Archived: Greenfield Care Limited

Updated 16 June 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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two Inspectors.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

Registered Manager

This 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 who was also the company director.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out, we wanted to be sure there would be someone in the office to speak with us.

Inspection activity started on the 10 May 2022 and ended on 12 May 2022. We visited the location’s office on the 10 May 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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.

We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and one relative about their experience of the care provided. We spoke with six members of staff including the registered manager, office administrator and care workers. We reviewed a range of records. This included four people's care records including medication records. We looked at three staff files in relation to recruitment. We also reviewed a variety of records relating to staff training, the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We received feedback from two social care professionals.

Updated 16 June 2022

About the service

Greenfield Care is a domiciliary care service providing personal care to people in their own homes. 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. At the time of this inspection there was 22 people using the service, 15 of these were receiving support with personal care.

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

There continued to be ineffective measures in place to adequately monitor the quality and safety of the service. There had been some improvements made since our last inspection in July 2021. However, these were either being planned and/or not fully implemented or embedded in practice to demonstrate people were provided with a safe and well-led service at all times.

There had been improvement since the last inspection in with regards to infection control systems and procedures. Some people's care planning and risk assessments had been reviewed and updated. However, in the ten months since our last inspection not all care plans had been reviewed and updated to reflect current needs.

Care plans contained conflicting information for staff in the management of people at risk of choking, diabetes, risk of falls and the management of people’s medicines. Where care plans stated people required only prompting to take their medicines, we found staff were actively involved in administration without the guidance needed to ensure people’s safety.

The registered manager had not learnt lessons from previous shortfalls identified regarding the safe care and leadership at the service. The registered manager continued not to have oversight of how the service was performing.

Where staff carried out shopping tasks for people, there continued to be a lack of procedural guidance and systems to ensure the safeguarding of people’s finances. Staff had access to people’s debit cards with security pin numbers. This conflicted with the providers policy which meant there was inadequate safeguarding measures in place.

Arrangements for staff recruitment, training and deployment did not support people's safety. Not all were evidenced to have received training and staff continued not to have complete recruitment information. In the ten months since our last inspection staff told us they continued not to receive regular supervision, spot checks on their performance and neither annual appraisals.

People told us they 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. Where people living with dementia there was a continued lack of care and risk management planning which would include an assessment of people’s mental capacity in relation to day to day decisions.

We recommended information be provided to people in how to raise a safeguarding concern and formal complaints, including details of how to contact relevant agencies such as the local safeguarding authority, the Care Quality Commission (CQC) and the complaints ombudsman.

People and relatives were mostly positive about the safety of the service. No formal complaints had been received since the last inspection.

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

At this inspection we found the provider remained in breach of regulations.

The last rating for this service was inadequate (published 21 August 2021). The service remains rated inadequate. This service has been rated requires improvement and inadequate over the last seven inspections.

There has been a continued history of non-compliance with repeated breaches of regulations. Improvements required from previous inspections going back as far as 2015 have continued not to be fully addressed.

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 safe and well-led which contain those requirements.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last inspections, by selecting the 'all reports' link for Greenfield Care Limited on our website at www.cqc.org.uk.

Enforcement

We have identified continued breaches in relation to governance, safe care and treatment, staff training and safeguarding 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 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 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 remains ‘Inadequate’ and the service remains 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.