Orchard House Care Centre

Updated 2 February 2024

Date of assessment 17 April to 24 May 2024. This assessment was completed following concerns received about staffing levels, personal care needs not being met, staff culture and leadership. We assessed a small number of quality statements and found areas of concern and good practice. The scores for these areas have been combined with scores based on the key question ratings from the last inspection. Processes did not always support high quality and inclusive care. We identified 2 breaches of regulation relating to good governance and fit and proper persons employed. There were shortfalls in some people’s care records, which contained inconsistent information or lacked detail. This placed people at risk of harm as staff did not have reliable information on how to mitigate risks in people’s care. The provider was unable to supply all necessary information to demonstrate safe recruitment practice. We noted a difference in the experience for people able to join in social and group activities and those cared for in their rooms. These concerns had not been identified or addressed through the service’s audits. We shared our findings with leaders during the assessment. They acknowledged our concerns and confirmed they would act to address the shortfalls identified. However, people and relatives told us they received safe care. The management team and staff understood their safeguarding responsibilities. Staff protected people's human rights in line with the Mental Capacity Act 2005. There was a proactive and positive culture of safety based on openness and honesty. Staff worked well together and with external professionals for the benefit of people. Staff knew people well and understood their individual needs. Staff recognised people’s independence and respected their rights to privacy. Workforce wellbeing and development was promoted. Staff were confident about the leadership of the home.

Updated 2 February 2024

We received mixed feedback from people and their relatives about their overall care experience. People told us they were not always offered a choice about what they did or where they spent their time. Some relatives raised concerns about people not being encouraged or supported to get out of bed when they felt they were able to. We noted a difference in the experience for people able to join in social and group activities and those cared for in their rooms. There appeared to be limited opportunity for meaningful interaction for those cared for in bed. Some people told us their preferences were not always respected in relation to bathing and showering. One person said, “I have a shower or a wash. I would love to have a bath.” People and relatives raised concerns that personal care needs were not always provided in a timely way, particularly in relation to oral hygiene and nail care. We received mixed feedback from people and relatives in relation to the caring nature of staff. Some told us staff were very kind, whilst others indicated some of the team could be, “brusque and not very friendly.” We received mixed responses from people in relation to staffing levels. Some people said they had to wait for support when they rang their call bell while others told us there were plenty of staff. However, people and relatives told us they felt safe. One person said, “They look after me.” Another told us, “Their training must be very good, they’re very accommodating.” People told us staff respected their privacy and confirmed they were supported to be independent. People felt their health needs were met and told us they could see medical staff if needed. People and relatives felt they were treated fairly by the management and staff team. People and relatives told us they knew how to complain should they need to and said they were confident action would be taken.