Archived: Orchard Court

Orchard Court 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. Orchard Court accommodates 63 people in one adapted building. At the time of our inspection there were 52 older people living at the home, some of whom were living with dementia.

There was no registered manager in post. 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. A new manager, who had previously been the registered manager at another of Anchor Trust’s services, had commenced in January 2018 and had applied to become registered manager. The new manager (manager) assisted us in our inspection.

Medicines management, infection control and safeguarding processes were not suitably robust. We also found at times staff were not always deployed across the service in a way which meant people received consistent attention. At the end of our inspection the manager and provider’s senior management told us an increase in staffing levels had been approved. Gaps in some people’s care records meant staff may not be using the most up to date information about a person.

People were supported by staff who knew them well and they got along with. Staff displayed kindness, care and empathy towards people and showed people respect. People were given attention by staff and staff adapted their approaches in response to individuals dependent on their need.

People had access to activities both in communal areas and within their individual living areas. Although no one was on palliative care there was evidence that staff discussed people’s end of life wishes with them.

People were cared for by staff who had gone through a good recruitment process and in the event of an emergency there was information and equipment in place for safe evacuation. People’s risks were identified and action taken in response to these. The manager reviewed accidents and incidents and as such had taken action to help reduce reoccurrence.

People’s legal rights were protected because staff were aware of the principals of the Mental Capacity Act (2005). The home environment was adapted for people living with dementia and people’s needs were assessed before moving into the home.

People had access to healthcare professionals where required and staff followed national and local guidance to provide effective care. People told us they liked the food that was prepared for them and their dietary needs were met. We also found that people were being cared for by staff who had access to a range of training to support them in their roles.

The manager had a clear vision for the service and had already started to make a positive impact on the care people received. However, this needed to be sustained and audits being carried out embedded to demonstrate continued improvement.

Staff felt supported by management and took part in staff meetings. There was a good culture within the staff team. People told us they liked the new manager and felt he was visible around the home. This was confirmed by our observations on the day.

People were involved in the running of the home and any complaints or suggestions were listened and acted on. Staff worked alongside other agencies to improve the quality of people’s care.

During our inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made a recommendation to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

At the time of our inspection 57 people were living at Orchard Court.

This inspection took place on 19 February 2016 and was unannounced. During this inspection we followed up on the two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which we found at our inspection in August 2014. Following that inspection we had received an action plan from the provider telling us what they planned to do in order to ensure there were enough staff on duty and staff treated people with respect and dignity. We found during this inspection the provider had taken the necessary action in relation to the these breaches.

The home 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.

Care plans contained information to guide staff on how someone wished to be cared for. Although we found records held for people were not always contemporaneous and there were some gaps in information.

Where people had risks identified staff were knowledgeable in how to help mitigate these risks. Accidents and incidents were recorded and monitored by the registered manager for trends and action taken when necessary.

People received care from a sufficient number of staff. Staff maintained people’s health and ensured good access to healthcare professionals when needed. For example, the doctor, optician or district nurse. People received their medicines in a safe way as staff followed correct and appropriate procedures in administering medicines. Medicines were stored safely and appropriately.

People were cared for by staff who evidently cared about them. Staff demonstrated they were kind and respectful to people. Care was provided to people by staff who were suitably trained. People and relatives were happy with the care provided and they were made to feel welcome when they visited.

People had access to a range of activities. Staff had worked hard to develop activities which were suitable for everyone living at Orchard Court. People were provided with a choice of meals each day and those who had dietary requirements received appropriate food to ensure they were not at risk of choking.

Staff understood the legal requirements in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The correct processes were followed when people were deprived of their liberty.

Staff received relevant support from their manager. This included regular supervisions and undertaking training specific to their role.

Safe recruitment practices were followed, which meant the provider endeavoured to employ staff who were suitable to work in the home. Staff were able to evidence to us they knew the procedures to follow should they have any concerns about abuse or someone being harmed.

Quality assurance checks carried out by staff to help ensure the environment was a safe place for people to live and people received a good quality of care. People, relatives and staff were involved in the running of the home as regular meetings were held and suggestions made were listened to.

Complaint procedures were available to people and should the home have to be evacuated there was a contingency plan in place which meant people’s care would be uninterrupted.

People who used the service told us they were visited by the home's staff who asked them various questions about what they liked and about their health.

Relatives told us they were consulted about their family member's needs and two relatives told us they came to look around the home before they made a choice on behalf of their relative.

We saw people were taking part in individual and group activities. Staff were sitting with people and singing festive songs, playing games and having morning coffee. Some people prefered to read the newspaper alone.

We saw the staff were kind and caring and approached people in a friendly manner to undertake specific tasks. Staff told us they enjoyed working in the home and felt they had the appropriate training to undertake their roles.

The home was preparing for Christmas and each unit had a Christmas tree and decorations that they helped the decorate and make.

People were safe and there were appropriate arrangements in place for the administration of medication.

Systems were in place to monitor the quality of service provision, and home meetings were facilitated.

We were told that the staff were kind and caring and always there when required. Someone told us that when the weather was nice that staff took them for walks in the grounds.

People who used the service told us that there was always something to do to keep them occupied. They told us that they enjoyed going to the large activities room on the ground floor to mix with people from other units and outside.

There was good feedback regarding the food. We were told that there was always something they liked available to eat and that the food was appetising and tasty.

We saw staff treated people who used the service with dignity and respect. Staff told us that they enjoyed working in the home and felt that they had the support and training to undertake their roles efficiently.

A relative told us that the home was always very welcoming and that they were involved in organised events.