Background to this inspection
Updated
28 March 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an assistant inspector.
Service and service type
This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.
The service had a manager registered with the CQC. 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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started and ended on 28 January 2020. We visited the office location on this date.
What we did before the inspection
We reviewed information we had received about the service and sought feedback from the local authority and professionals 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 who used the service and five of their relatives about their experiences of the care provided. We spoke with six members of staff including the registered manager, care manager, deputy manager and three care workers. The registered manager was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two professionals, a social care worker and a housing worker from the local authority.
We reviewed a range of records. This included two people’s care and medicines records in full and one in part. We looked at two staff recruitment files and five staff supervision records. We looked at a variety of records relation to the management of the service, including quality assurance records and staff meeting minutes.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We contacted two professionals who work with the service to seek feedback, including a worker from the housing provider and a healthcare professional.
Updated
28 March 2020
About the service
Orchid House is a domiciliary care service providing personal care for people living in an extra care housing scheme. The service was supporting 23 people at the time of our inspection, including older people, people with physical disabilities and people living with dementia.
The service is located near to local services and shops. People live in their own apartments or bungalows across the extra care site. Emergency support is available 24 hours a day. The service has an on-site bistro and access to outside space.
Not everyone who used the service received personal care. The Care Quality Commission (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.
People’s experience of using this service and what we found
The provider was committed to providing high quality, person-centred care and ensuring staff shared their values.
People received safe care from staff who were safely recruited and knew how to keep them safe. Staff were proactive in identifying ways to manage risk, they used their knowledge of people’s needs to develop support they would respond to, such as social support. We made a recommendation about medicines best practice guidance.
People received effective support from consistent staff, who were knowledgeable, trained and supported. Staff worked effectively with other professionals to ensure people received the support they needed in a timely way, including with their health needs.
People and their relatives were involved in their assessments and care plans. Consideration was given to any additional support people may need on moving in to the service, to help them adapt to this change. 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.
People consistently praised the caring approach by staff. People and staff formed caring relationships based on trust, dignity and respect. This helped people to accept their care and be independent.
People’s care was developed based on their needs. Staff had a detailed knowledge of each person’s preferences and life histories, which they used to provide person-centred care.
The provider was integrated into the local community, with well established relationships with local health and social care professionals. They used their knowledge of local services to help people remain active members of their community and reduce the risk of them experiencing social isolation.
People and their relatives experienced effective end of life care. Staff recognised the emotional support needed for people and their family members at this life stage.
The provider was committed to achieving good outcomes for people. Staff worked effectively as a team to improve people’s quality of life. The provider used their quality assurance checks and feedback from people, relatives, staff and professionals to drive improvements. Lessons learnt were shared with the staff team to improve practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 22 March 2019 and this is the first inspection.
Why we inspected
This was a planned inspection based on when the service was registered.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.