Orangery Care Home

The care home accommodates up to 60 people in a three storey building, providing care on four designated units for people who require nursing and/ or dementia care. Communal areas were located on the ground floor, and the service was situated around an enclosed courtyard area and secure garden. At the time of the inspection there were 52 people living there.

The service had a registered manager. 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 Act 2008 and associated Regulations about how the service is run.

People had been safeguarded from the risk of abuse; staff understood both their role and duty to protect people and had access to relevant guidance. A range of risks to people had been assessed and care plans were in place to manage them. The required utility and equipment safety checks had been completed to ensure their safe use. People were safe as they were cared for by sufficient numbers of staff whose suitability for their role had been assessed. Processes were in place to ensure people received only the medicines they required, from trained staff. The service was clean and staff had undergone relevant training to enable them to understand how to protect people from the risk of infection. Processes were in place to ensure learning took place following incidents and improvements had been made to people's care to reduce the risk of repetition.

People's needs had been assessed prior to them being offered a service. The provision of people's care reflected good practice guidance. Staff had received a suitable induction to their role, on-going training and supervision.

People's nutritional and fluid intake needs had been identified and met. Processes were in place to ensure staff worked both across the organisation and with external professionals to ensure people's health and social care needs were met. People were supported to access a range of healthcare professionals.

The service was in the process of being refurnished to ensure it met people's needs. The garden was attractive, secure and accessible for people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us they liked the staff, whom they felt had promoted both their independence and their privacy and dignity, visitors were welcomed. Staff treated people kindly and ensured they were comfortable. Overall people were asked for their views about their care and offered choices about their care. The registered manager had taken action to ensure all staff consistently promoted the choices available to people at lunch.

Staff understood people's needs and work was underway to ensure written care plans were fully centred on the individual. Staff had undertaken training in meeting the needs of those living with dementia, although some staff were more confident than others in their interactions with people. People's needs for social and spiritual stimulation had been met. People's complaints had been listened to, responded to and used to improve the service. People had been well supported at the end of their lives.

People were cared for within a positive culture where staff felt valued. Staff felt improvements had taken place to the quality of people's care under the leadership of the registered manager. There was a clear management structure and oversight and support provided both from the provider and regional manager. The registered manager was visible and accessible to people within the service. Processes were in place such as audits, trackers, surveys and meetings to monitor the quality of the service and to drive improvements for people. Staff worked in partnership with other agencies.

The five questions we ask about services and what we found