Kingfisher Home Care Ltd

Forest Green Care Services Ltd is a domiciliary care provider. At the time of this inspection 7 people received personal care support from the service. The service supported older people, some of who were living with dementia, within their own homes.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided by the service. Not everyone who used the service received personal care.

People’s experience of using this service and what we found

Governance systems had improved since the last inspection, but we continued to find examples where records relating to people’s care and to the management of the service were not always complete and up to date. Further improvements were planned and new systems were being introduced to support this.

Staff felt supported by management and enjoyed working at the service. The provider had an open and honest approach to care delivery and reported accidents and incidents and informed those involved as necessary.

People felt safe using the service. Improvements had been made to the recruitment checks to ensure that new staff were of good character. Risks concerned with people’s health, care and the environment were being more robustly assessed and reduced as far as was practicable. Medicines administration records (MAR) confirmed people had received their medicines as prescribed.

Systems were in place to protect people from abuse. Staff we spoke with were aware of how to identify, prevent and report abuse. There were enough staff to keep people safe. Staff training had improved. Staff received regular support to enable them to carry out their roles effectively. People were supported with their nutritional needs.

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.

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 14 October 2022). 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.

This service has been in Special Measures since 09 March 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions in Safe Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forest Green Care Services Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Forest Green Care Services Ltd is a domiciliary care provider. At the time of this inspection nine people received personal care support from the service. The service supported older people, some of who were living with dementia, within their own homes.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided by the service. Not everyone who used the service received personal care.

People’s experience of using this service and what we found

People using the service were not always kept safe. We could not be assured risks associated with people’s needs were always assessed appropriately or managed. Relevant recruitment checks had improved but were still not robust. A lack of robust record keeping meant medicines were not always managed safely.

Staff training had improved however, staff still required practical training for manual handling, and we could not see that all staff had been supported by regular supervision to discuss areas of development and to enable them to carry out their roles effectively.

During our inspection we found there was a lack of effective management and leadership. Governance systems were not effective in ensuring people received high quality care. People were not safe from potential harm because known risks to them were not effectively being monitored by the management and staff team.

People were treated with kindness and compassion. Staff we spoke with were enthusiastic about their jobs and showed care and understanding for the people they supported.

People told us they felt safe. Systems were in place to protect people from abuse. Staff we spoke to were aware of how to identify, prevent and report abuse. Sufficient staff were deployed to meet people's needs. People were supported with their nutritional needs.

People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way, while promoting their independence. People told us they were treated with dignity and respect.

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.

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 inadequate (published 9 March 2022). 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 the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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 continuing breaches in relation to risks to people, poor recruitment practices, medicines, staff supervisions and training, poor record keeping and lack of management oversight and governance at this inspection.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures:

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Forest Green Care Services Ltd is a domiciliary care provider. At the time of this inspection 15 people received personal care support from the service. The service supported older people, some of who were living with dementia, within their own homes.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where people do receive personal care, we also consider any wider social care provided by the service. Not everyone who used the service received personal care.

People’s experience of using this service and what we found

People using the service were not kept safe. We could not be assured risks associated with people’s needs were always assessed appropriately or managed. There were no plans in place for foreseeable emergencies. Relevant recruitment checks had not been undertaken to ensure staff were safe to enter people’s homes. There were inadequate numbers of staff to cover the calls resulting in the office staff providing hands on care and not keeping up with ensuring records and systems were in place.

Staff had not received all of the training relevant to their role and had not been receiving regular supervision to discuss areas of development and to enable them to carry out their roles effectively.

A lack of robust record keeping meant medicines were not always managed safely. Not all staff were provided with training and checked to ensure they were following correct procedures.

Not everyone using the service had an assessment of their needs resulting in some people not having a care plan to direct staff on how to provide safe and personalised care for people.

The provider had failed to ensure effective oversight of service provision. Care plans were not consistently person centred and lacked detailed guidance for staff to ensure people received care in a person centred and safe way.

During our inspection we found there was a lack of effective management and leadership. Governance systems were not effective in ensuring people received high quality care. People were not safe from potential harm because known risks to people were not effectively being monitored by the management and staff team.

People were treated with kindness and compassion.

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

Rating at last inspection

This service was registered with us on 25 September 2020 and this is the first inspection.

Why we inspected

This inspection was prompted in part due to concerns received about medicines, staffing and poor records. A decision was made for us to inspect and examine those risks.

Enforcement

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 risks to people, poor recruitment practices, staffing, person centred care, poor record keeping and lack of management oversight and governance at this inspection.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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 with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special measures

The overall rating for this service is ‘Inadequate’ and the service in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.