Orchard Manor Care Home

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.

This is the first assessment for this service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff made sure people’s care and treatment were effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

People’s needs were assessed prior to them moving into the service to help ensure Orchard Manor Care Home was the most appropriate place for people to live. The pre-admission assessment then formed the basis of a person’s care plan, which was reviewed, amended and updated during the first few days of moving in. The registered manager told us, “We audit a person’s care plan between 5 and 7 days of them moving in to help ensure it is accurate.” We found evidence of this when we read relatively detailed information in 1 person’s care plan despite only recently moving into the service.

Staff did not always plan people’s care and treatment in line with evidence-based good practice and standards.

People’s needs were assessed using nationally recognised tools, including MUST for nutritional risk, Waterlow for pressure sore risk, and dependency assessments to determine care needs. However, although 1 person’s severe food allergy was recorded and known to care and kitchen staff, there was no guidance in their general risk assessment on how to respond to an anaphylactic reaction. This highlighted a gap in risk management documentation, as critical information was not consistently recorded.

The environment was well designed to support people who liked to walk, with circular corridors enabling safe movement. Yet, we noticed limited evidence of meaningful areas of interest or stimulation for some people living with dementia. However, we saw individual rooms did have personalised identifying features.

Staff 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.

The service worked with the local GP practice through an online monitoring system where management submitted people’s weights and other clinical readings, such as blood pressure, each week. The system was linked to NHS 111, and follow-up calls and advice were available should any information appear abnormal for the person.

Staff had liaised with staff from a day centre regarding one person to gain a better understanding of the individual and their presentation when away from their family home. This helped them understand the person and their needs better when they first moved in, enabling staff to adapt their approach in a way that was more flexible for the individual.

Staff 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.

Various health care professionals supported the service to help ensure people remained in good health. These links enabled staff to make referrals and seek advice or reviews quickly. The registered manager told us, “We can email clinicians in between the nurse visits, and contact the pharmacist who works with the GP to review and amend people’s medication. At the moment the district nurses are visiting twice a week for those people who need it and we have the community psychiatrist nurse (CPN) coming this afternoon to see 2 people.”

People’s needs were considered, and changes or support were introduced to reduce their risk of requiring additional external help. One person was very petite and although this was their natural build, staff provided fortified foods to help support them to keep healthy. One person told us, “When I first did my leg, I had to go every 3 months for a check, and they (staff) used to send a girl with me in a taxi for the appointment.” A second person said, “They look after our health. I have pain relief at night as I get pains in my arms.”

Staff 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.

One person had moved into an upstairs room when they first arrived at Orchard Manor Care Home, but staff found they were reluctant to receive personal care and were disengaged with the activities being held. In discussion with family, staff moved the person to a downstairs room, nearer the lounge area and where they could see more movement around them. This resulted in the person becoming more engaged, joining in on activities and accepting personal care from staff.

Relatives felt their family member’s health was responded to well. One relative told us, “I told staff he wasn’t hearing very well and they took his hearing aids and they now change the filter every week and it’s made such a difference to his hearing.”

Staff told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us that staff asked for their consent before providing care. One person said, “They wouldn’t do anything you didn’t like” and another told us, “Yes they do (ask). They are very kind.”

Staff generally understood the principles of the Mental Capacity Act 2005 (MCA) and applied these when assessing a person’s capacity and making decisions on their behalf. Capacity assessments were in place for most people living in a building that had a locked door, having a sensor in their room or for the use of a lap belt when in a wheelchair. If the person was deemed not to have capacity, a best interest’s decision was made to ensure that any measures taken were of the least restrictive possible. A staff member said, “Don’t assume they don’t have capacity. Capacity assessment and best interest meeting, but make sure it’s the least restrictive.”