Orchid Homecare Ltd

Updated 14 January 2021

The inspection

This was a targeted inspection to check whether the provider had met the requirements of the breach identified during our August 2020 inspection in relation to Regulation 17: Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Orchid Homecare Ltd is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, the registered manager was not working at the service at the time of this inspection and a new manager had been appointed.

Notice of inspection

This inspection was unannounced.

Our inspection activity started on 8 December 2020 with telephone calls to people using the service and relatives, and ended on 15 December 2020 with a visit to the office location to speak with staff and look at records.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from the local authority who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with five people using the service, five relatives of people using the service, the new manager, a new quality and compliance manager, the office administrator and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at various records, including care and medicine records, for 11 people, as well as other records relating to the running of the service. These included staff records and audits. This was so we could corroborate our findings and ensure the care and support being provided to people were appropriate for them.

Updated 14 January 2021

About the service:

Orchid Homecare Ltd is a domiciliary care agency. It provides personal care to adults living in their own homes, so they can live as independently as possible.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of this inspection 58 people were using the service, 56 of whom were receiving personal care. People had a variety of care and support needs including dementia, mental health and physical disabilities.

People’s experience of using this service:

The management and staff team as a whole had worked extremely hard to ensure people’s care and support needs were fully met during the ongoing Covid-19 pandemic and lockdown period. Unfortunately, changes made at the service to manage over this period had impacted on other areas of the service and we identified a number of improvements that were required.

There was no overall quality monitoring process that looked at all the areas we (CQC) look at when we inspect services. This meant we found areas requiring improvement during the inspection that the provider had not identified for themselves. This included: safeguarding training for all staff, the detail included on food and fluid charts, staff recruitment processes, the punctuality and consistency of staff, medicine record anomalies, inconsistencies in the use of PPE (personal protective equipment) and protecting people’s confidential data.

Despite our findings, the majority of people using the service and relatives were happy with the service they received and provided lots of positive feedback. One relative told us, “It’s outstanding care from the carers. They make [relative] smile, they always talk her through everything.” Another added, “[ would] definitely definitely recommend the service to a friend.”

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. Staff knew how to protect people and keep them safe. They had the right skills and knowledge to meet people’s needs, and people were generally happy with how they maintained good standards - in relation to infection control and hygiene.

There was strong leadership at the service and the provider demonstrated their willingness and commitment to learn lessons and improve the service where required. People and staff confirmed they were given opportunities to make suggestions and provide feedback about the service. They told us they felt listened to and feedback was responded to in a positive way.

Rating at last inspection:

The last rating for this service was Good (published 27 March 2018).

Why we inspected:

The inspection was prompted in part due to concerns received about safeguarding, the assessment process, medicines, consent, dignity and respect, infection control, records, staffing and recruitment. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of Safe and Well-Led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

This is the first time the service has been rated Requires Improvement.

We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. They have already taken action to address some of our findings and given assurances that appropriate action will be taken to address the remainder.

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

Follow up:

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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