were not always sufficiently trained or knowledgeable to respond to people’s need. For example, if people needed medication at night, staff explained there would be a delay as there no staff on duty who could support with this. We did find that there was clear individualised guidance for staff on how they would respond if a person was distressed to ensure they received the support they need in the moment. This included having Positive Behaviour Support (PBS) plans in place for some of the people being supported. These are documents setting out how staff should respond if a person is distressed as well as which factors may cause somebody to be distressed, and how these can be reduced.

The provider cared about and promoted the wellbeing of their staff. Staff we spoke to explained they enjoyed working at Orchard House, and that they would be supported by the service if they ever needed any additional support or had concerns. One staff member told us “The manager is really good at training and pushing me to do more. Within a short period I am much more knowledgeable about care work”. There were regular surveys to help the provider understand the experience of staff, and staff explained they had frequent supervision and felt always able to approach the manager with any concerns.