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Gemini Exclusive Care Ltd Good

This service was previously registered at a different address - see old profile

Reports


Inspection carried out on 13 August 2020

During an inspection looking at part of the service

Gemini Exclusive Care Ltd is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community.

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 an

Inspection carried out on 4 June 2019

During a routine inspection

About the service:

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

Inspection carried out on 13 September 2016

During a routine inspection

This inspection took place on 12 and 14 September 2016, with an announced visit to the service.

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.

Inspection carried out on 09/11/2015

During an inspection looking at part of the service

Gemini Exclusive Care Ltd provides personal care to adults in their own homes, as well as supporting them to access the local community. They currently provide care for nine people in and around the Bedford area.

This inspection was announced and took place on 09 November 2015.

We carried out an unannounced comprehensive inspection of this service on 20 August 2015. Three breaches of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to regulation 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gemini Exclusive Care Ltd on our website at www.cqc.org.uk.

The service had a registered manager. 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.

Systems had been introduced to ensure people’s medication was managed safely. Comprehensive medication audits had been introduced and staff competency assessments had been carried out. This had led to improvements in the recording of people’s medication administration.

Staff had been provided with the training and support that they required to perform their roles. Improvements had been made to the format of staff supervision and there were systems in place to record these accurately.

The registered manager had implemented new quality assurance procedures. These were used to ensure the service was performing effectively and to highlight areas for development. The registered manager was also exploring additional checks and audits, to continue developing the oversight of the service.

Inspection carried out on 20 August 2015

During a routine inspection

Gemini Exclusive Care Ltd provides personal care to adults in their own homes, as well as supporting them to access the local community. They currently provide care for 9 people in and around the Bedford area.

This inspection was announced and took place on 20 August 2015.

The service had a registered manager. 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’s medicines were not always well managed. Records were not always completed appropriately and there was insufficient guidance for staff. Staff had not received a competency assessment, before administering people’s medication.

Risks to people were assessed, however there were not always sufficient control measures in place to ensure they were managed appropriately.

Staff received training and support from the service and registered manager. However, this did not cover all the areas they required, to perform their roles and meet people’s needs.

Quality assurance systems were in place, but they were not always effective and some areas which required development had not been identified by the registered manager.

People were protected from harm or abuse by staff who knew about safeguarding, and understood the reporting requirements associated with it.

Staffing levels were sufficient to ensure that people’s needs were met. Staff were robustly recruited to ensure they were of good character, before they started working with people.

People received support to sustain a healthy and balanced diet, if this support was required.

Staff helped people to make and attend appointments with relevant health professionals where needed.

People were treated with kindness and compassion by staff and the registered manager. Their privacy, dignity and independence were promoted by the service.

Feedback was encouraged by the service and people’s views and opinions were used to improve the care that was delivered. There were plans to carry out a survey to gain feedback from people and identify areas for development.

There was a system in place to handle complaints and carry out investigations if necessary.

There was a positive culture at the service. People were aware of who the registered manager was and felt they were well supported.

We identified that the provider was not meeting regulatory requirements and was in breach of a number of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.