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Greenstar Health Care

Overall: Requires improvement read more about inspection ratings

The Tannery, 91 Kirkstall Road, Leeds, LS3 1HS (0113) 247 3835

Provided and run by:
Greenstar Health Care Ltd

Latest inspection summary

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Background to this inspection

Updated 5 February 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 Care Act 2014.

Inspection team

This inspection was conducted by three inspectors.

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 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 3 December 2021 and ended on 23 December 2021. We visited the office location on 3 and 16 December 2021.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we held about the service including information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included the local authority safeguarding team, commissioning team, and Healthwatch Leeds. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We spoke with two people using the service and two relatives about their experience of the care provided. We gathered information from four members of staff including the registered manager.

We reviewed a range of records. This included four people’s care plans, risk assessments and associated information, and other records of care to follow up on specific issues. We also reviewed multiple medication records. We looked at three staff files in relation to recruitment, training and supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at policies and procedures, quality assurance records, supervision records and further records of care.

Overall inspection

Requires improvement

Updated 5 February 2022

About the service

Greenstar Health Care is a domiciliary care agency providing personal care to adults living in their own homes, some of whom were living with dementia and require end of life care. At the time of the inspection, the service was supporting 23 people.

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

We found the service needed to improve to ensure accurate and complete records were maintained, in relation to people’s care and management of staff. The provider’s internal audits had already identified some of the issues found at this inspection, but other areas for improvement had not been previously identified or timely improved.

People told us they felt safe with the care received by staff who were kind and friendly.

We found most risks to people's care were well documented and mitigation measures had put in place to manage the risks. We could not be sure the equipment used to support people was always safe. Staff followed appropriate infection control procedures and enough personal protective equipment was available.

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 well supported by the registered manager and there were systems in place to ensure staff were inducted into their jobs, trained, monitored and supported regularly.

People's care plans were centred around their needs and most included relevant details about their health and care needs and preferences. The provider told us people's care were reviewed, when required. However, we noted some people's care visits were regularly shorter than what had been planned.

The registered manager understood their responsibilities in relation of their regulatory requirements. They collaborated with the inspection process and either took immediate action to address the issues found or told us about their plans to improve.

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 10 January 2020 and this is the first inspection.

Why we inspected

This was a planned inspection.

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

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


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.

We have identified breaches in relation to good 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 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.