Background to this inspection
Updated
20 November 2019
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 an inspector, assistant 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
The service is a domiciliary care agency. It provides personal care to people living in their own homes in the community.
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 the provider would be in the office to support the inspection.
Inspection activity started on 23 September 2019 and ended on 27 September 2019. We spoke with people and relatives to gain their views on the service on 24 and 25 September 2019, we visited the office location on 25 September 2019 and spoke to staff on 25 and 27 September 2019.
What we did before the inspection
Prior to the inspection we had received information about the service since the last inspection. We sought feedback from the local authority who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.
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.
During the inspection
We spoke with six people who used the service and eight relatives about their experience of the care provided. We spoke with the provider who is also the manager and six members of care staff.
During the inspection we looked at three people's care plans in detail which included a range of support plans and risk assessments. We reviewed a range of documents relating to how the service was managed including; three staff personnel files, staff training records, policies, procedures and quality assurance audits.
Updated
20 November 2019
About the service
Orchids Care is a domiciliary care agency. On the day of our inspection 79 people were receiving care and support from Orchids Care.
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
During this inspection, we identified a breach of regulation. Regulation 17 (good governance) governance and performance management systems were not always effective.
People told us they felt safe although said care staff were sometimes late. Identified risks to people’s health did not always contain detailed information to direct staff. Staff did not always receive annual medicine competency checks to check practices were safe prior to administering medicines.
Recruitment processes were of good quality. New staff received an induction. Staff received training which was up to date. The service received the input of other healthcare professionals where needed.
Staff were caring. People we spoke with were mainly complimentary about staff and the service. People and their relatives told us they very happy with the service. People were treated with dignity and respect. Care plan review dates were not always recorded within a person’s care plan record to show these had been updated.
The provider had a complaints procedure in place. People and their relatives were aware of how to make a complaint. People and staff were consulted and asked for feedback about the quality of the service.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 March 2017).
Why we inspected
This was a planned inspection.
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.
Enforcement
We have identified a breach in relation good governance. Please see the action we have told the provider to take at the end of this report.