Orchid Care Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

In this key question we looked at 5 quality statements in relation to kindness, compassion, and dignity, treating people as individuals, independence, choice, and control, responding to people’s immediate needs and workforce wellbeing and enablement. People and relatives spoke positively about the exceptional care the home provided and how the RM and staff had gone over and above to make sure their relatives received the best person-centred care. Staff felt very well supported by leaders. Staff and leaders told us procedures were in place to ensure a good work/life balance. Additional training was provided to support staff development. Leaders showed their appreciation for staff, for example, by holding regular staff events.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives spoke very highly about how the service supported their relative with kindness, compassion, and dignity. Relatives said; ‘The first thing I noticed was that people were treated with the utmost dignity. I felt immediately at home. It does not feel like a hotel it feels like home!’ And ‘My (relative) had outstanding care; I couldn't have wished for anything better.’ One relative explained how the home took a creative and balanced approach to risk and how the service had supported their relative to move and position themselves in a person-centred way. The relative said 'The home is driven by safety, but also by the need to keep their relative's dignity.'

Staff said they treated people with dignity and respect by getting to know people’s preferences. Staff said they read people's care plans to help them understand a person's support preferences. Staff told us they have been trained around treating people with kindness, compassion, and dignity. Staff told us they had been observed by a senior staff (with the consent of the person) delivering personal care. Leaders said they routinely check people were treated with dignity and kindness by walking the home daily, observing and listening to people’s feedback. The RM said they had a ‘butterfly system’ used through to identify a resident is on the end-of-life pathway. The RM said, ‘A butterfly symbol is placed on the outer door of a unit to remind staff to consider relatives may be present and may require additional support or reassurance.’ We heard from leaders how bereaved families are given an opportunity to include their loved one’s name on a ‘butterfly’ memory wall in the service.

Partners said the service showed kindness, compassion and dignity. Partners said, the service used their own transport to take people to appointments, 'this helps reduce the stress and anxiety on the person. Another partner said, 'the home works in a person-centred way, I don't see residents get upset, the staff try and understand why they get upset and help the person.' Another partner said, 'Residents are always referred to us in a timely fashion and the nurses always know their patients well.'

We observed people were supported with kindness, dignity, and respect. We observed staff using people’s first names when talking with them, and respected people’s dignity and privacy by closing doors for personal care or knocking on doors before entering. We observed staff were very proactive in helping a person who was becoming distressed in a timely and compassionate way and reducing the person’s distress.

Relatives were very complimentary and gave examples of how the service helped their relative to do things they enjoyed doing. We also heard how the service helped people to stay connected with people who were important to them. One relative told us how the service spoke with them to understand and respect their relative’s ethnic and cultural needs and wishes. ‘It is very clear they know my mum, her dislikes and personality very well. I feel I can have peace of mind.’ Another relative said, ‘My relative has a personal carer, someone who is responsible for their care, each resident has one. They ring me once a month and tell me how things are and if there is anything you want to talk about or change to her care. I never have to complain as I speak to them once or month or I can talk to them anytime. They are very proactive.’

Leaders told us they took a person-centred approach around care planning, involving the person, family, and friends. Leaders told us how they developed an individualised care plan centred around a person. For example, leaders said the service helped a person to maintain their carpentry skills and the person had been involved with several projects in the home including making a bar for the service. Staff told us how they found out about people through their care plans and by talking with people. Staff told us about the keyworker system in place for sharing information with relatives about the person. One staff member said, ‘we make sure we contact family once a month, we can talk with the family about the person, if they need anything, how their days are and what they have done families are very well informed.’

We observed people’s choices were offered and decisions were respected throughout the onsite visit. For example, staff respected a person's choice not to continue with the activity they were part of. We observed how staff applied their training to adopt a person-centred approach that validated people’s reality and helped reduce anxiety for people.

Systems and processes were in place to make sure people were treated as individuals. Comprehensive care planning information was in place to help staff to understand what was important to the person, for example, what the person liked to wear, their favourite routines, personal history, religion, and how the person liked to celebrate special dates. Risk assessments were in place to enable people to take positive risks that enabled them to live meaningful lives, for example, to support a person to become a respected part of the maintenance team and utilise their carpentry skills.

People felt they were supported very well in the home around independence, choice and control. Relatives and people told us they were given choices to do what they wanted to do. One person told us, 'I have got independence, company if I want. I have my own room where I can be my own boss….'

Leaders told us about a risk assessment in place for a person to use an electric scooter to enable the person to venture out of the service and continue to do things they enjoyed. Leaders told us electric wheelchair sessions were held to check the safety of drivers. We also were told by leaders about one resident who had volunteered in the service reception desk by greeting families and answering the phone. Leaders told us the person felt valued, and that life could be purposeful. Staff told us how they encouraged people to make choices and maintain the person’s independence. For example, by encouraging the person to do as much as possible for themselves and encouraging people to do their physiotherapy exercises to maintain and gain their independence.

We saw people had autonomy in the service People were free to join activities or leave if they wanted to. We saw people were offered choices about drinks and activities.

Systems and processes were in place to maximise people's independence, choice, and control. People and their relatives were actively involved in making decisions about their own care and treatment and with the running of the service, for example residents took the lead in running resident's meetings. Feedback from these meetings was given to the manager to identify actions to take. Care plans reviewed were person-centred and written in corroboration with the person and others who were involved with the person.

Relatives said the service responded very well to people's needs, medical attention was sought, and pain relief administered when it was needed. People we spoke with said they got their medication for pain relief when they ask for it. Relatives said they were involved in reviewing and making decisions around their relative's care plan and health. Relatives said record keeping was good. 'If I ask what weight my relative is, they will look at the records and tell me.' Relatives said the home was very responsive to concerns when they were raised.

Staff told us about the systems they used to understand if people were in pain, including training on a new and innovative medical device which uses artificial intelligence to help understand if a person were in pain where they could not communicate effectively. Staff said they would report and record concerns about people's pain to the nurse straight away.

We saw people were supported in a timely way. We observed staff responded to call bells quickly and were responsive to a person in distress.

Staff said they felt very well supported in the home by the leaders and had regular opportunities to speak with their manager. Staff said, 'the leadership team are supportive and approachable, they listen and try to help.' Staff said they have regular breaks planned throughout the day and can take holiday when they need it. One staff said, ‘Each unit has a leader who staff can speak with if they feel they are struggling at work.’ Staff felt their equality, diversity and wellbeing needs were recognised and well supported. Staff gave examples about how leaders listened and acted on their suggestions, 'We suggested about needing extra staff, day, and night. We showed the dependency tool and gave reasons why. This was implemented and we have seen an improvement for residents' wellbeing.' Leaders told us about an initiative they had in place to support overseas staff. For example, staff members on sponsorship programs were supported to understand about working in UK, setting up a bank account and how to look at housing prior to commencing employment. Leaders said with people’s consent they invited the relatives of overseas staff to meet the manager to help strengthen relationships with overseas staff and Leaders.

Systems and processes were in place to ensure all staff were well-supported and valued. Supervisions, appraisals, and team meetings took place regularly and were documented. Staff surveys were completed, and an action plan was set because of feedback received. For example, leaders made changes to ensure enough staff were available to support people during mealtimes. Support was put in place for staff who were struggling in the workplace. Training was provided support staff members from overseas to understand cultural differences in the UK. Systems were in place to support staff with their religious and cultural beliefs. The service routinely celebrated diversity in the team, by holding international celebration days with staff and people using the service.