Orchard Court

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

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

This service scored 57 (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 make sure people were at the centre of their care choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in their needs. Available care records covered a wide range of needs, but some information was out of date or contradictory. This could make it difficult for staff to follow and understand people’s needs, particularly for newer staff. Records contained limited information about who the person was, their likes and dislikes and things they would like to do and did not reflect the full person. People told us they were not included in discussions about their care and records did not support that people had been consulted.

The provider understood the diverse health and care needs of people and their local communities, so care was joined up. People were supported to maintain their relationships with their relatives and friends and visits were not restricted. The nominated individual had started to share newsletters with people’s relatives so they could be informed and involved in changes happening in the service. Staff engaged with and sought the support of professionals in their care of people. Systems were in place to support continuity of care including handovers and effective admission processes. An organisation specialising in interactive sessions for young children held some of their classes at the service which was noted to be a positive experience and promoted integration.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The Accessible Information Standard is a requirement for NHS and care services to ensure they understand people’s communication needs and provide information in an appropriate format. People’s communication needs were assessed and information recorded about how they communicated. We observed, on the first day of our assessment staff used show plates to promote choice, which was positive. We received feedback that this was not consistent practice within the service which we shared with the manager.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There were limited opportunities for people and their relatives to feed back about their care. Meetings and surveys were not routinely completed to make sure people felt heard and well-supported. Feedback can also help shape the future direction of the service, which the management team acknowledged and had plans to arrange future meetings.

Although people were not regularly afforded formal opportunities to feed back about their care, people told us the manager was approachable and visible within the service. Staff told us meetings were held and they found these useful, although records required development to capture these and ensure staff voice was reflected. Some staff had completed questionnaires, which were generally positive. However, they weren’t automatically anonymised which could have affected the honesty of responses.

The provider had a complaints policy. Only a small number of formal complaints had been received, and these had been responded to. We did, however, highlight that responses to complaints should provide clear information about how to escalate the complaint, if dissatisfied with the outcome.

The nominated individual noted they maintained regular contact with people’s relatives via phone and tried to be visible within the service.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

There was one part of the building which only contained four bedrooms; people had to alert for staff assistance if they wanted to move to another part of the building. This was discussed with the nominated individual who noted they were actively addressing this issue of access, alongside access to the garden space. The remaining parts of the building were accessible for people.

Whilst people’s bedroom doors had their photographs on and were painted different colours to help people identify their room, bathrooms and toilets were sometimes more difficult to distinguish. We found some toilets were also locked when not in use. The environment was not always enabling people to find their way around independently.

Staff understood how to contact health professionals on people’s behalf, including outside of normal working hours, and request emergency support when needed.

Staff and leaders did not always actively listen to information from people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. The limited opportunity for feedback and review of people’s care and outcomes with them, limiting their opportunities to share their experiences. In addition, social activities were not always planned in line with people’s preferences, which meant people were not consistently supported to engage in meaningful and stimulating activities.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Whilst some people had the opportunity to discuss their end of life wishes, for others this was minimal or still waiting to be discussed. Staff were aware of people who were at the end of their lives and liaised with the relevant health professionals. Staff had also completed training to help people receive good care at the end of their lives.