Orchard Mews

Updated 2 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

2 inspectors carried out the inspection on day 1 and 1 inspector on day 2. An Expert by Experience made telephone calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Orchard Mews is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Orchard Mews is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 20 July 2023 and ended on 7 August 2023. We visited the location’s service on 20 & 26 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 13 relatives about their experience of the care provided. We spoke with 9 members of staff including, the registered manager, managing director, area manager, quality improvement lead, 2 care assistants and 1 senior care worker and 2 nurses. We gained feedback from external professionals.

We reviewed a range of records. This included 5 people's care records and medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, were reviewed.

Updated 2 September 2023

Orchard Mews is a residential care home providing personal and nursing care to up to 39 people. The service provides support to older and younger people living with dementia, learning disabilities and autism. At the time of our inspection there were 27 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

Right Support:

People were supported by staff who understood their care and support needs. Risks in relation to people's care and support were assessed. However, we found these difficult to understand. Assessments contained relevant information but were in a piecemeal order which led to a disjointed approach to determine people’s needs. Despite this staff knew people very well, including new starters.

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. However, we noted staff needed further training around applying MCA (Mental capacity act) due to limited knowledge when considering mental disorders.

There were enough staff to support people as the service had recently undertaken a recruitment drive. Agency staff and internal bank staff had supported the service with any shortfall previous to this. The same agency workers were used to allow continuity of care.

Right Care:

People received kind and compassionate care from staff who knew them well. Staff protected and respected people's privacy and dignity. They understood and responded to people's individual needs. People were safe and staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

People’s family members spoke positively about the care planning process. One person's relative told us, "We are very much involved in [person] care, they are always asking us what we think and want.”

Right Culture:

There was a positive culture at the service, that promoted good outcomes for people. Staff were inclusive and natural. Everyday interactions with people that were kind, enabling and very respectful. Systems and processes were in place to monitor the quality of the service and drive improvements. The service was currently undergoing a refurbishment.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about medicines and staffing. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service is good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.