Green Cross Medicare Limited

Green Cross Medicare Limited provides personal care to people in their own homes. At the time of the inspection it was caring for 23 mostly older people.

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

People were protected from abuse and avoidable harm. People said they felt safe with staff, who had the training and skills they needed to provide care safely and effectively. People had regular staff who arrived when expected.

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.

People’s physical, mental health and social needs were comprehensively assessed. There were regular reviews to ensure care was meeting their needs. Staff were well supported through training and supervision. They were proactive in supporting people to manage their health.

People and relatives said staff were kind, caring and respectful. They felt staff understood them and knew what was important to them. They were involved in decisions about their or their loved one’s care. Where people had preferences regarding the gender of staff who provided their care, these were respected.

People and relatives spoke highly of the care provided. They said the service was flexible to accommodate special requests or changes. Care was tailored to people’s individual needs. There were aspects of outstanding practice in the way the service went beyond expectations to counter social isolation.

People, relatives and staff expressed confidence in the way the service was run. They described it as open and welcoming. The registered manager was readily available to people, relatives and staff. They had an open and honest approach to complaints. Quality monitoring and improvement were robust.

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 10 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At our last inspection in November 2013 the service was compliant with the regulations.

Green Cross Medicare Limited, provides personal care and support to people who live in their own homes. At the time of our inspection they were providing personal care and support to 27 people.

The service is required by law to have a registered manager, and 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.

Everyone we met and spoke with was content and happy with the service they received. People were provided with support and care by a small, consistent team of staff who knew them and understood their care and support needs well. People were kept informed of any changes to their timetable or if staff were running late.

Staff received training, which was refreshed at regular intervals, to ensure they had the skills and knowledge they required to be able to provide care safely. There was an on-going programme of staff supervision meetings and appraisals to ensure staff performance was monitored regularly. Staff were provided with support and guidance to carry out their role effectively.

Quality assurance systems were in place to monitor and where necessary improve the quality of service being delivered.

We looked at documentation such as care plans, visit schedules, policies and procedures, training records, staff records, surveys and audit material on the first day of our inspection. We met with two care workers and discussed the training and support they received. We spoke to four other care workers on the telephone.

On our second day with the agency's manager we met two people in their own homes. They told us about the service they received. We also spoke with two relatives of two other service users on the telephone.

At our last inspection we found care plans had not always been updated when people's needs had changed. There was also insufficient evidence to show that staff care workers had received regular support to enable them to carry out their work effectively. On this inspection we found the agency had taken remedial action to ensure compliance with their legal obligations about these matters.

Service users and /or their relatives who spoke with us said they were treated with respect and their dignity, privacy and independence were upheld. They said they were involved in decisions about the support they wanted and described the agency as flexible and responsive.

The provider employed sufficient trained and experienced staff to provide the support people wanted and required.

Arrangements were in place to monitor the quality of the agency's service, check procedures were carried out properly and identify and manage risks to people.

There was not any evidence that risks were being regularly monitored and there was not any evidence that procedures were put in place to minimise risks occurring in the future. However, risks were recorded within the front of the care plan which showed that other health care professionals had been involved and actions taken.

We saw that people had detailed records relating to their medicines which included; how they were stored, how they were ordered and audited, the support the individual needed to ensure they received their medicines correctly and the details of what each medicine was for and any side effects.

We looked at three staff records to assess the recruitment procedure the provider had in place. We observed that recruitment procedures were followed in order to ensure no person was employed without the necessary checks.

We were unable to evidence that regular contact took place between the manager and staff. There was not any evidence that the manager checked the competency of staff on a regular basis once employed at the service or that regular supervisions took place.