Greenline Healthcare Group Ltd received an overall rating of Requires Improvement on its first inspection, with breaches of Regulations 11, 12, and 17 relating to unsafe medicines management, absent risk assessments, inadequate mental capacity documentation, and poor governance oversight. The service demonstrated genuine strengths in staff compassion, dignity, infection control, and partnership working, but requires significant improvement to care planning, record keeping, supervision, and quality assurance systems.
Concerns (11)
criticalMedication management: “Medicine records did not contain the required information to ensure people received their prescribed medicines safely... no instructions in place relating to medicines which were required 'as needed'.”
criticalCare planning: “Records contained inaccurate information and were not updated when people's needs changed... care plans did not demonstrate whether this was safe.”
criticalConsent / capacity: “People's human rights were not always respected with appropriate mental capacity assessments and best interest decision making documented.”
criticalGovernance: “The provider failed to have oversight of the service, to ensure care was high quality and improvements were made. This was a breach of regulation 17.”
moderateRecord keeping: “Records we reviewed were not well personalised and did not always reflect the care that people were receiving.”
moderateSupervision / appraisal: “Staff Supervisions were infrequent... the deputy manager had not had any formal supervisions since starting in post in April 2022.”
moderateIncident learning: “Documentation of actions and outcomes following incidents had only been recently implemented. Incident analysis needed further embedding to ensure lessons were learnt in a timely manner.”
moderateEnd-of-life care: “The service did support people with life limiting conditions and there were no end of life care plans in place for those people.”
moderateStaff training: “Not all staff had completed an interview or had two employment references completed.”
minorPerson-centred care: “Care plans did not always accurately describe people's history, their background, goals, likes and dislikes.”
minorCommunication with families: “Communication needs had not always been fully assessed. A communication care plan we reviewed was generic and did not adequately direct staff.”
Strengths
· People received care from consistent staff who knew them well at their preferred time.
· Staff were kind, caring and always treated people according to their wishes, with dignity and respect.
· Infection prevention and control measures, including PPE use and testing, were effective.
· Staff made timely referrals to health and social care professionals when specialist advice was needed.
· Healthcare professionals were exceptionally positive about the service's responsiveness.
Quality-Statement breakdown (23)
safe: Using medicines safelyRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietRequires improvement
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesRequires improvement
responsive: End of life care and supportRequires improvement
responsive: Meeting people's communication needsRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving careRequires improvement
well-led: Engaging and involving people using the service, the public and staffRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
Greenline Healthcare Group Ltd improved from Requires Improvement to Good across all inspected key questions (Safe, Effective, Well-Led), having remediated multiple prior regulatory breaches including medication management, risk assessment, consent and governance. The service demonstrated embedded audit systems, specialist staff training, and a person-centred culture with no current breaches of regulation identified.
Strengths
· Medicines managed safely with detailed administration records and daily monitoring; staff competency assessed.
· Risks fully assessed including complex needs such as RIG tubes, catheters, oxygen and PEG tubes with detailed care plans.
· Safe recruitment practices reinstated: all staff had references, interviews and DBS checks in place.
· Mental capacity assessments completed for specific decisions; least restrictive options considered.
· Strengthened audit systems with monthly audits covering care plans, medicines and health and safety.
Quality-Statement breakdown (15)
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Learning lessons when things go wrongGood
safe: Preventing and controlling infectionGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced diet
Good
effective: Staff support: induction, training, skills and experienceGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood