About the service: Orchard House is a care home which is registered to provide personal care and accommodation for up to 52 people, some of whom are living with dementia. There were 38 people using the service at the time of the inspection.

The home had changed their registration since the last inspection and were no longer providing nursing care, which had caused the reduction in the number of people using the service since we last visited.

People’s experience of using this service: People and their relatives told us they were happy with the care they received at Orchard House. Staff were described as warm and friendly, and the registered manager was approachable and supportive.

There were systems in place to maintain the safety of people and checks were in place on the premises and equipment.

The mealtime experience we observed lacked a social atmosphere and staff appeared task focused. We were advised this might have been due to the disruption of the building work which had displaced people and possibly interfered with routines. The manager assured us they would address this.

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.

We observed numerous kind and caring interactions between staff and people. People were treated with dignity and respect.

Care plans were person centred and people had access to a variety of activities. People’s social needs and interests were considered.

The registered manager had a clear focus on continuous improvement. Systems were in place for the monitoring of the quality of the service and records held by the manager were extremely well organised and easy to navigate.

Rating at last inspection: Good (published July 2016).

Why we inspected: This was a planned inspection which was based upon the previous rating.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate and high-quality care. Further inspections will be planned for future dates.

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

We inspected Orchard House Care Home on 10 May 2016. This was an unannounced inspection. The service provides care and support for up to 52 people. When we undertook our inspection there were 48 people living at the home.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses or because they were experiencing difficulties coping with everyday tasks due to memory loss. The home also provided end of life care.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 Care Act 2008 and associated Regulations about how the service is run.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection there was no one subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period. There was a dedicated wing for those with memory problems. This was staffed separately to the main building for continuity of care for people living in that area.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan for each person. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

Staff had taken care in finding out what people wanted from their lives and had supported them in their choices. They had used family and friends as guides to obtain information and accessed a number of different resources within the community.

People had a choice of meals, snacks and drinks. Meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. Some people helped with setting tables for meals.

The provider used safe systems when new staff were recruited. All new staff completed induction training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements. Since our last inspection the provider had updated and refurbished many parts of the home.

We inspected Orchard House Care Home on 17 and 22 December 2014. This was an unannounced inspection. Our last inspection took place on 16 October 2013 during which we found there were no breaches in the regulations.

The service provides care and support for up to 52 people, some of whom may experience memory loss associated with conditions such as dementia. When we undertook our inspection there were 45 people living at the service.

There was no registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 Care Act 2008 and associated Regulations about how the service is run.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection two people had their freedom restricted. The necessary authorisation papers were in place.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe. Processes were in place to ensure people lived in a safe environment.

People told us they were happy with the service they received. They said staff treated people with respect and were kind and compassionate towards them. People and the relatives we spoke with told us they found the staff and manager approachable and that they could speak with them at any time if they were concerned about anything.

Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s diverse needs.

The provider had systems in place to regularly monitor, and when needed take action to continuously improve the quality and safety of the service.

nCare and treatment was planned and delivered in such a way that was intended to ensure people’s safety and welfare. We looked at four care plans for people who used the service. These were personalised and provided detailed guidance about how people’s needs should be met.

We spoke with a visiting professional who was involved in someone’s care review at the time of our inspection. They told us, “This home provides excellent care; the records are very well maintained. The people here are looked after very well.

We looked at the menus and saw they offered a wide range of hot and cold meals. One person who lived at the home commented, “I like the meals here, they are lovely.”

We looked around the home and observed a good overall standard of cleanliness. We saw people’s rooms were clean and communal areas were clean and tidy. One relative told us, “It's [the home] is immaculate; it’s kept spotless.”

People looked relaxed in the company of the staff. One person told us, “They look after us really well.”

We spoke with three people who used the service. They told us that staff were kind and caring, and that they were given support to be as independent as possible. One relative told us, “He is getting looked after excellently, the staff are lovely and there is plenty of good food.”

We saw that people living at the home were happy and well supported.