Gemini Exclusive Care Ltd

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.

At the time of our inspection, 15 people were receiving personal care from the service.

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

This focused inspection was prompted due to a delay in the provider notifying CQC about a safeguarding concern. The provider had raised the concern with the local safeguarding authority but had not raised a safeguarding notification with CQC. Once this was brought to the attention of the provider they promptly sent in the required notification. They said this was due to human error and understood their responsibility to raise safeguarding concerns to the relevant authorities without delay.

Where the provider took on the responsibility to support people to take their medicines, this was provided safely in line with people’s individual needs and preferences. The provider said they would ensure clear procedures were in place for people prescribed rescue pack medicines. ('Rescue packs' are antibiotics and oral steroids for people with pre-existing conditions like asthma or chronic obstructive pulmonary disease (COPD). To ensure people received these medicines timely.

People received safe care and were protected against avoidable harm, neglect and discrimination. Risks to people’s safety were assessed and strategies were put in place to reduce the risks. People were supported by regular, consistent staff who knew them and their needs well.

Systems were in place to control and prevent the spread of infection including the transmission of COVID-19.

The provider ensured that lessons were learned when things went wrong, so that improvements could be made to the service and the care people received.

People’s needs, and choices were assessed before they received a care package. Staff received an induction and ongoing training that enabled them to have the skills and knowledge to provide effective care.

Staff supported people to live healthier lives and access healthcare services.

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 at the service supported this practice.

Staff had built up good relationships with the people they provided care to. People and relatives, where appropriate, were involved in the planning of their care and support. People using the service, relatives and staff were encouraged to provide feedback which was analysed and acted upon. People's privacy and dignity was always maintained.

There was a complaints procedure in place and systems to deal with complaints effectively. The service was able to offer care to people at the end of their lives, although at the time of inspection no people required end of life care and support.

The service was well managed. There were systems in place to monitor the quality of the service and appropriate actions and improvements were made to the service when required. People said the registered manager / provider and senior staff team were approachable and provided good leadership. The service worked in partnership with outside agencies.

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 14 June 2019).

Why we inspected

This was a focused inspection based on information we had received since the last comprehensive inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Gemini Exclusive Care Ltd is a domiciliary care agency who are registered to offer support to adults with; Dementia, Learning disabilities or autistic spectrum disorder, Older People, Physical Disability and Sensory Impairments. They provide personal care to people living in their own homes. Not everyone using Gemini Exclusive Care Ltd received personal care. At the time of our inspection, nine people were receiving personal care.

People’s experience of using this service:

People and relatives used phases such as, “Friendly”, “caring”, “polite” and “lovely” when describing staff.

People told us staff were reliable and on time and built good relationships with them.

Staff had a good knowledge and understanding of the people using the service and people received care based on their individual assessed needs.

People were treated respectfully and were involved in every decision possible. All care plans had been signed by the person or their representative.

People were listened to and supported to express their views and opinions. A member of staff told us, “We always make sure we give people choices, treat as individuals, and respect different traditions and choices.”

The registered manager gained regular feedback from people, relatives and staff via a feedback questionnaire.

The provider ensured safe recruitment processes were completed and all staff completed an induction which included training and shadow shifts, to ensure they had the knowledge and skills to carry out their roles and responsibilities. However not all staff we spoke to fully understood the Mental Capacity Act (MCA), and did not always know if a person lacked capacity. The registered manager agreed to retrain staff on the MCA as required.

Staff and people told us, that staff always ensured people were involved in decisions about their care and staff understood what they needed to do to make sure decisions were taken in people's best interests.

When people needed referring to other health care professionals such as GP's, occupational therapists or district nurses, staff understood their responsibility to ensure they passed the information onto relatives so that this was organised, or they assisted the person to call themselves.

The provider had safeguarding and whistleblowing systems and policies in place

The registered manager had quality assurance systems in place. Audits were in place which enabled the management team to monitor the service and drive improvements as required. Where improvements were identified actions were put in place to address any issues.

The service met the characteristics for a rating of ‘Good’ in all five key questions we inspected. Therefore, our overall rating for the service after this inspection was ‘Good’; More information is in the full report.

Rating at last inspection:

At the last inspection the service was rated Good. (Report published 27 September 2016).

Why we inspected:

This inspection was a planned inspection

Follow up:

We will continue to monitor this service and plan to inspect in line with our reinspection schedule for services rated Good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Gemini Exclusive Care provides people with personal care in their own homes in Bedford. They provide care to older people, as well as people with physical disabilities. When we inspected the service they were providing care to 18 people.

The service had 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.

People felt safe when they received care from the service and staff worked to protect them from harm or abuse. There were systems to identify potential risks to people, and to put steps in place to help staff manage those risks effectively. Staffing levels were consistent and sufficient to meet people's needs without the need for agency staff. Background checks and references were completed for all staff members to ensure they were of good character and suitable for their roles.

Staff were given the training and support they needed to equip them with the skills and knowledge required to meet people's needs. Staff received regular supervision and were able to discuss any concerns they had. People's consent to their care and support was sought and there were systems in place to help make best interest decisions if people lacked mental capacity. Staff supported people to maintain a healthy and balanced diet and helped them to see healthcare professionals if necessary.

People were treated with kindness and compassion by staff members. Staff worked to build strong relationships with people and their family members, which helped them to deliver people's care in the way they wanted. Information about people's care and the service was available to them and their family members and they were involved in planning their own care. Staff members treated people with respect and made sure their privacy and dignity was upheld.

Person-centred care was given, which ensured people received care and support which took their specific needs and preferences into account. Initial assessments were carried out to identify people's needs and care plans were updated on a regular basis to ensure they were accurate. Feedback from people was encouraged, as were compliments and complaints, to help the provider develop the service.

There was a positive and open culture at the service. People were happy with the care they received from members of staff and felt that there had been positive developments at the service. Staff were aware of their roles and responsibilities and were motivated to work with people and meet their needs. The manager had been newly appointed and was positive about the service and the direction they wanted to take it in. They were aware of their statutory requirements and had systems in place to oversee the service and identify areas for development.