The inspection took place on 12 and 13 March. It was unannounced.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The Orchards is care home with nursing for older people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and we looked at both during this inspection.

The Orchards provides accommodation and nursing care for up to 44 older people in a purpose built building across two floors. It has special facilities for people who require end of life care or have problems associated with dementia. At the time of our inspection there were 32 people living at the service.

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.

People living at the home at the time of the inspection told us they felt safe. One person said, “I always feel safe staff look after me.” The provider had policies and procedures in place for safeguarding vulnerable adults. Staff understood how to recognise and report signs of abuse or mistreatment.

The provider had a health and safety committee that met three monthly to discuss any issues relating to the home. Each person had risk assessments in place. Staff assessed risks identified and took appropriate action to mitigate them. The provider had robust recruitment policies and procedures in place. There was enough staff to meet the needs of the people living at the home.

The provider had systems in place to manage medicines safely. There were suitable arrangements for storing and recording medicines that required extra security. Staff recorded room and fridge temperatures.

The provider protected people living at the home from infection. The home was visibly clean; communal areas and bedrooms smelt fresh and were in good condition. One person commented, “It’s always nice and clean.”

Staff knew how to report incidents and accidents. Records showed that staff had taken appropriate action where necessary and made changes to reduce the risk of a re-occurrence of an incident.

Staff had the skills, knowledge, and experience to deliver effective care and support. Mandatory training included safeguarding (adult and child protection), and Mental Capacity Act 2005.

The provider supported people to eat and drink enough to maintain a balanced diet. People who lived at the home told us they were very happy with the food provided. One person said; “There’s a good choice of food and you can have what you want” and, “The food is pretty good here.”

Staff discussed people’s care and support with them. People received personalised care. One person said, “They usually say, when would you like to get up.” Another person commented, “They ask me what I want to wear.” Staff worked in partnership with other professionals to ensure they effectively met people’s healthcare needs. One person living at the home told us, “They get the doctor to see you if you need it.”

The provider sought consent to care and treatment in line with legislation and guidance. When people moved to the home, staff assessed their capacity to consent and took appropriate steps if assessed the person as not having capacity to make a specific decision.

The provider ensured that staff treated people with kindness, respect, and compassion. Staff also

This inspection was unannounced and took place on 16 and 17 November 2015.

There is 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. The registered manager was not available for the inspection. The quality and compliance manager acted on their behalf

At our last inspection of the service in October 2013 we did not identify any concerns with the care provided to people.

People told us they received care from care workers who were knowledgeable about their needs and were appropriately trained to meet them. Care workers had access to training specific to their roles and the needs of people for example they had received training in diabetes care. However some staff said they would like to attend the dementia awareness training. The quality and compliance manager confirmed some staff had attended dementia awareness training and the course would be made available to the rest of the team. Records of staff training were not up to date and did not reflect the training carried out. Staff understood people’s needs and were able to explain to us how they would care for each person on a daily basis. One staff member said, “We have good handovers and the care plans have a lot of information.”

Before the inspection we received concerns that there were no activities taking place in the home. We spoke with one relative who said, “The programme is non-existent. That list is not followed.” The quality and compliance manager confirmed there was a full activities programme in place however due to both activities persons being on sick leave the activities had not been happening. Both staff members returned to work the week of the inspection and plans were in place to restart the programme and to add extra sessions. One person said, “I look forward to bingo on a Tuesday.” We observed the bingo take place with people enjoying the company and chat. One activities person said the home had a regular memory café which they hoped to extend to the community and the home had taken part in the Archie project when children from the local school had visited one day a month to talk with people in the home.

There were quality assurance systems in place to monitor care, staff development, accidents and incidents. However they had failed to identify that records maintained to evidence training and supervision had been carried out were not up to date. This was noted by the quality and compliance manager following their most recent audit visit they were in the process of rectifying this at the time of the inspection.

Before the inspection we received concerns that staffing levels were low in the home which may have impacted on the safety of people. Duty rosters showed people were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed staff took time to talk with people during the two days of our inspection. People told us the staff did listen to them and when they could took the time to sit down and chat. We observed very caring compassionate approaches to care. Staff said they had a good team who would help out when necessary.

People living at The Orchards told us they were happy with the care and support provided. They said the manager and staff were open and approachable and cared about their personal preferences. They confirmed staff kept them involved in decision making around their care. One person said, “I am very happy here I am looked after very well.” One relative said, “She is well cared for and comfortable, she’s so much happier.”

People living in the home told us they felt safe, one person said, “I feel as safe as I can be.” A relative said, “I

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. The name appears because they were still the Registered Manager on our register at the time.

We spoke with three people who used the service and three relatives. All spoke very positively about The Orchards. One person said "It's lovely. I'm very comfortable". Another said "Everyone is very accommodating".

We observed that people's privacy and dignity were respected and that they were included in making decisions about their care. They were encouraged to be as independent as possible and their families were encouraged to spend time with them. There was a wide variety of activities to take part in and meals were varied and nutritious.

There was a team of skilled and committed staff who provided a sensitive and caring service. The staff were supported and managed effectively and were encouraged to update their skills and knowledge. They demonstrated a good understanding of the needs and wishes of the residents and created a friendly, safe and welcoming environment.

We spoke with seven of the people who lived in the home and the relatives of three people who were unable to communicate verbally with us. Everyone we spoke with said that the staff were respectful and treated them properly. People told us, “I think the staff are really wonderful” and “Staff are perfectly kind and respectful”. We observed people in the dining room at lunchtime. Staff treated people respectfully and introduced themselves whenever they engaged with people or offered to assist them with their meals. People told us, “The food is excellent” and “They come around and ask you what you would like”.

Everyone we spoke with said they were happy over all with the care provided. We were told “We all get our share of attention and we are all looked after properly” and “Staff come quickly when I need them”. One person said, “The staff are very pleasant people. I feel perfectly safe here”. A relative told us, “I’ve seen nothing but kindness here, I can’t speak highly enough about the staff” and “The staff have bent over backwards to make sure my relative is comfortable”. However, some people thought the activities provided had declined over the last year. One person said, “I’m quite happy over all, the only thing I would like is more activities and to go out more”.

People told us they were able to express their views and get involved in making decisions about their care and daily living. We were told, “I’ve got no grumbles, if I ask for anything it will be sorted” and “I’m not sure whether I’ve discussed my care plan or not. But I’m not really interested in that, I just say what I need”.

People told us that the manager was very visible and continually checked that people were receiving an appropriate standard of service. We were told, ”The manager is always around and into everything. You name it and she is there” and “I’m happy I’ve come to this home. I’ve had no second thoughts”. People’s relatives were able to visit at any time and could stay for as long as they wished. Relatives told us that they were made to feel very welcome. We were told, “Staff are good at communicating and will let us know about any issues” and “I would recommend this home to everyone”.