The Orangery

Updated 9 September 2020

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

This was a targeted inspection looking at the infection control and prevention measures the provider has in place. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

This inspection took place on 18 August 2020 and was announced. The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

Updated 9 September 2020

About the service

The Orangery is a nursing home providing personal and nursing care to 40 people aged 65 and over at the time of the inspection. The service can support up to 40 people.

The Orangery is laid out over two floors, Azalea Wing, supporting people who require general nursing care and Gardenia Wing, supporting people who are living with dementia. Gardenia Wing includes a communal dining area and rooms are set out around the ‘orangery’, a glass roofed space used to accommodate activities. A smaller communal lounge is situated next to the nursing station. Azalea wing offers one large lounge that is converted into a dining space during meal times, when tables are pulled into the centre of the room. All of the rooms offer en-suite facilities and there are communal bathrooms and toilets available for people on both wings. A lift ensures people can access all areas of the home and there is level access to the garden from both floors of the building. The manager’s office is situated adjacent to the communal entrance on the ground floor.

People’s experience of using this service and what we found

People told us they were supported by staff who were kind and caring. We observed many kind and caring interactions between people and staff. Considerations were given to people’s equality characteristics. Staff practice ensure people’s dignity and privacy was respected.

People told us they felt safe. Risk assessments were in place and provided sufficient guidance for staff about how to protect people from potential harm. Staff we spoke with were confident about how they would identify potential abuse and actions they would take if abuse was witnessed or suspected. The home was clean and free from malodours. Medicines were managed safely.

The provider responded to complaints and concerns appropriately, relatives said they felt able to raise complaints and concerns. People received a responsive service that was personalised to meet their individual needs. Activities were available for people and the provider had recently employed an additional staff member to assist with activity provision. People with a disability or impairment were supported to access information that was relevant and important to them.

The provider ensured notifications were sent to the commission in line with statutory requirements. Staff were involved with a research project in partnership with a local university and national researcher. Links with the community included those with a local school and religious organisation. There was a person-centred culture and staff spoke about people in a person-centred and respectful way. Staff told us they worked as a team.

People’s oral healthcare needs were not always assessed and people were not always supported to access dental check-ups in line with published guidance about best practice. People were supported to access healthcare, however there was a risk people may not be supported to access the dentist as required. When fluid targets were in place for people who were considered at risk of dehydration, fluid charts did not always show staff were acting to improve the person’s fluid consumption. However, we did not find evidence that people were dehydrated.

People’s end of life care preferences were explored and the provider had received compliments from loved ones of people who had passed away about the care they received during the end of their life. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We have made one recommendation about oral healthcare assessment and support.

Rating at last inspection Good (published May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Orangery on our website at www.cqc.org.uk.