Fresh Tree Care

Fresh Tree Care provides personal care and support to people who require assistance in their own home. At the time of the inspection 41 people were being supported by the service. 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 the service and what we found

Improvements were required relating to recruitment checks, some aspects of medicines management and carrying out robust internal investigations following safeguarding concerns.

People were not receiving care at their preferred times. The quality systems had not identified these concerns.

People were protected by the providers prevention and control of infection practices and arrangements. People said they felt safe and had no concerns about their safety or wellbeing.

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 February 2020]. The service is now Requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about recruitment practices and management of people's care and visits. A decision was made for us to inspect and examine those risks.

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 recruitment practices, quality assurance and person-centred care.

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 inspect next.

Fresh Tree Care is a domiciliary care agency. At the time of the inspection it was providing personal care to four people living in their own homes.

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

Staff were not always safely recruited. Not all relevant checks were completed prior to staff starting work. Following our inspection, the registered manager responded promptly to ensure all documentation was in place. We have made a recommendation about the safe recruitment of staff.

People received their medicines as prescribed. Staff were trained in the administration of medicines but their competency to administer had not always been checked and records were not always fully completed.

People were supported to access healthcare services; however, people’s oral health needs had not been assessed by the service. We have made a recommendation about supporting people with their oral health.

Risks to people were assessed and monitored and staff knew how to protect people from the risk of abuse. People’s care records were personalised to reflect their individual needs and preferences. People and relatives were involved in making decisions about care

People and relatives spoke highly of the registered manager and told us the staff were kind and caring in their support. People knew how to raise concerns and told us they were confident action would be taken to address their concerns.

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.

Staff felt supported by the registered manager and had been offered a range of training relevant to their role. The registered manager asked people, relatives and staff for regular feedback.

The service had started to implement systems to monitor the quality and safety of the service. The registered manager was quick to respond to the concerns we raised and immediately looked at how they could improve their processes to ensure more effective monitoring of the service.

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 15 February 2019 and this is the first inspection.

Why we inspected

This was a planned inspection to check the quality of the service.

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.