Geocare Services Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The service was in breach of legal regulation in relation to people’s consent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. There was a lack of clear and comprehensive care plans in place. The plans that were available did not consistently cover all aspects of people’s assessed needs, which meant staff did not have the necessary guidance to deliver person-centred care. This meant people were at increased risk of not receiving the support they required in line with their preferences and needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Care plans and risk assessments were not in place to provide staff with information regarding people’s particular healthcare needs,such as skin integrity concerns and catheter care. Where some people were at risk of falls, we did not see any falls risk assessments. We could not see any Malnutrition Universal Screening Tool (MUST) or water low assessments to identify risk of pressure sore development in any care plans we viewed. This meant people were at increased risk of experiencing falls, skin tears and developing pressure sores.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services. The manager told us they had systems in place to ensure people received coordinated and joined up care. The manager told us the information from local authority support plans and their observations formed the detail of people’s care plans. The provider told us the electronic care records were used to ensure all staff were up to date on information about people’s needs. Staff told us care plans provided them guidance on people’s needs and they were confident to escalate concerns to health professionals. However, staff did not have access to sufficient information to deliver safe and effective care and support to people. People either had no care plans in place or care plans in place had not been kept up to date when changes in care needs and risk had occurred. Although some people were happy with their regular staff supporting them others described feeling rushed with their care. One person told us, “The carers are very good they are always smiling, and I can have a laugh and a joke with them, they are more or less on time, they do seem a bit rushed sometimes”. A relative told us “Sometimes they are a bit rushed, and they don’t wash [person’s name] hair.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.People expressed their concerns about the lack of personalised care and attitude of staff. People told us staff did not know their needs and were always in a rush to leave. The majority of people we spoke with raised concerns about not being able to understand what carers were saying due to language barriers. One person raised concerns staff would approach them regarding food options whilst they were attending to their own personal care. However, some people reported no concerns with the quality of care they were receiving. Staff told us people were able to access appointments with health professionals, and their advice was always followed. However, records did not always show updated advice from health professionals. The provider had failed to ensure staff were provided with information that would reduce the risk of harm to people and to themselves, and to ensure continuity of care.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Care plans did not contain evidence people’s health and wellbeing was routinely monitored. Staff were aware of people’s day-to-day care and support needs, and the general support they needed to maintain good health. However, staff were not sufficiently aware of people’s individual risks and the implications these had for their care. Staff confirmed they shared information with people’s relatives and worked alongside other professionals. Risks to people had not always been explored and staff were not provided with the most up to date information to monitor and mitigate those risks to improve outcomes for people.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. We received mixed feedback from people about how they were supported to make their own decisions. Some people told us staff did not always take their wishes into consideration. However, other people told us staff treated them with respect. Staff told us they sought consent, for example, before starting personal care. The provider had no evidence they had undertaken any formal assessments of people’s capacity to make decisions about their care where it was recorded they lack capacity. There was no documentation of any best interest decisions to show care was being delivered in people’s best interests. We could not be assured care decisions made on behalf of individuals were in line with the principles of the Mental Capacity Act 2005. We were not assured of the provider’s ability to support the rights of people who lacked capacity to make specific decisions and to ensure decisions were made lawfully and in their best interests.