About the service: Orchard House Nursing Home provides residential and nursing care for up to 31 older adults who may have dementia and/or other health conditions. At the time of our inspection 31 people were living at the home.

Accommodation was provided over two floors and communal areas, including a conservatory, lounge, dining room, and a sensory room. People either had their own room or shared with another person. People had access to gardens at the rear of the home.

People’s experience of using this service:

People we spoke to were positive about the service. We saw friendly interactions between people and staff.

Staff treated people with respect, patience and kindness. There were sufficient staff to meet people’s needs, to give the support they needed and to spend quality time with them.

Orchard House Nursing Home is a founding member of the Namaste programme. The programme was developed for people living with dementia and anxiety. It is a sensory activity programme designed to promote wellbeing particularly for people who do not respond to structured activities.

People had access to a range of healthcare professionals and services.

External health professionals gave us positive feedback about the service, for example a pharmacist told us, “Orchard House are definitely one of the most organised, friendly, caring and resident knowledgeable homes we deal with. Whenever, I have been in the home, the staff have had a great mannerism with me, each other and most importantly the residents. I would be happy to have my mum looked after in this home. The residents always come first.”

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 were supported by staff whose suitability was checked through a robust recruitment process. People’s medicines were managed safely.

Care plans guided staff about people’s needs and how to meet them. Staff supported people to be involved in decisions about their care. People were supported to stay at Orchard House Nursing Home until the end of their lives.

People’s needs were fully assessed, before they came to live at the home, to ensure that staff could meet their needs appropriately. Staff completed relevant training to meet people’s needs and were supported to do additional training. Staff told us they felt supported, received regular supervisions and an annual appraisal.

Staff knew how to keep people safe in an emergency, such as a fire. People were supported by staff who were trained to recognise the signs of any potential abuse. Staff had been trained in safeguarding and knew what action to take if they had any concerns about people’s safety or welfare.

People’s risks were identified and assessed appropriately.

Arrangements were in place to assess and monitor the quality of the service, so that improvements could be made.

This service met the characteristics of Good. More information is in the ‘Detailed Findings’ below.

Rating at the last inspection: Good. The last inspection report was published on 24 November 2015.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care services.

Follow up: We will review the service in line with our methodology for 'Good' services.

There were 27 people living at the home on the day of our visit, one person was in hospital, no one knew we would be visiting. We spoke to three people who lived at the home, three relatives, four staff and the manager.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them. People told us and we saw that choices were offered and that people's views were sought and acted upon. One person said, “They do things the way I like them done.’’

Staff spoken to was able to tell us about people's needs so that they received care in a way that they preferred. All three relatives told us they were consulted about their relative’s care and kept informed about their relative’s health so that so they felt involved in their care. This meant that people received care in the way they wanted. One person told us about using the computer to receive emails from relatives who could not visit often.

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm. A person said, “Its great here and I do feel really secure and safe.’’

The needs of people living at the home are met through the provision of sufficient and appropriately skilled staff.

There were systems in place to monitor how the home was run, to ensure people received a quality service.

There were 29 people living at the home on the day of our visit, no one knew we would be visiting. We spoke to three people who lived at the home, three relatives, four staff and the manager.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them.

People told us and we saw that choices were offered and that people's views were sought and acted upon. Staff spoken with was able to tell us about people's needs so that they received care in a way that they preferred.

All three relatives told us they were consulted about their relative’s care and kept informed about their relative’s health so that they felt involved in their care. A relative told us that the home had set up emails for people who use services so they could email relatives who could not visit often. This means that people are supported to maintain the relationships that are important to them.

We saw that people were relaxed in their environment and that systems were in place to keep them safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support the people who lived in the home.

This inspection took place on 20 and 21 October 2015 and was unannounced. At the last inspection on 24 and 25 November 2014, the provider was not meeting the regulations which related to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguarding guidance to restrict people’s liberty in their best interests. We asked the provider to send us an action plan. We found improvements had been made. Staff had received up to date training and the provider was now taking the correct action to protect people’s rights in line with current legislation.

Orchard House Nursing Home provides residential and nursing care for up to 31 older adults who may have dementia and/or other health conditions. At the time of our inspection 28 people lived at the home.

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.

Although the dining experience provided to people was not always positive, people were supported to have choices and received food and drink at regular times throughout the day. Staff supported people to eat their meals when needed.

People who lived at the home felt safe and secure. Relatives believed their family members were kept safe. Staff felt people were kept safe. The provider had processes and systems in place to keep people safe and protected them from the risk of harm.

People received their medicines as prescribed and appropriate records were kept when medicines were administered by trained staff.

Risks to people had been assessed appropriately and well maintained equipment was available for staff to use.

There was sufficient staff on duty to meet the support needs of people. The provider ensured staff were recruited and trained to meet the care and nursing needs of people.

People were supported to access other health care professionals to ensure that their health care needs were met.

People, relatives and health care professionals, felt staff were caring, friendly and treated people with kindness and respect.

People’s health care needs were assessed and regularly reviewed. People were involved in group or individual social activities to prevent them from being isolated.

People and relatives were confident that if they had any concerns or complaints, they would be listened to and the matters addressed quickly.

The provider had management systems in place to assess and monitor the quality of the service provided. This included gathering feedback from people who used the service and their relatives.