Orchard View

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

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.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People were involved in planning their care and staff used information in care plans to understand what mattered to them. Care plans reflected people’s physical health, wellbeing and communication needs, and regular reviews took place. Staff supported this with consistent day-to-day oversight. We observed daily handovers and saw staff communicated effectively with people.

Relatives reinforced that staff knew people well and provided person-centred support with one saying, “The care is person- centred. They know them really well.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People had enough to eat and drink and could choose what they wanted. Staff encouraged people to be involved in preparing food where and when they wished and supported people to make drinks and snacks when appropriate. Staff told us they had enough time to support people, and we observed this in practice. Staff appeared confident and competent when providing care and support, including understanding how best to support people with diet-controlled diabetes.

Relatives told us staff supported people to maintain a healthy diet. One said, “(Relative) gets a good diet, and they do all they can to ensure (relative) gets healthy food.”

The provider 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.

We saw evidence of multi-disciplinary team (MDT) meetings and information shared with external health partners. Care plans were written clearly so partners and other services could understand people’s needs, and records showed what had been offered or completed.

Hospital passports were in place and up to date where appropriate, supporting safe pathways and transitions between services.

Relatives described timely communication about healthcare contacts. A relative told us, “They always keep me informed and communicate well… I get to know about (relatives) appointments.”

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had health action plans and were supported to attend routine health monitoring, including dentist, chiropody, optician and screening appointments where appropriate. Staff supported people to be as physically active as possible in ways that matched their interests and abilities, such as walking, running, gym, swimming and sailing.

Relatives described a strong focus on meaningful activity and community participation that improved people’s day-to-day lives. A relative said, “They always encourage (relative) to do things. (Relative) gets out a lot. (Relative) goes sailing… They go to a music charity every week.” Another relative told us the person looked healthier and better since moving in. “(Relative) looks good when I see them and looks better now than they did before they went in.”

The provider consistently demonstrated a strong commitment to supporting people’s health, wellbeing and independence through personalised care, proactive monitoring, and meaningful community engagement. Evidence showed people were encouraged to stay active, maintain routine health appointments and pursue activities aligned with their interests. Positive feedback from people and relatives confirmed improved wellbeing and quality of life.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

People’s wellbeing was recorded daily and care records focused on expected outcomes. Staff used this information to support people to progress and build independence. For example, one person who had previously been frightened to go out because of falls was now attending garden centres and outings and becoming more independent with everyday tasks such as making drinks and washing up. People enjoyed a range of activities, for example some enjoyed marathon running, sailing, and camping.

Relatives reported clear improvements in wellbeing and independence. A relative said, “They promote (relatives) independence. They seem younger and happier.” Another relative described staff support as “life changing” and said they received regular updates, including photos, helping them remain involved in progress and outcomes. “They send me photos every day… They ring me if anything happens or send me a message.”

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider did not always make sure people’s consent to care and treatment was managed and recorded in line with the Mental Capacity Act (MCA) and related guidance.

We were not assured that best-interest decision-making was consistently recorded to a clear standard. MCA and best-interest decisions did not clearly evidence discussions, consideration of the environment, how the process was explained to the person, what questions were asked, whether decisions were revisited, or who was involved. This was raised during the assessment, and the manager told us actions had been added to the service action plan.

The manager and staff were trained and understood what MCA is and their responsibilities.