Orchard Manor Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated as Requires Improvement. This meant the management and leadership were inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Management had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. People had positive comments to make about the service, telling us, “It is managed well because (manager) has a very nice personality”, “It’s a very happy place” and “I think it does have a good atmosphere.”

Relatives also spoke highly of the service. One visited on the day, and we heard them say to the registered manager, “We are so happy with this place. It’s fabulous.” Feedback from relatives included, “This beautiful place with the most incredible team makes my mum’s dementia journey so much easier and less stressful on the family, as we know she is in the best place”, “(When relative returned from a hospital admission) I could see the calming effect familiar faces and his own room had on him”, “Orchard Manor has improved my mum’s life” and, “Overall we are so happy with Orchard Manor and couldn't think of a better place for [relative’s name] to be.”

There was a positive culture within the service. The registered manager told us, “We do have policies and procedures to follow, but we are human as well and staff need to know we are here for them. It is important I am present for morning handovers and I see the night staff 5 mornings a week.” They added, “We have a strong team who are used to working with each other. We are friends, but we don’t cross professional boundaries when at work.”

Management were open and transparent in relation to the feedback we gave them during the inspection. This included where we had identified shortfalls, as they acted on them immediately. This demonstrated an understanding of the need to provide high quality care to people.

The registered provider did not always understand the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Staff told us they did not feel supported by the registered provider as their feedback did not lead to changes. They said they had raised their concerns about staffing levels through staff surveys but felt the registered provider had not taken their concerns seriously. Staff had fed back in the survey, ‘above the regional, all outside positions lack understanding of care homes’, ‘they may listen, but often nothing changes’ and ‘higher up like HR and operations do not like hearing criticism. They do not like hearing negative things.

Although staff told us they felt supported by their immediate line manager and the registered manager. Staff, without fail, told us how supported they felt by them. We heard, “[Registered manager] is the perfect manager. She is very strong”, “[Registered manager] is really good. She has a lot of input” and “She is very supportive.”

In turn, the registered manager told us how supported they felt by their immediate line manager. They said, “I couldn’t have a better regional manager. I have never met someone who truly understands what it’s like being a home manager. She has spent time getting to know me and nurturing me and has a delicate way of ensuring I am okay. She knows every resident and their needs as well as every staff member.”

Staff were encouraged in their individual development. A staff member said, “[Registered manager] is kind and encourages training and she’s asked me twice if I’d like to be a senior carer.” Furthermore, several staff were being supported to complete a work-based qualification for staff working in the care sector.

The registered manager fostered a positive culture internally where staff felt they could speak up and their voices would be heard. Although we heard from staff that they felt they were not taken seriously by the provider when raising concerns.

At all levels, staff said they would have no concerns about speaking up with the registered manager. One told us, “I feel comfortable. We are all adults and I feel we can speak.” A second said, “I would raise anything with the manager.” The registered manager told us, “(My immediate manager) provides a safe space for me to vent if needed.”

Management valued diversity in their workforce. They worked towards creating an inclusive and fair culture by improving equality and equity for their employees.

Staff were recruited on sponsorship, from the UK or taken on as bank staff, and the staff team included staff with different abilities, with management ensuring appropriate support was in place. The registered manager told us, “All I care about is that they have a heart and want to learn as well as a wish to keep people safe.”

The registered manager had arranged an in-house training day for staff so they could shadow other team members. This encouraged good teamwork and inclusion at all levels, as well as learning and development, as each staff member learnt about other roles within the service.

Management had clear responsibilities, roles, systems of accountability and good governance; however, these systems did not always identify shortfalls.

The service used an internal electronic auditing system. This enabled them to input and review information and findings to identify where changes were needed. This included infection control, medicines, accidents and incidents and care planning audits. However, upon review of some audit outcomes, we found that shortfalls or areas for improvement had not always been identified. For example, where medicine practices could be improved, such as addressing the generic, incorrect, or missing information in people’s care plans. In addition, despite the registered manager recognising the need for staff to improve their recording of people’s bowel movements or repositioning, these were still not being consistently done.

We also found there was an inconsistency from staff in ensuring everyone was provided with person-centred, individualised care, as not everyone was being given opportunities in line with their interests.

Therefore, although the registered manager had good oversight of the service, there were elements of the service that needed improvement to ensure good practices were consistently embedded.

Staff understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

The service had links with local day centres and care agencies as well as a community group for people with a learning disability, dementia or who were just lonely. Residents at Orchard Manor Care Home organised fundraising events for the group, as well as delivering homemade cakes.

Local art groups came in to run sessions for people, and taxis were arranged for those who wished to attend local churches for services.

Additionally, healthcare and social care professionals were involved in the service. This included the GP, speech and language therapy team, district nurses and community nurse.

Management focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. People told us they felt nothing could improve for them. One person said, “I’m quite happy. I can’t think of anything better” and another told us, “We’re in a place where if somebody falls they’re looked after.”

The registered manager said, “We will mess up, but it’s how we learn from it. The provider didn’t want care staff to access body maps for people other than through the electronic system, but we want to reintroduce paper ones, as staff need to know if a person has a wound or a bruise, as they are the ones carrying out the personal care and will raise concerns if things change. We also want to introduce a monitoring regime for people who have had falls. We will continue to monitor and check them twice a day for 7 days.”