479 Green Lanes

Updated 31 March 2020

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

This inspection was carried out by one inspector, a specialist advisor pharmacist and two Experts by Experience. Both Experts by Experience made telephone calls to people and relatives to gain feedback about the service they received. 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed the action plan that the provider submitted following the last inspection in January 2019. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the nominated individual, the registered manager, the deputy manager and the care co-ordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 17 people’s care records and 12 people’s medication records. We looked at eight staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with ten people who used the service and 17 relatives about their experience of the care provided. In addition, we spoke with six care staff.

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 31 March 2020

About the service

479 Green Lanes is a domiciliary care service providing the regulated activity of personal care to older people aged 65 and over, some of whom were living with dementia. At the time of the inspection the service was supporting 112 people.

Not everyone who used the service received personal care. 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

People and relatives told us that they received good care and support from a regular and consistent team of care staff.

People told us that they felt safe with the care staff that supported. Care staff described how they would recognise any signs of abuse and the actions they would take to report their concerns.

Risks associated with people’s health and care needs were identified and assessed with guidance available to staff on how to minimise known risks to keep people safe. However, further improvements were required in ensuring staff were provided with detailed guidance in relation to people’s identified individualised risks.

Management oversight systems in place enabled the registered manager to identify issues and improve the quality of care people received. Significant improvements had been made since the last inspection in this regard. However, during the inspection we did identify minor issues relating to detailed risk assessments and ensuring care plans were updated consistently where change was identified.

People received their medicines safely and as prescribed. Policies and processes in place supported this.

Process in place allowed for only those staff assessed as safe to work with vulnerable adults were recruited. There were sufficient numbers of staff available to meet people’s needs. People told us that they received care at the agreed time and where staff were running late this was communicated effectively.

Care staff received the required training and support to carry out their role effectively.

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

People’s nutrition and hydration needs were assessed and appropriate support provided where required. Where people required support and assistance to access health and social care professionals due to a specific identified need, care staff and the service helped people with this.

People and relatives told us that care staff were kind, caring and respectful and that they received care and support that upheld their privacy and dignity.

Care plans were detailed, person-centred and captured people’s needs and wishes about the care and support that they required.

People and relatives knew who to speak with if they had any concerns and were confident their concerns would be addressed and resolved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 17 January 2019). We found breaches of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. Whilst there were no breaches in regulations, further improvements were required under well-led for the provider to further implement and embed the required improvements.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.