Archived: Fresh Tree Care

Updated 15 December 2022

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 team consisted of two inspectors 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

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 72 hours' notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 3 November 2022 and ended on 15 November 2022. We visited the office on 7 November 2022.

What we did before the inspection

We reviewed information we had received about the service since registering. We sought feedback from health professionals. 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. This information helps support our inspections. We used this information to plan our inspection.

During the inspection

We spoke with 1 person and 7 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager, care team leader and office administrator. We also received feedback from a health professional.

We reviewed a range of records. This included 4 people's support plans. We reviewed 8 staff records in relation to recruitment and staff supervision and a variety of records relating to the management of the service.

Updated 15 December 2022

About the service

Fresh Tree Care provides personal care and support to people who require assistance in their own home. At the time of the inspection 41 people were being supported by the service. 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 the service and what we found

Improvements were required relating to recruitment checks, some aspects of medicines management and carrying out robust internal investigations following safeguarding concerns.

People were not receiving care at their preferred times. The quality systems had not identified these concerns.

People were protected by the providers prevention and control of infection practices and arrangements. People said they felt safe and had no concerns about their safety or wellbeing.

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 February 2020]. The service is now Requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about recruitment practices and management of people's care and visits. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to recruitment practices, quality assurance and person-centred care.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we inspect next.