Orchid Home Care Support Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received person centred care, which was designed around their needs and wishes. People’s likes, dislikes, life history and what was important to them was gathered as part of the assessment and care planning process and used to generate individual support plans. People were supported to generate and achieve goals.

Staff knew what person-centred care meant and how to ensure this was provided. A staff member told us, “Person-centred care means putting the individual at the heart of everything I do. I take account of people's protected characteristics, including their age, disability, gender, ethnicity, religion, and sexual orientation, when planning and delivering care. Care plans reflect each person's individual identity and preferences, and I ensure I follow these carefully.”

Staff were trained in person-centred care to ensure they had a sound understanding of positive person-centred values and practices which the provider expected them to demonstrate when supporting people. Some people’s daily notes tasks were not always reflective of what was documented in their care plans and risk assessments. For example, one person required their skin to be monitored but this was not listed on the daily tasks for staff. This was raised with the registered manager who quickly amended this.

Policies were in place to support person-centred care; these included polices on advocacy, dignity respect and choices, privacy, restrictive practices, safeguarding and equality and human rights. Understanding person-centred care was part of the staff induction process.

All people we spoke with said they knew who to talk to if they felt they had a problem or an issue. People also said they would be happy to discuss anything with the care staff or registered manager, who were all very approachable.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People told us they had access to the care they needed to live well. People were confident in the staff to summon emergency medical advice if needed.

The registered manager explained how they placed great emphasis on continuity of care and told us, “Continuity of care helps build trust, consistency and positive relationships between service users and staff. We aim to allocate a regular team of carers to each individual, so they are supported by staff who understand their needs, preferences, routines and communication styles. We avoid sending unfamiliar staff unless absolutely necessary, as we recognise this can cause anxiety or distress.”

People’s care records showed staff routinely contacted professionals to support people such as, GP’s and social workers. A person said, “The manager is really good; when she visits with the social worker, if I don’t understand what the social worker is saying, she [registered manager] will say it in a different way.” A relative told us, “There are enough staff, [person] has 2 carers 4 times a day; it is always the same team.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication preferences were included in their care plans and staff ensured these were followed. People’s care records explained their communication needs and any aids they required to support this. The provider was meeting the requirements of the Accessible Information Standard (AIS). The AIS tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. It also says that people should get the support they need in relation to communication.

The service user guide was available in alternative formats including large print, easy read including pictures, audio version and on various coloured paper; this guide, and other information, such as how to make a complaint and how to report a safeguarding issue, were provided to people and relatives.

The provider had up to date policies and procedures in place relating to supporting people’s communication and sensory needs. Staff received training and guidance to help them meet people’s communication needs. A staff member told us, “I adapt how I communicate based on what works best for each individual. For someone with dementia, I use simple, clear language, non-verbal cues, and a calm tone of voice. For someone who uses a communication aid or pictorial system, I familiarise myself with that method and use it consistently. I also ensure that written information, such as activity schedules or notices, is presented in a format that is accessible and easy to understand. It is about removing barriers, not creating them.”

A compliments and complaints policy and procedure was in place. We saw a person had been supported whose primary language was not English. To address this, the provider allocated staff who could speak Hindi and Gujarati, which significantly improved understanding and trust, enabling the person to express their preferences clearly and become more involved in decisions about their care.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and relatives told us they knew how to provide feedback and felt confident it would be listened to and acted upon. Systems were in place to gather feedback, including regular reviews, surveys and ongoing communication with staff, which supported people to express their views openly.

Information about how to raise concerns or make a complaint was provided in a way people could understand. Where concerns were raised, these were taken seriously, investigated appropriately and used to drive improvements in the service. People told us they were kept informed about the outcome of any concerns they raised and felt reassured their voices were heard.

Staff involved people in decisions about their care and support. People were supported to express their preferences, make choices about how their care was delivered and contribute to reviews of their care packages. Care records reflected people’s involvement and demonstrated staff valued their views and wishes.

The provider demonstrated a strong, person-centred approach to listening to and involving people. People were empowered to share their views and were actively involved in shaping their care and the ongoing development of the service.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured people accessed the care, treatment and support when they needed to and in a way that worked for them; this helped to promote equality, remove barriers or delays and protect people’s rights. A staff member told us, “The service has a range of aids and adaptations in place including hoists, adapted bathrooms, wheelchair-accessible communal areas, and specialist equipment tailored to individual needs. For people with communication difficulties, alternative communication methods and visual aids are used.”

People were very confident the provider would arrange for support with healthcare needs where this was needed; they felt staff knew their individual likes and dislikes and knew and respected them well.

Leaders considered staffing levels and deployment to ensure there were always staff available, and staff had appropriate access to support for emergencies when out of hours. The provider operated a dedicated on-call system, where a member of the management team was available each day and night over a 7-day period to provide guidance, respond to emergencies and support staff working in the community. Staff were aware of how to access on-call support and were encouraged to contact the on-call manager whenever needed.

Providers use people’s feedback and other evidence to actively seek to improve access for people more likely to experience barriers or delays in accessing their care. In the 12 months prior to our inspection the provider had received a small number of isolated complaints relating to visit timings, continuity of staff, communication, and documentation; these were reviewed promptly by leaders and used as learning opportunities. In response, the provider strengthened staff rostering arrangements, improved rota planning, reduced unnecessary carer changes, and monitored time-band compliance more closely through their electronic care management system.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People and relatives did not report any concerns about discrimination and were supported with the development of positive relationships, and access to the local community. Staff received equality and diversity training and there was an equality diversity policy in place to provide guidance. People were provided the opportunity to share what was important to them if they chose to.

We saw enough staff were available on the staff rota each day to support people safely. The provider identified any barriers to accessing care during the initial assessment and through ongoing reviews and actively addressed them; this person-centred approach focused on promoting equality, inclusion and independence.

The provider allocated appropriate resources to support people based on their needs; this includes assigning staff who could communicate in the person’s preferred language, adapting care delivery to respect cultural and religious practices, and providing additional support where required to enable community access.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care plans reflected people’s individual preferences for how they wished to be supported as their needs changed, ensuring care remained responsive and person-centred. Staff demonstrated an understanding of people’s needs and supported them to review and update their plans when circumstances changed. A person told us, “We have a review once a year, all the family attends. The care plan is flexible, last time I was given some extra hours. If I have to cancel or change visits, they [staff] are as good as gold, they don’t mind.”

People were given the time and information they needed to consider their options and make decisions about their future care. Where appropriate, staff supported people to access other professionals and services, such as healthcare providers, to ensure their future care was planned in a coordinated and informed way.

End of life care planning was approached with sensitivity and respect. Where people had expressed preferences about their end-of-life care, these were recorded and shared with relevant professionals to support continuity and consistency of care.

Staff understood the importance of respecting people’s dignity, comfort and wishes at this stage of their lives. A staff member told us, “Good end of life care means that the person is free from pain, their wishes are respected, and they are surrounded by those who are important to them. It means maintaining dignity at all times, communicating with compassion, and ensuring that the family is also supported. It involves working closely with healthcare professionals, including district nurses and palliative care teams, to ensure the right equipment and medication are in place. I believe that how we support someone at the end of their life is one of the most important things we do in this role.”

Systems were in place to review and monitor care plans and ensure they remained accurate and up to date. The provider used this information to ensure care remained appropriate and responsive.

The provider demonstrated a proactive and compassionate approach to planning for the future. People were supported to make informed decisions, and their preferences were respected and embedded in their care, promoting continuity, dignity and person-centred outcomes.