Archived: GreenSquareAccord Oldham

GreenSquareAccord Oldham is a domically care agency providing personal care to 312 people at the time of the inspection.

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

Risks relating to people’s health conditions were not always assessed: whilst some people had risk assessments in place, others with specific health conditions did not. We found numerous instances where medicines records were not completed.

The service had a high number of staff vacancies and records indicated there were a number of late calls. Staff told us they felt the service was under-staffed. Staff were recruited safely into the business. Safeguarding policies and procedures were in place and staff were using appropriate personal protective equipment during the delivery of care.

Audits were in place, however when risk was identified (in areas including staffing and gaps in recording of medicine administration), the service had not been able to rectify these issues. The speed of improvements needed had been impacted by operational challenges relating to COVID-19, difficulties in recruiting new staff and specific contractual requirements. Feedback about management was mixed. The registered manager understood their responsibilities under the duty of candour to be open and honest. Appropriate referrals had been made to CQC and safeguarding. 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 13 September 2018).

Why we inspected

The inspection was prompted in part due to concerns received. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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

The provider had taken various steps to mitigate some of the risks identified and an internal action plan had been put together to ensure improvements were made.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for GreenSquareAccord Oldham on our website at www.cqc.org.uk.

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 have identified breaches in relation to safely assessing risk relating to health conditions and recording gaps in medicines administration, good governance and staffing at this inspection.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Not everyone using Direct Health (Oldham) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, the service offered support to 120 people who lived in Oldham, Rochdale and an ‘extra care’ scheme in Higher Blackley, Manchester. We visited ‘The Byrons’ on day two of the inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. Checks were carried out on staff to assess their suitability to support vulnerable people.

People's needs were assessed before using the service and on an ongoing basis to reflect changes in their needs.

A robust system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely.

Newly recruited staff were required to undertake a probationary period before being offered a permanent position, which included observed practical assessments before confirmation of their role. Staff induction was aligned with the requirements of the Care Certificate, where appropriate. Staff were receiving the appropriate range of training to enable them to carry out their job effectively.

People told us they considered staff to be knowledgeable and skilled in meeting their needs and confirmed the care workers and other staff they met were competent. Staff told us they had enough time when visiting people to effectively meet people’s needs and people told us staff stayed the full length of the visit but could sometimes be late.

Staff understood the principles of the Mental Capacity Act 2005 (MCA), they told us that if they had any concerns about the capacity of a person using the service, they would contact the office. We saw where people lacked capacity this was clearly recorded within their care plan.

People who used the service and their relatives told us care staff were kind, caring and helpful and treated them with respect. All the people/relatives we spoke with felt the care staff were approachable, listened to them and acted in accordance with their wishes. People we spoke with told us staff respected their privacy and dignity and felt they encouraged them to be as independent as possible.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there and their relatives. Staff had regular supervisions and were invited to team meetings.

Direct Health (Oldham) had a comprehensive business continuity plan in place to prepare the service in case of unforeseen circumstances and emergencies.

We recommended that the service review the staff rotas to improve continuity for people using the service.