Orchid Care Home

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• 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

In this key question we looked at 7 quality statements in relation to: shared direction and culture, capable, compassionate, and inclusive leaders, freedom to speak up, workforce equality, diversity and inclusion, governance, management and sustainability, partnerships, communities, and learning, improvement, and innovation. Leaders demonstrated they were highly committed to continuous improvement to deliver high-quality care and held good oversight of the home. The home had successfully implemented and embedded effective auditing systems. This included regular internal health and safety audits and audits giving the home an overview of people’s safeguarding and health. People’s views of the home were listened to effectively with actions recorded identifying improvements where needed.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager said they had set clear objectives to staff, outlining their vision of the service and had worked alongside staff to earn their respect, and develop trust within the team. Leaders also encouraged staff to work to the standards they had set. Staff we spoke with clearly understood the objectives and vision of the service set by leaders. We heard how staff were planning activities during their shift to help improve people's daily experiences. One staff member said, 'on each floor we try to do something for people, we might take it in turns and go for walks with people or take people to see the home’s pets.' Staff told us how leaders were improving people’s dining experience by observing staff interactions during lunch time and feeding back to staff where there was good practice and where improvements were needed. Staff and leaders told us about the service’s ‘stop the clock’ procedure, where at 3 pm each day all staff in the home stop what they were doing and go to spend time with a person living in the home to uphold the home’s person-centred ethos.

The service’s shared direction and vision was included in all new staff’s induction package, was referenced at staff meetings on an ongoing basis and communicated to staff during the induction process and staff meetings. The service’s principles and values were clearly documented in the staff handbook.

The Registered Manager (RM) told us they have support from the leadership team to develop staff and to support continuous business functioning. The RM said all new members of staff have a period of shadowing for 2 weeks, or longer, to ensure the safety of the residents. Staff told us they can speak with the RM when they are in the home and the RM checks how they are doing.

Leaders had the experience, capability, and oversight to ensure operational risks and team culture were managed well. Leaders were knowledgeable about where to access support to develop staff, for example, leaders regularly involved health professionals in providing specific guidance and training for the team.

Staff said they had opportunities to speak up if they had any concerns. Staff felt they could speak with leaders. Staff told us leaders had listened to their concerns and had made changes when required. Leaders said they have an open-door policy, and staff were made aware of the whistle-blowing policy during their induction.

The service has policies and processes in place to give staff the freedom to speak up, these included regular staff supervisions and meetings. Staff were encouraged to feedback to the provider through an annual survey and action plans had been created to address aspects of the service where staff had expressed concerns. For example, the RM has communicated to all staff about their open-door policy. The service also encouraged family and carers to speak up by sending out an annual questionnaire and actions were taken from feedback received. Outcomes from those surveys were clearly displayed for everyone to see.

Leaders told us the service recognised and celebrated different religions and cultures. We heard about one occasion where team members from India and Nepal, dressed in traditional costumes, had demonstrated national dances and prepared food for residents to sample. We heard from leaders how several staff from overseas have been able to invite their parents to visit the service when they have travelled to visit their relatives. Leaders told us this initiative was warmly received by staff.

Systems and processes to promote an inclusive and fair culture were in place and had been embedded in the service. The service demonstrated it was working towards an inclusive and fair culture, and that it valued workforce equality, diversity, and inclusion. For example, there was a policy in place which supported staff to successfully balance their work and personal life. The service embraced Equality and Diversity in the workplace and regularly recognised and celebrated Pride Day and other special days in the calendar for all religions and cultures. For example, the service celebrated Jamaican Independence Day with all residents joining in a discussion about the culture and tasting rum. Families of overseas staff were offered opportunities to visit the service when they had travelled to visit their relative, with the consent of the people living at the service.

Leaders demonstrated a clear understanding of their responsibilities in meeting all relevant legal regulations. We heard from leaders as to how they complete daily walk rounds in the service and hold daily meetings with senior staff to help maintain oversight and address any concerns in a timely way. Staff were clear about their roles and told us they had had regular supervision and opportunities to discuss any concerns with management.

We found leaders held good oversight of the service. The service had successfully embedded effective auditing systems. This included regular internal audits such as health and safety audits and audits giving the service an overview of people’s safeguarding and health, listening to people's views and putting action plans in place to address the shortfalls. The provider also audited the service routinely and an effective service improvement plan was in place which identified shortfalls and actions required to make improvements.

Relatives said the service was working in partnership with them through regular meetings, phone calls and updates following health appointments. One relative said, 'they contact me regularly, their keyworker is asking how I feel about their care plan. I can see them when I want to. I feel involved.' We heard examples from relatives how the service worked in partnership with them and other health professionals to ensure people’s needs were safely met in the service. One relative said, ‘the care home are getting the mental health team in and someone did a mental health assessment yesterday.’ Another relative said how the assistant manager and manager were in the meeting about funding for their relative, ‘They offered such support; they said we know (person) should be here and we will fight to keep them here. They are very good.’

We saw numerous examples of innovative collaborations between the service and other agencies. For example, we heard the service worked with in partnership with the Mental Health Nurse who supported the service with dementia care, and how this had led to a decrease in behaviours of distress for people. Leaders told us they worked closely with their colleagues in the local authority, specialist services and with people and organisations in the community. The service routinely worked closely with a range of health professionals and specialist nurses to improve people’s health and wellbeing. We heard how the nursing team manager and dementia lead held weekly meetings and how this had led to better outcomes for residents and families, because staff and families had a better understanding about dementia and strategies to reduce behaviours of distress.. We also heard how residents had benefited from different organisations, including volunteers, coming into the service to provide activities. Volunteers from a local organisation had also spent 4 days in the service to help with the garden and painting outside furniture to improve the outside space for people to enjoy. We also heard local schools visited the service and entertained people with activities. Leaders also told us how the service helped host a regular Dementia Cafe, which benefited the well-being of people in the community and their carers’ as well as those who lived in the service.

Partners spoke very positively about their partnership with the service. Relatives said the service was working in partnership with them through regular meetings, phone calls and updates following health appointments. One relative said, 'they contact me regularly, their Key-worker is asking how I feel about their care plan. I can see them when I want to. I feel involved.' Partners said ‘Orchid Care Home's staff and management are very friendly and helpful. The staff are always welcoming and more than happy to help with any queries. Nothing is too much trouble for them.’ Another partner said, ‘The team have been fantastic, my client has become less isolated, more active, their mood has improved and in part also their health.’ Thirdly, ‘The team ask for help and do what is recommended, it's a really good team culture, staff work in a person-centred way.’

Effective processes were in place and embedded in the service to ensure partnership working with people, relatives, health professionals were maintained and to improve people's experiences, health, and wellbeing. The service routinely participated in local authority-led meetings for information and provider updates around best practice.

Leaders told us they use technology to support residents in a person-centred way. For example, we were told the service had introduced an innovative piece of technology to help assess people who were unable to verbalise their pain. The system used Artificial Intelligence to identify pain in people and was used as an evidence base to support pain management interventions for people. We also heard how the home also used technology to enable people to enjoy personalised activity programmes based around their specific needs and interests. Staff told us incidents and learning from incidents were discussed in meetings, where staff learnt and discussed how to make improvements for people.

Effective systems were in place for continuous learning and improvement. Residents led on resident meetings and identified improvements for the service. These were then acted upon by the service. For example, the service responded to people’s requests for pet therapy by introducing a rabbit, goats, and ducks to the home. Relative meetings took place routinely where actions were taken from feedback given, for example offering people a face wash after all meals to maintain dignity. Relatives we spoke with said, ‘The home learns from feedback. I have been to a few relatives' meetings; you can go and give your thoughts.'