You are here

Archived: Orchard Court Inadequate

The provider of this service changed - see old profile

We are carrying out a review of quality at Orchard Court. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 13 March 2018

During a routine inspection

We inspected Orchard Court on 13 March 2018. The visit was unannounced.

At the previous inspection on 23 November 2017, we found breaches of legal requirements and the service was rated inadequate overall and the service was put into special measures. We imposed urgent conditions on the registration which prevented new admissions to the service and required the provider to submit regular reports to prove the safety of people using the service.

After the comprehensive inspection, the provider was asked to provide an action plan to tell us what they would do to meet legal requirements in relation to breaches in person centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, staffing and good governance. The service was also in breach of the registration regulations failing to notify the Commission of events affecting people. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches identified.

At this inspection we found the service had made some of the required improvements. However, the rating for the service remains Inadequate and the service remains in special measures. We found three continued breaches and three further breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Orchard Court is registered to provide residential and personal care for up to 20 people. There are three separate units within the service with six to seven people living on each unit. At the time of this inspection there were 20 people living in the service. There were people using the service who could not always express their needs and wishes because they had a mental health condition or because their ability to communicate was impaired. Many of the people using the service had complex needs which, at times, needed one to one or two to one support from staff who were trained in specific and specialised areas of care delivery. During our inspection it was not evident that support was being provided to the level people needed, to provide both meaningful activities or ensure their safety.

The service 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 2008 and associated Regulations about how the service is run.

The staff team had received training on the safeguarding of adults and were aware of their responsibilities for keeping people safe from avoidable harm. The provider’s safeguarding policy had not always been followed when a safeguarding concern had been identified.

The risks associated with people's care and support had been assessed though not all of the assessments had been personalised to cover the individual needs of the person.

The deployment of staff was ineffective and people were not being provided with the support they needed at a time that suited them. The way in which shifts were organised and the necessity for the staff team to carry out cleaning duties meant the people using the service missed out on participating in activities and interests that were important to them.

Appropriate checks had been carried out on new members of staff to make sure they were safe and suitable to work at the service and an induction had been provided. Whilst the staff team had received a number of training courses since our last inspection, some staff members had yet to receive training on specific health conditions people lived with.

People were not always supported with their medicines as prescribed by their GP. Not all of the staff team were aware of which of the people using the service were receiving their medicines covertly. [Disguised in food].

The premises were not clean or hygienic. The staff team were required to carry out cleaning and laundry duties as well a

Inspection carried out on 23 November 2017

During a routine inspection

This unannounced inspection took place on 23 November 2017. It was the provider's first inspection at this location since registering with CQC.

At this inspection we found breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Registration Regulations 2009. The breaches we identified posed a significant risk to people who used the service due to the complexity of their care needs. Many of the people using the service were extremely vulnerable, and highly dependent on the care staff supporting them. Our observations of peoples’ needs during our inspection showed that they were not always receiving the necessary support to ensure risks to their health, safety and well-being were effectively managed. There was a lack of care delivered to meet people’s individual needs and to promote and encourage their independence.

Due to the breaches we identified during our inspection and the risk these posed to some people, we made a safeguarding referral to the Local Authority as we were concerned about people's safety and well-being. The overall rating for this is inadequate.

Orchard Court is registered to provide residential and personal care for up to 20 people. There are three separate units within the service with six to seven people living on each unit. At the time of this inspection there were 20 people living in the service. One of these people was in hospital during our inspection. There were people using the service who could not always express their needs and wishes because they had a mental health condition or because their ability to communicate was impaired. Many of the people using the service had complex needs which, at times, needed one to one or two to one support from staff who were trained in specific and specialised areas of care delivery. During our inspection we found that this was not being provided at the service to the level people needed to ensure their safety.

There was a registered manager in post at the time of our inspection. 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.

We found there to be insufficient numbers of staff working at the service to keep people safe. People were not receiving the levels of supervision they needed and staff lacked the specialist knowledge and skills to care for and support people safely. People had experienced and were at risk of experiencing unsafe care and support as a result. Staff training was not adequate and not designed to meet the needs of people who used the service.

People were not safe due to safeguarding incidents not being appropriately acted on or reported and risks to people were not adequately planned for. Care plans and risk assessments did not always reflect people's current needs.

Medicines were being managed safely when we inspected the service, however, there was a lack of information for people with diabetes. We raised this with the provider who took steps to address this during the course of our inspection.

People had a choice of food and drink each day and were given these in sufficient quantities, however, people's nutritional risk was not always safely monitored and addressed.

People were not able to spend their time engaged in activities they may have enjoyed and people were not often given the opportunity to access the community. This was due to staffing levels at the service. People were not living fulfilling lives and there was a lack of emphasis on people's goals and aspirations. People spent long periods of time with little or nothing to do.

We found some staff to be caring and compassionate towards people, however, due to staffing levels at the service they lacked time to be a