Geocare Services Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this newly registered service. This key question has been rated inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care. The service was in breach of a legal regulation in relation to governance at the service.

This service scored 36 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. The manager told us they did not have a documented strategy or vision for the service. However, the manager told us their vision for the service was to provide “compassionate care from the heart.” Staff were passionate about the people they cared for. Staff we spoke with told us they felt supported by the management team. Regular supervisions, training, reflective practice and an effective induction helped to ensure staff felt supported and equipped to carry out their care roles. Staff also told us they felt they worked well as a team. The manager had recognised the need to improve the service they delivered.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.The provider failed to utilise the systems and processes they had in place to provide them with effective oversight of risks, performance and quality of care.They could not be assured they had complete oversight of the service to ensure care was appropriately delivered and risks were well managed. This meant there were gaps in the service people received. However, staff told us how they were supported as employees and encouraged with their own development. The manager was visible. People, relatives and staff all felt able to contact the manager. One person told us, “[The manager] is magic, they are excellent, they are like a breath of fresh air. [The manager] is understanding”.

People did not always feel they could speak up and that their voice would be heard. There was no evidence that complaints were consistently responded to in a timely or transparent manner. There was a lack of documented evidence showing safeguarding concerns were addressed and resolved appropriately. There was no complaints policy or a complaints log in place demonstrating concerns raised were acted upon effectively. People knew who the manager was and who they could speak to if they had any concerns. The provider had a policy in place to support staff in raising concerns, allowing them the freedom to speak up and whistle-blow. Staff were complimentary of the manager and felt they could approach them and raise any issues they had. The policy guided staff on how to raise concerns and assured them concerns would be taken seriously and investigated appropriately.

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. We spoke with people and relatives during the inspection who thought staff were not sufficiently competent in the English language to understand or communicate with them effectively. This put people at risk of harm if staff were unable to understand people’s instructions. The provider had a policy in place to support equality and diversity. The policy set out to ensure all staff worked in an environment which was free from harassment and discrimination. The policy set out how staff would receive equal treatment regardless of their protected characteristics in all aspects of their employment.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider failed to ensure effective systems were in place to consistently assess, monitor and improve the safety and quality of care to people. When we asked the provider for evidence of audits to show how they assessed and monitored safety and quality at the service, for example, care plan audits, they did not produce any. This meant effective systems were not in place to regularly assess, monitor and improve safety and quality at the service. When we asked for evidence of medicines administration audits the provider submitted a ‘medicines analytics’ graph. This graph only referenced a medication count for each person. No evidence was produced to show the content of people’s medication records was accurate or completed appropriately. This meant there was a risk medicines concerns would not be identified and acted upon. The provider did not have a system in place to ensure staff recruitment files were audited and contained the necessary information. This meant omissions were not identified and addressed so we could not be sure people were supported by appropriate staff. This failure undermined the effectiveness of the provider’s governance arrangements and limited their ability to make safe and informed decisions regarding staff recruitment and oversight. This meant effective governance systems were not in place to ensure complete staff records were maintained in relation to the recruitment of staff.

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement. The provider had not established effective systems and processes to record contact with external teams and professionals, and associated outcomes and agreed actions. We saw information in people’s care plans referenced skin integrity concerns and the involvement of the District Nurse. However, the provider failed to provide guidance to the staff on how to identify wounds and when to escalate concerns. The lack of wound care plans meant we were not assured the provider had oversight of people’s healthcare needs. We saw evidence of people’s equipment to support with mobility being broken and no action had been taken to address this.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research. The quality assurance processes in place were not fully effective and had not consistently identified areas of risk. They had not always identified those aspects of the service which required improvement, as evidenced by the issues we identified at this inspection. There was no analysis of incidents and accidents which meant learning was not shared with staff to reduce the risk future incidents. There was no learning process in place for safeguarding incidents or complaints and therefore there were missed opportunities to learn and make improvement to the overall quality and safety of the service.