Geocare Services Limited

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met. The service was in breach of legal regulation in relation to receiving and acting on complaints.

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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Staff were able to explain how they supported people, but the information and knowledge they shared with us was not always reflected in people’s care plans. This meant people were at risk of receiving inconsistent care and treatment. Some care plans we viewed lacked detail around people’s preferences. The provider was unable to demonstrate to us formal reviews of people’s care were taking place which would provide staff with up-to date information on how to meet people’s particular care needs.

The manager told us they had good relationships with other health professionals and worked in partnership to deliver people’s care. Staff confirmed they often worked closely with other professionals such as the General Practitioner (GP) and District Nurses (DN). However, due to a lack of detailed records, we could not be assured appropriate systems were in place to ensure professional advice was followed and met the needs of the people supported.

Although we did not see an assessment of people’s communication needs, we saw in people’s care plans what their main form of communication was and whether they had an auditory or vision impairment. Staff told us they informed people before carrying out any personal care and if they did not understand they would explain again. However, we did not see any alternative formats of communication used.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. People told us they knew who the manager was and how to raise concerns, but they felt they were not listened to. One person told us, “I have complained about things, but they don’t seem to take it seriously.” People told us the provider had asked them for feedback through a survey after CQC announced our inspection, rather than a regular, ongoing proactive approach for gathering feedback. There were limited formal opportunities for people using the service to regularly share their views or be actively involved in shaping their care.The registered manager told us there was a complaints policy in place and investigations were carried out in line with this.However, we did not see a complaints policy despite asking for it. We asked to see a complaints log and the investigations following those complaints. The provider failed to maintain a complete complaints log, and evidence of correspondence for all complaints submitted.The provider did not demonstrate all concerns were captured, analysed and resolved to ensure incidents were not repeated, and trust was maintained with people and their families. This meant we were not assured the provider was acting on and responding to complaints.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. The provider did not ensure suitable equipment and adaptations were in place to enable people to access the care and support they needed. Where a person required the use of hoists this was not available. Another person had a hoist but there was no moving or handling assessment in the person’s care plan. This meant we could not be assured staff understood how to safely transfer people.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Protected characteristics were considered by staff providing care and these were included in care plans. For example, we saw details about people’s sexuality, religion and culture in care plans. Whilst we found care plans were not routinely reviewed, shared with people and lacked guidance for staff, they did correctly identify how people could be supported to have equity in their experiences. The provider had a policy in place to ensure they were meeting the legal requirements and promoting and protecting the equality and human rights of people using the service, making reasonable adjustments.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. At the time of the inspection there was 1 person on an end-of-life care pathway. However, we were unable to find any care plans in relation to their end-of-life care needs. This meant there was no information or guidance to support staff to provide person centred end-of-life care that met this person’s individual preferences. The manager told us they were awaiting paperwork from the person’s social worker and medical team.