Orchid Home Care Support Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The registered manager was committed to providing high quality, person centred care which helped to promote a positive culture where people were treated with respect, kindness and fairness. The registered manager told us, “Our service is built around a strong person-centred approach, where individuals are supported as unique people with their own preferences, routines, cultural needs and life goals. Our core values include dignity, respect, compassion, equality, diversity, independence and continuous improvement.”

People’s individual backgrounds, beliefs, identities and life experiences were recognised and respected. Care was delivered in a way which valued each person as an individual and promoted equitable access to care and support. A relative who lived with a person being supported told us, “Once a week a carer sits with [person] whilst my daughter takes me shopping. They know [person] really well; our relationship with them is amazing. We celebrate each other’s birthdays and Christmas, and they are more or less a part of our family.”

There was an open and transparent culture within the service. Staff felt confident to raise concerns, share ideas and contribute to the ongoing development of the service. The provider encouraged honest communication and learning, and staff told us they felt listened to and supported; this helped foster trust and accountability across the service. A staff member said, “I think the culture of the service genuinely supports openness, and staff are actively encouraged to share feedback, not just about problems but also about ideas for improvement. Knowing your voice is valued makes a significant difference to how you feel about coming to work.”

The provider actively engaged with people, relatives and staff to understand their experiences and views. Feedback was welcomed and used to inform decisions and improvements. The provider demonstrated awareness of the challenges faced by people, and the wider local community. A relative told us, “I can speak to the manager directly, even in out of hours times.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider ensured leaders had the appropriate skills, knowledge and experience to carry out their roles effectively. Leaders were visible and approachable, and staff described them as supportive and responsive. There were clear lines of accountability, and managers demonstrated confidence and competence in decision-making, including managing risks and addressing concerns promptly.

We saw evidence leaders acted with integrity, openness and honesty, for example, the registered manager acted promptly to rectify any issues we identified during this inspection. Leaders were transparent in their communication with staff, people using the service and other stakeholders. Where issues had been identified, the registered manager acknowledged these openly and took appropriate action to address them. A staff member told us, “They [leaders] are qualified and experienced leaders; they are always visible and available for guidance. They do regular audits and act fast to fix any culture or quality issues. I receive regular feedback and guidance.” A relative said, “The manager is friendly, helpful and supportive, she is adaptable to our needs. She visited with flowers and chocolates when I was upset about [person’s] ill health.”

Leaders fostered an inclusive working environment, where diversity was recognised and respected. The registered manager understood the importance of workforce wellbeing and had implemented measures to support staff, including regular supervision, team meetings and opportunities for feedback. There was a culture of learning, with leaders encouraging reflective practice and continuous improvement.

Staff told us they felt empowered to raise concerns and were confident these would be acted upon. A staff member said, “The managers ensure staff take their breaks during shifts, which I think is important both for our own wellbeing and for the quality of care we provide. Managers try to be fair and consistent with rotas, and there is an awareness that long stretches of intense work can take a toll. If someone has had a particularly difficult or distressing experience at work, there is a debrief process in place and managers check in to make sure the person is alright. I also know that there are employee assistance resources available if anyone needs additional support outside of the workplace.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The provider had up-to-date freedom to speak up policies and procedures. The registered manager ensured there were appropriate forums and opportunities for staff to speak up. Staff had access to an on-call system, team meetings and supervision sessions. A staff member told us, “In my experience, raising a concern has always resulted in a considered response. Managers do not dismiss what you say or make you feel as though you are being difficult for speaking up. I have raised concerns in both formal supervisions and informally, and in both cases the response has been thoughtful and follow-up has happened.”

Staff said they were asked by leaders for their opinions and concerns on a regular basis. A staff member told us, “They [leaders] have an open-door policy and listen to my suggestions.” There were mechanisms in place for staff, people and relatives to speak up and people and relatives told us the service was well led. A person told us, “The manager is very nice, polite; she calls to ask if everything is okay.”

People told us they felt they were listened to, and leaders were quick to respond. A person told us, “I made a complaint about a carer who kept turning up late; the manager took the carer off my breakfast visit and sent another one.” Relatives told us staff kept them informed if they had any concerns about their loved ones. People said they had confidence in the staff, who also consulted with leaders for advice.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Leaders provided flexible working agreements to staff to account for personal circumstances such as caring responsibilities and health issues and had put reasonable adjustments in place for some staff to help them carry out their role. A staff member told us, “The service is generally accommodating when it comes to flexible working and tries to take individual circumstances into account when creating rotas. In my experience, managers are willing to have open conversations about working arrangements and will make reasonable adjustments where it is possible to do so. I think this goes a long way towards making staff feel supported and valued.”

Leaders took steps to ensure staff were representative of the population of people being supported. Staff told us they were treated equally by leaders. A staff member told us, “I believe I am treated fairly. The service is inclusive and there is a genuine effort to respect the diversity of both the staff team and the people we support. I am not aware of any practices that discriminate against staff based on their background, and I feel that people are valued for what they contribute rather than who they are.”

Managers engaged with staff via appropriate forums such as individual supervisions, various staff meeting types and staff surveys, to ensure their voices were heard. Staff were confident they could raise concerns directly with their leaders, and had received training in equality, diversity and human rights. The providers’ equality statement identified they were committed to equal rights and the promotion of choice, person centred care and independence.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Staff were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service. A clear organisational staff infrastructure was in place.

The provider operated effective governance processes undertaking regular audits, and analysis of recorded accident and incident data was in place to provide trend analysis and lessons learned. However, audits had not always identified the gaps we found in some people’s daily care notes, which did not always indicate the exact tasks carried out. For example, for one person it mentioned personal care had been completed but did not mention oral hygiene, despite this being something which was required for this person, therefore, there would be no way of monitoring if oral care had been completed. We raised this with the provider who took immediate action.

Systems of recording supported staff at all levels to work safely with people. Managers and staff were clear on the risks they faced and worked hard to make improvements and mitigate any risks. Performance and risks were routinely discussed in staff and leaders' meetings.

A range of operational meetings, were used to review data, including any incidents, complaints, medication errors, and any further concerns. There were regular meetings, focusing on risk and oversight of people’s assessed needs to ensure appropriate action had been taken.

The provider had a business continuity plan, which covered the relevant areas. Policies which were reviewed as part of this inspection were up to date.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager told us, “Staff are encouraged to build meaningful relationships with service users, understand what matters to them and deliver care that goes beyond task completion.” This was supported by feedback we received, for example, a relative said, “[Person] knows all about her carer's families; they chat together. The carers are very family orientated. They gave [person] a card and gift on [their] birthday. The only people [person] sees are the carers; they make [them] feel involved and cared for.”

People’s care records identified any other key professionals involved in supporting them. The registered manager understood the importance of working collaboratively with external professionals to ensure continuity of care for people. The service had built links with other care providers and partners, and these services were working effectively together.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had systems and policies to ensure continuous learning and improvement. We noted lessons learned were in place and where concerns had been identified, these were shared with the staff team. The registered manager was responsive to feedback from all sources.

The provider was committed in ensuring quality assurance was in place to maintain high standards of care and ensure the well-being of people being supported. There were clear and established standards for various aspects of care such as people’s safety. The provider and registered manager regularly reviewed any incidents, and any necessary improvement actions were taken.

The provider regularly assessed the care provided through audits, internal quality assurance visits, and by analysing feedback from people and their relatives. Learning was derived from complaints and suggestions, for example, following one complaint investigation, learning had determined, ‘small things like curtains and bedding can make a big difference to someone’s comfort and care plans should clearly reflect personal preferences’; in this instance care plans had been updated accordingly.

The provider adequately trained staff and they understood the quality standards and procedures. A relative told us about how [person’s] behaviour could be difficult to manage, and stated, “The carers are able to judge [person’s] moods, when he is being verbally aggressive and angry, and they [staff] are always trying new solutions to manage [person’s] care.”

All staff we spoke with confirmed leaders encouraged them to speak up with ideas for improvement and innovation and actively invested time to listen and engage; we also verified this by looking at a range of meetings which had taken place throughout the year. A staff member told us, “Staff are actively encouraged to share feedback, not just about problems but also about ideas for improvement. Knowing your voice is valued makes a significant difference to how you feel about coming to work.”