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Inspection carried out on 29 October 2019

During a routine inspection

About the service:

Orchard House is a care home providing accommodation and personal care for up to five people with mental health needs. At the time of the inspection, five people were living there.

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

People told us they felt safe and had a good relationship with staff. Staff felt confident to raise safeguarding concerns with the registered manager and were aware of external agencies where they could report concerns.

Staff supported people to manage their medicines safety. There were enough staff available to support people safely and ensure people that needed support to access the community could do so. Staff were recruited safely. Risks to people were identified and guidance was in place for staff to reduce the level of risk to people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where required, decision specific capacity assessments were completed and there was an effective system to monitor Deprivation of Liberty Safeguards applications and authorisations.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care needs. Staff received regular one to one supervision and told us they felt supported.

Support plans were detailed and reviewed regularly. People’s healthcare needs were identified and met. Staff worked with a range of healthcare professionals and followed professional advice and guidance when needed. Feedback we received from professionals who worked with the service was positive.

People were supported by caring staff who worked towards promoting their dignity, privacy and independence.

There were systems to ensure care was responsive. People felt their concerns and complaints would be listened to and responded to. People had plans relating to end of life care decisions where required.

People gave us positive feedback about the quality of care they received. The feedback on the leadership of the service and the registered manager from people and staff was positive.

There were effective governance systems in place to monitor the quality of service and the health, safety of welfare of people.

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 January 2017)

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

Inspection carried out on 23 November 2016

During a routine inspection

Orchard House is a small care home that provides care and support for up to five people with mental health issues. The home is registered as a step down service from Shrewsbury Independent Hospital that treats people with a mental illness. The home is owned and operated by Whitepost Health Care Group Limited. On the day of our inspection four people were living in the home.

The registered manager operated more than one location and was not present at the 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 and associated Regulations about how the service was run. The provider had appointed a service manager to undertake the day- to- day management of this service. They were present for the duration of our inspection.

Medicines were managed in a safe way and recording of medicines was completed to show people had received the medicines they required.

There were sufficient numbers of staff on duty to meet people’s care needs. Appropriate checks, such as a criminal record check, were carried out to help ensure only suitable staff worked in the home.

Staff met with the service manager on a one to one basis to discuss their work. Staff said they felt supported by the registered manager and the service manager and felt confident with the level of management support they received.

Staff were aware of their responsibilities to safeguard people from abuse. Staff and people were able to tell us what they would if they suspected an incident of abuse occurred. Staff had access to a whistleblowing policy should they need to use it.

People were involved in their care and had a copy of their care plan. This was discussed and reviewed with then at least once a month. People’s bedrooms had been decorated to a good standard and were personalised by them according to their choice

People and staff interaction was relaxed. It was evident staff knew people well and understood people’s needs and aspirations. Staff were very caring to people and respected their privacy and dignity.

People were provided with a range of nutritious foods to maintain a healthy diet. People told us they planned the menus weekly. People cooked their own meals and had arrangements in place to manage this. We saw people had access to drinks and snacks throughout the day and made drinks for each other.

People had risk assessments in place for identified risk of harm. The service manager logged any accidents and incidents that occurred and put measures in place for staff to follow to mitigate any further accidents or incidents.

Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). There was nobody living at the service subject to a DoLS authorisation.

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

The registered manager and service manager operated an open door policy and we say several examples of this throughout the day. People felt comfortable to approach the service manager to seek their support and advice.

If an emergency occurred or the home had to close for a period of time, people’s care would not be interrupted, as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was displayed in the communal area and people had been provided with a copy of this, which they kept with their care plan.

People were encouraged to feedback their views and ideas into the running of the home.

Inspection carried out on 8 October 2013

During a routine inspection

This was the first inspection undertaken at Orchard House since the home was registered to provide a rehabilitation service for up to five female service users. The home works alongside Shrewsbury Court Independent Mental Health Hospital and was set up as a facility to promote independent living.

There were three people using the service at the time of our visit. It was possible to meet and talk with one person who used the service, one person did not wish to meet us and the third person was out with a staff member.

The registered manager was off duty and there was a senior care staff in charge of the home.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plans.

We looked at care plans that were electronically maintained. People who used the service had been involved in their care planning and were provided with a paper copy of their plan.

People's privacy and dignity was protected and they were supported with independence and community involvement.

We observed that there were enough staff available to meet people's assessed needs.