27 April 2016
During a routine inspection
The Orchards Care Home provides residential care (not nursing) for up to 22 older people. At the time of our inspection there were 14 people living at the home. The person registered as manager for the service was also the provider. They had little presence in the home and therefore management duties are undertaken by an acting manager who intended to apply to the Commission to be the registered manager. 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 2008 and associated Regulations about how the service is run.
People told us they felt safe and staff knew what to do if they thought someone was at risk. However we found issues which could mean people were not safe. Medicines were not managed safely and people had not always been receiving their medicines as prescribed. Staff recruitment procedures had not been followed which meant some staff working at the home had not been subject to checks on their background; this included criminal record checks. There were not enough staff available at all times to make sure people were safe and not all staff were up to date with necessary training. Checks on the safety of the environment were not up to date and we found environmental issues which could put people at risk of harm.
People told us they were well cared for. Staff appeared to know people well and we saw some caring interactions between staff and people living at the home. People told us the food was good and our observations confirmed this. People received the nutrition they needed to maintain their health.
The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The service was working in line with these requirements.
We found staff were not always respectful of people's confidentiality, privacy and dignity needs. Not all communal toilets and bathrooms had locking mechanisms and much of the furniture available to people was stained and dirty. Private records were not stored securely.
We found improvements had been made to care plans since our last inspection although care records did not always reflect a person centred approach.
People had access to healthcare services such as GP, district nurse and dieticians. We saw these services were accessed in a timely manner.
People were able to engage in activities although time for this was restricted by staff having to attend to other duties.
There was a system in place for people to make complaints and we saw complaints were managed and responded to.
We found the systems for auditing the quality and safety within the home were ineffective which meant issues which could affect people’s safety and wellbeing had not been identified or addressed.
At the last comprehensive inspection this provider was placed into special measures by CQC. This inspection found that there was not enough improvement to take the provider out of special measures.
CQC is now considering the appropriate regulatory response to resolve the problems we found.