HF Trust - Orchard View

Updated 11 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors carried out this inspection. A third inspector completed telephone calls to relatives to seek feedback about the care provided at HF Trust – Orchard View.

Service and service type

HF Trust – Orchard View is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. HF Trust – Orchard View is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection, there was not a registered manager in post. An interim agency manager had been employed to provide short-term managerial oversight and the provider was actively recruiting a new registered manager at the time of our inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We met with all of the people who lived at HF Trust – Orchard View. We spoke with 1 person and 3 relatives about their experience of the care provided. We spent time observing how staff interacted with people. We spoke with 7 members of staff including 2 support workers, 1 senior support worker, 1 temporary staff member supplied through an agency, the interim deputy manager, the interim agency manager and the residential operations manager. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included information contained in 3 people's care records and samples of medicine and daily records. We also looked at 1 staff recruitment file and records related to the management and quality assurance of the service.

Updated 11 March 2023

About the service

HF Trust - Orchard View is a residential care home providing accommodation for persons who require personal care and have a diagnosis of a learning disability and/or autism. The home can accommodate 6 people and at the time of the inspection, 6 people were receiving support.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

People did not always receive person centred care in line with Right, Care, Right Support, Right Culture.

Right Support: People had limited opportunities to leave the service and pursue social interests within their local community. Where people had been allocated one to one staff support to complete meaningful activities, people had not always received this support. There was limited guidance to inform staff how to enrich people's lives through positive engagement and meaningful activities. People's goals and aspirations were not always identified with people or those involved in their care. Risks associated with people’s health and wellbeing were not always managed safely. Where risks had been identified, some records contained conflicting information about how staff should manage these risks.

People were not always supported to have maximum choice and control of their lives, but staff supported them in the least restrictive way possible and in their best interests; the providers policies and systems supported best practice, but these were not always followed by staff.

Right Care: People were not always involved in making decisions about their care. There was limited consideration given to the varying ways people could be empowered to make everyday choices using different communication methods.

Right Culture: The service did not always have a person-centred culture which empowered people to achieve their goals and aspirations. Systems were not operated effectively to identify if people were receiving person centred care in line with Right Care, Right Support, Right Culture. There was insufficient recording and reviewing of behaviours where a person had experienced distress.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 3 October 2019).

Why we inspected

We received concerns in relation to safe staffing numbers and governances. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. Please see the safe, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for HF Trust – Orchard View on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, person centred care and good governance at this inspection. You can see what action we have asked the provider to take at the end of this full report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.