About the service Greenline Healthcare Group Limited is a domiciliary care agency providing personal care to older and younger adults. The service supported six people at the time of the inspection. Everyone who used the service received personal care. The Care Quality Commission (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
Medicines were not always managed safely. Medicine records did not give adequate instructions to staff to ensure medicines were administered safely. Risks were not always assessed in people’s homes to ensure they could be supported safely. We found little evidence incidents had always been investigated and acted upon in a timely manner as auditing had only recently been implemented. Recruitment of staff needed strengthening to ensure all people were recruited safely. People told us they were supported by staff who knew them well. Infection control measures were in place to protect people from the risk of infection.
The registered manager had recently introduced quality monitoring systems however audits in place had not picked up the issues we found during the inspection. Quality assurance systems in place required further development and embedding to ensure all issues were picked up in a timely manner. People and staff told us the registered manager was approachable, listened when issues were raised and worked in partnership with others.
Care was not always delivered in line with best practice guidance and the law. Care plans did not demonstrate people were supported to have maximum choice and control of their lives, staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People’s nutritional needs were not always assessed, risks associated with eating and drinking were not always managed safely. Staff were trained in areas such as safeguarding, moving and handling and infection control.
People and their relatives told us they were involved in planning their care. However, we found little evidence within care records to document people had been involved in planning and developing care plans. Further work was required to ensure care plans detailing end of life care wishes were assessed and documented. There was a complaints policy in place and people and staff told us all concerns were dealt with by the registered manager.
People told us they were provided with consistently kind and caring support. Care was delivered at people’s preferred times and people told us they received support from caring staff who respected their wishes. Records demonstrated people were treated with dignity and respect.
Rating at last inspection
This service was registered with us on 9 October 2020 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.
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 assessing risk, managing medicines, gaining consent and management of the service at this inspection.
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 next inspect.