Orchard Home Care Services Limited

Updated 21 June 2023

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. There was a manager in post who had applied to CQC to be the registered manager.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 10 May 2023 and ended on 18 May 2023. We visited the location’s office on 10 May 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 3 relatives about their experience of the care provided. We spoke with a director and the registered manager. We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed. We looked at training data and quality assurance records. We received written feedback from 8 members of staff.

Updated 21 June 2023

About the service

Orchard Home Care Service Ltd is a domiciliary care agency providing personal care to people of all ages. Some people using the service had a learning disability and/or autism. At the time of our inspection there were 142 people using the service.

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.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

Staff helped people to live as independently as possible. 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. No one using the service at the time of our inspection lacked capacity to make their own decisions, but staff understood how to make decisions in people’s best interests. Risks were assessed and staff had guidance to support people safely. People were supported to take medicines safely. The provider continued to face challenges with recruitment but had introduced several incentives to attract and retain staff. People told us they knew the staff who supported them and were happy with the support they received.

Right Care:

People using the service were able to express their own views. When things went wrong, actions were put into place and lessons learned were shared with staff to improve the standard of care delivered. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. Staff worked with health professionals where they had concerns about people’s health.

Right Culture: People told us the service was consistent, reliable and they received a caring service. Some staff told us that the way visits were planned meant they were sometimes late or felt rushed. Although office staff monitored visits daily to ensure people received care, the provider had limited oversight of the timeliness of visits so they could monitor and improve this. We have made a recommendation about the provider continuing to review their systems to ensure care and support is delivered as planned. The management team understood their roles and responsibilities and had made improvements to governance systems. The provider worked closely with the registered manager, they were aware of their focus for further development and were introducing new electronic systems which they hoped would give them better oversight.

The management team sought feedback from people using the service, their relatives, and staff. Most feedback was positive. Some staff told us communication could be improved or they raised issues several times before they felt listened to. The provider was working on better communication and demonstrated sharing the actions they had taken on issues staff raised. Staff understood and spoke positively about the importance of person-centred care and helping people to live as independently as they wished. They were confident concerns about people’s care would be addressed.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 22 December 2021) and there was a breach of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service on 22 November 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

Recommendations

We have made a recommendation that the provider continues to review their systems to ensure they have effective oversight that care, and support is delivered as planned.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.