The Orchards

We found 2 breaches of the legal regulation in relation to safe care and treatment and good governance. We found some inconsistent and missing information around people’s known risks and health conditions in care records. We also found a lack of regular blood sugar monitoring for people with diabetes to help ensure their well-being. Whilst we found no poor outcomes to people, these monitoring checks and records were used to guide staff to help promote people’s well-being. This included new staff and or agency staff on how to support people safely and effectively. This increased the risk to people’s well-being being managed safely. Governance systems in place to monitor the accuracy of records held and the service provided were not robust. The improvements required found during this assessment had either not been identified previously by the service or had been identified but not been fully embedded and sustained.

There was a continuity of care when people moved between different services and staff worked with health professionals to promote people’s wellbeing. There was a reflective learning culture in place to improve the quality of the service provided, however not all improvements found were sustained. In the main staff were trained to carry out their role effectively, however we did identify a gap in training around monitoring a specific health condition. There were enough staff to meet people’s care and support needs. Systems and checks were in place to help recruit staff safely. Medicines were stored, administered and managed safely. Consent and least restrictive practices were in place as required by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff listened to and respected people’s choice.

Staff treated people with kindness. In the main people’s dignity and privacy was promoted and maintained by staff. Both group and individual activities including links with the local community helped promote people’s well-being. Staff understood the importance of reporting concerns, and systems were in place to help protect people from the risk of abuse.

People’s communication needs had been assessed, and they felt listened to. People’s end of life care needs and wishes were documented to guide staff. Complaints when raised were recorded, investigated and resolved where possible.

The environment was visibly clean and well maintained. Equipment and utility checks were undertaken. There was a business continuity plan in place to manage any adverse incidents. Staff told us they enjoyed their roles and were given the opportunity to develop their skills, and knowledge should they choose to do so. Leaders were visible within the service and led by example.

During this assessment the registered manager left their employment, however, the provider had recruited a new manager.