Archived: Orchard House

We considered our inspection findings to answer questions we always ask: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager and staff were aware of new changes in the law with regard to DoLS. Where applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We looked at the provider's arrangements for ensuring that the planning and delivery of care and, where appropriate, treatment met the needs of the people who lived in the service. We found that improvements had been made to care plans which ensured that all of a person's care needs were recorded, and that information included how risks were to be proactively managed.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs.

Where people were deemed as not having capacity to make decisions about their care and treatment or to manage their affairs, we saw that the provider acted in accordance with the legal requirements of the Mental Capacity Act 2005 (MCA).

Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.

People's preferences, interests, aspirations and diverse needs had generally been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People's choices were taken into account and listened to. People who used the service were provided with the opportunity to participate in activities which interested them.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

Since the last inspection the provider had improved the arrangements in place to assess and monitor the quality of the service provided. For example, audit processes and procedures had been made more robust. The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Where applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

We saw appropriate processes were in place with regard to medication and it's administration, so that people could be confident they were protected from the unsafe use and management of medicines.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We looked at the provider's arrangements for ensuring that the planning and delivery of care and, where appropriate, treatment met the needs of the people who lived in the service. We found that improvements were required to ensure that all of a person's care needs were recorded, and that information included how risks were to be proactively managed.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs.

People were supported to be able to eat and drink sufficient amounts to meet their needs. We saw they were provided with a good choice of meals on a daily basis.

Where people were deemed as not having capacity to make decisions about their care and treatment or to manage their affairs, we saw that the provider acted in accordance with the legal requirements of the Mental Capacity Act 2005 (MCA).

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and respectful manner. We saw that staff treated people with respect. One staff member told us: "We all know the service users well and I think we all work well together. Things are improving now we have a new manager, we are better supported."

Staff had a good knowledge and understanding of people's care and support needs, including recognising and supporting them as an individual. Where people required assistance, staff provided this in a timely manner and at a relaxed pace. This ensured people received care and support consistently and in ways that they preferred.

People's preferences, interests, aspirations and diverse needs had generally been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People's choices were taken into account and listened to. People who used the service were provided with the opportunity to participate in activities which interested them.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

The provider had some arrangements in place to assess and monitor the quality of the service provided. However systems were not in place, as detailed within this report in relation to the monitoring of care plans and risk assessments. Improvements were also required to ensure that shortfalls identified throughout this report, for example, audit processes and procedures were made more robust. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to assessing and monitoring the quality of service provision.

We saw that people had individual ways of communicating and were able to make members of staff aware of their needs and preferences.

We noted that the environment at Orchard House was spacious, with sufficient communal areas to meet the needs of people living there. We saw that people were comfortable in their surroundings.

We found that staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people using the service. We saw that staff treated people with respect.

Orchard House was well managed and the registered manager had put robust systems and processes in place to ensure people received a good service that took into account their needs and preferences.