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Inspection carried out on 5 December 2018

During a routine inspection

Generixcare Luton is a domiciliary care service. They provide care and support to people living in their own homes so that they could live as independently as possible. Not everyone using Generixcare Luton receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection, 36 people were being supported by the service.

This announced comprehensive inspection took place between 5 December 2018 and 21 December 2018.

Following the last inspection in August 2017, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe and Well-led to at least good. At this inspection, we found they had improved the areas we had previously been concerned about. However, Well-led was again rated ‘requires improvement’ because further improvements were required to the deployment of staff to improve the timeliness of care visits and people’s overall experience of the service. They needed to ensure that systems in place to improve this were effective to enable them to achieve this quickly.

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.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or harm. There were now safe staff recruitment processes in place and there were sufficient numbers of staff to support people safely. Staff took appropriate precautions to ensure people were protected from the risk of acquired infections. People’s medicines were managed safely, and there was evidence of learning from incidents.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Staff had regular supervision and they had been trained to meet people’s individual needs effectively. The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people’s consent prior to care and support being provided. Where required, people had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services when urgent care was needed.

People were supported by caring, friendly and respectful staff. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.

Staff regularly reviewed the care provided to people with their input to ensure that this continued to meet their individual needs, in a person-centred way. The provider had an effective system to handle complaints and concerns. Improvements were made in response to concerns raised by people. However, further work was necessary to ensure staff knew how people wanted to be supported at the end of their lives.

Inspection carried out on 14 August 2017

During a routine inspection

This announced inspection was carried out between 14 August 2017 and 5 September 2017. The service provides domiciliary care and support to people in their own homes. At the time of the inspection, 21 people were being supported by the service. The service had a registered manager, who was also the provider. 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.

The provider did not have effective staff recruitment processes in place to ensure that people were always supported by staff who were suitable for their roles. There were missing references, and a risk assessment had not been completed when information of concern was highlighted in one member of staff’s Disclosure and Barring Service (DBS) report.

Some of the records were not up to date which meant that information was not always kept in an accessible manner. Although the provider completed audits, they did not have robust systems to drive continual and sustained improvements.

We found these were breaches of regulations of the Health and Social Care Act (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.

People were safe because the provider had systems to keep them safe from risks of abuse and harm, and staff had been trained on how to safeguard people. There were risk assessments in place so that staff knew how to support people safely. Where required, people had been supported safely to take their medicines. There was sufficient numbers of staff to support people safely.

Staff received training, support and supervision that enabled them to provide appropriate care to people who used the service. People were able to provide verbal consent to their care and support, and the requirements of the Mental Capacity Act 2005 were being met. Where required, people had been appropriately supported to have enough to eat and drink, and to access health services.

Staff were kind and caring towards people they supported. They treated people with respect and supported them to maintain their independence as much as possible. People were happy with how their care was being provided, and they valued the support they received from staff and the registered manager.

People’s needs had been assessed before they were supported by the service. Care plans took account of their individual needs, choices, and information received during assessments. Staff were responsive to people’s needs and where required, they were working closely with people’s relatives to ensure that the support they provided was appropriate. The provider had a system to manage people’s complaints and concerns, and concerns raised by people had been managed appropriately.

The provider worked closely with people, their relatives and staff to ensure that the service provided appropriately met people’s needs. They also promoted a caring and inclusive culture within the service.