We carried out an announced inspection on 21 February 2018 when we visited the registered offices for the provider. We also spoke with people using the service and staff on 8 March and 13 March 2018.

Orchid Homecare Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, and younger disabled adults. Not everyone using Orchid Homecare Ltd receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

We previously inspected the provider and rated them as requires improvement overall due to a breach of regulation. At the last inspection on 27 January 2017, we asked the provider to take action to make improvements to care plans. We asked the provider to complete an action plan to show what they would do and by when to improve the key question to at least good. At this inspection we found that care files were now clear and comprehensive and contained relevant health and personal information.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The provider followed the local authority policy and guidance when dealing with safeguarding people from harm and the staff we spoke with demonstrated a good understanding of safeguarding issues.

There was a robust recruitment procedure to help ensure the staff recruited were suitable to work with the people using the service.

Staffing levels were sufficient to provide the level of care required.

Risk assessments were in place and were regularly reviewed and updated.

Cleanliness and infection control procedures were in place and followed by staff to minimise the risk of acquired infection.

Staff were trained to administer medicines safely and had undertaken further training to ensure they could deal with a number of health issues. Regular checks were undertaken to help ensure on-going competence in this area.

Staff demonstrated a good understanding of their roles and responsibilities. The service demonstrated a commitment to staff training, which was on-going and regular refreshers were undertaken.

Supervisions were undertaken regularly and considered important in offering an opportunity for discussion between staff and management.

The service was flexible and responsive to people's changing needs, desires and circumstances.

Confidentiality was respected and independence was promoted.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Communication with relatives was on-going throughout the duration of their relative's involvement with the service.

Comments and feedback was encouraged formally and informally and there was a complaints policy in place.

Team meetings were regularly undertaken, giving staff the opportunity to discuss any issues and to share good practice examples.

A number of audits were undertaken to ensure processes were being followed.

Further information is in the detailed findings below.

This inspection took place on 27 January 2017 was announced.

This was the first comprehensive inspection carried out at Orchid Homecare Limited.

Orchid Homecare Limited is a domiciliary care agency providing a range of personal care and domestic support services for vulnerable people living in their own homes who may be unable to carry out these tasks for themselves. At the time of our inspection the service was providing personal care to 18 people.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

We found that where people’s needs had changed, the care plans had not always been updated in a timely manner to reflect the changes. This meant that staff did not always have up to date information on how to fully meet people’s needs.

Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. Staffing numbers were appropriate to keep people safe. There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their role. Systems were in place to ensure that medicines were managed safely.

Staff received regular training that provided them with the knowledge and skills to meet people’s needs. They were well supported by the registered manager and had regular one to one supervision and annual appraisals. Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation. Where the service was responsible people were supported by staff to access food and drink of their choice to promote healthy eating. If required, staff supported people to access healthcare services.

People were treated with kindness and compassion by staff and had established positive and caring relationships with them. People were able to express their views and to be involved in making decisions in relation to their care and support needs. Staff ensured people’s privacy and dignity was promoted.

People’s needs were assessed prior to them receiving a service. This ensured the care provided would be appropriate and able to meet their needs. The service had a complaints procedure to enable people to raise a complaint if the need arose.

Staff were positive about the management and leadership at the service. A variety of audits were carried out, which were used to drive continuous improvement.