Orchard Court

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

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

This service scored 55 (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 did not always ensure people were treated with kindness, empathy and compassion, or their privacy and dignity respected.

Due to the concerns identified during the assessment, we could not be assured that people consistently received high‑quality, compassionate care that upheld their dignity and rights. We identified shortfalls in several areas of people’s care and support, including the application of the Mental Capacity Act, access to social activities, involvement in care planning, and aspects of the environment. Despite these concerns, people and relatives provided mostly positive feedback about how staff cared for them. Comments included, “The staff are absolutely marvellous. They absolutely treated [person] with dignity and respect” and “They will do anything for you.” We observed staff knocking on people’s doors before entering, giving words of reassurance and chatting and interacting warmly with people. We did observe an occasion where a person’s dignity was compromised during their mealtime which the manager agreed to address.

The provider did not always treat people as individuals or make sure people’s care and support met their needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Very limited information had been gained and recorded about people’s lives, relationships, former employment and hobbies. This information can aid staff in how to approach and care for people, including those who may have moments of distress. We discussed this with the nominated individual who acknowledged this and noted gathering information about people’s lives would be a key part of the activities co-ordinator role.

Information was captured about people’s religious views, and the manager was in the process of liaising with the local church to arrange church services for those who wanted to attend. Information was recorded about people’s individual communication needs and staff understood how to communicate with people. A staff member told us, “Communication is key; I'm not doing my job if I don't have that effective communication.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

There was limited information recorded about people’s abilities and independent living skills. We observed staff were kind and patient in their care of people, but people were not always asked if they wanted to be involved or encouraged to do things they may have been able to do themselves, such as to get a cold drink. We also observed some unoccupied toilets were locked which did not promote people’s independence in this area. We highlighted this to the manager who agreed to address this.

People were not consistently supported to engage in meaningful activities. A theme of the feedback we received from people and relatives, was about the lack of activities. We observed people were quite sedentary, but people responded positively when a member of staff set up a game of snakes and ladders. On the second day, we observed a few more individual activities happening which some people engaged with. Records did not support people were regularly engaged in activities tailored to their own needs and interests, including for people who chose not to or were unable to access communal activities.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We received mixed feedback from people and their relatives about whether staff responded to people’s immediate needs. For example, a relative noted, “When the residents ask for something they say you will have to wait.” Some people described slight delays in staff responding to their call bells and people’s requests for support. Whilst other people noted staff were there when they needed them. Records, however, did not always support that people’s needs had been attended to in a timely manner. For people who had moments of distress, records lacked sufficient detail to demonstrate the efforts made to support them. This was discussed with the manager.

During our assessment, we observed staff responded in a timely way to people’s requests for support. When staff observed a person who appeared unsettled or uncomfortable, they attended to them and offered further support.

Staff completed first aid training so they would be able to support people in the event of a medical emergency.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. There was a new management team in place at the service, and staff spoke positively about the changes being made. Staff consistently fed back about how approachable the manager was and felt confident they would support any issues affecting their well-being. A staff member noted how accommodating the manager had been around some of their personal circumstances, and went on to note, "I can always go and talk to [manager], and they have protected my confidentiality." On-call arrangements were in place to support staff if they needed advice outside of normal office hours. A staff member confirmed they had always been able to speak with somebody and noted, “You’re not stuck for people to contact.” However, staff had not consistently received supervisions to formally record the support being provided and identify areas for development. The manager noted supervisions were being arranged with the staff team.