Background to this inspection
Updated
28 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2014 and to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Before the inspection we reviewed information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We reviewed the action plan submitted to us following our last inspection setting out how they will make the required improvements.
The inspection was unannounced and carried out by two inspectors and an expert by experience. An expert by experience is someone who has used this type of service or supported a relative who has used this type of service.
During the inspection we spoke with and received feedback from eight people who used the service, six relatives, six staff members, the deputy manager and the manager, the regional manager, the operations manager and two additional supporting members of the management team. We received information from service commissioners and health and social care professionals. We viewed information relating to seven people’s care and support. We also reviewed records relating to the management of the service.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us due to their complex health needs.
Updated
28 April 2018
This inspection was carried out on 20 March 2018 and was unannounced. At their last inspection on 8 August 2017, they were found to not be meeting the standards we inspected. As a result we issued a warning notice in regards to the management of the home. In addition we placed the service in special measures. At this inspection we found that although they had made some improvements and were meeting the standards, there were some areas that required improvement and further development.
The Orchards Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 63 people in one adapted building over three floors. At the time of the inspection there were 36 people living there. This was because parts of the home were going through refurbishment.
The service had a manager who was not yet registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 is run. The manager had submitted an application to register and this was in progress.
There were systems in place to monitor the quality of the home. However, they had not identified all of the areas that required improvement that we found on inspection. The service was making good progress in regards to an action plan in place to ensure a good quality service was provided and sustained. People and staff were positive about the running of the home which included the new manager and staff were proud about what they had achieved.
Most people were supported in a safe way. However, some people did not always receive appropriate pressure care.
There were sufficient staff to meet people’s needs, however, feedback was mixed. We found that staff were recruited safely. Staff knew how to recognise and report any risks to people’s safety and medicines were managed safely.
People were supported by staff who had received updates to their training and people were supported in accordance with the principles of the Mental Capacity Act 2005. People were supported by staff with respect and kindness and confidentiality was promoted in most cases. However further development was needed to ensure people’s dignity was always promoted.
People gave mixed views about the food, however, most were positive. We sampled the food and food that it was tasty and looked appetising.
People had regular access to health and social care professionals. The design of the building on the two refurbished units was well throughout and made for a pleasant environment. The second floor was still waiting to be refurbished.
People were involved in the planning of their care and most people received care in a person centred way.
People told us that they enjoyed the activities provided, however, these needed further development to ensure they reflected and met people’s individual hobbies and interests. Some feedback was that activities did not meet everyone’s needs.
People’s feedback was sought to help make changes in the service and there was a complaint’s process which people and their relatives knew how to use.