Orchard Place

Updated 30 December 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We made an unannounced inspection on 23 November 2017. The inspection team consisted of one Inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had knowledge and experience of care for older people.

We looked at the information we held about the service and the provider. We looked at statutory notifications that the provider had sent us. Statutory notifications are reports that the provider is required to send us by law about important incidents that have happened at the service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This information helped us to focus our inspection.

We observed how staff supported people throughout the day. We spoke with nine people who lived at the home and four relatives, We spoke with the registered manager and three members of staff. We also considered written comments from a GP. We looked at three care plans, which contained risk assessments, capacity assessments, reviews of people's needs, healthcare information and life histories. We also looked at the minutes from residents’ meetings, two staff pre-employment checks, quality assurance audits. We carried out a stock check of two medicines and looked at ten medication administration records.

Updated 30 December 2017

Orchard Place is located in Ledbury, Herefordshire. The service provides accommodation and care for up to ten older people. On the day of our inspection, there were ten people living at the home.

The inspection took place on 23 November 2017 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

At our previous inspection on 29 May 2015, we found the service was 'Good' overall, but 'Requires Improvement' in the key question of Effective. At this inspection, we found the service remained 'Good' overall, but 'Requires Improvement' in the key question of Safe.

Medicines had not always been administered in accordance with the prescriber's instructions.

There continued to sufficient staff to meet people's safety needs, as well as their emotional and wellbeing needs. Risk assessments were in place, which set out how to care for each individual safely, and these were adhered to. Measures were in place to reduce the risk of infection.

There was an understanding amongst the staff team of their responsibilities under the Mental Capacity Act. There was an understanding of capacity, and of people's right to make decisions which may appear to be unwise.

People continued to be supported to access a range of different healthcare professionals and services. Changes in people's health and wellbeing were recognised and responded to.

People were encouraged to provide feedback about the service and about any improvements or changes they wanted to see made. This included speaking directly with the provider and arranging to meet with them.

People were able to enjoy their individual hobbies and interests, as well as to try new social and leisure opportunities,

People continued to benefit from respectful and positive relationships with staff, with staff knowing people well and understanding their individual routines and preferences.

There continued to be an inclusive and happy environment within the home. People were involved in the running of the home, as much as possible. Links had been developed with the local community for the benefit of people living in the home.