Geocare Services Limited

On this page

• 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.At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

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.People told us they were aware care plans were in place; however, they were not always involved in developing or reviewing them. One relative told us they had conversations when the care plan was being developed, but following that they had not seen the care plan and felt it did not always reflect the care required.Staff were able to describe how they supported people; however, care plans lacked sufficient detail to guide person-centred care. For example, where people had specific health conditions, such as epilepsy or skin integrity concerns, there were no corresponding care plans or risk assessments in place. Staff were not always aware of these conditions, including active pressure sores, which placed people at risk of receiving care that was not person centred.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.People and relatives described care as generally reliable and consistent, with staff often knowing people well, although feedback regarding timekeeping was mixed.One person told us, “I’m quite satisfied with the service I get. The carers change a lot. The problem is, you don’t know when they are coming. Sometimes they can be up to 2 hours difference from 1 day to the next”. Another person told us, “The carers normally come on time, and if they are ever late, they will always inform me by phone”.Staff told us they worked with external professionals, including GPs and District Nurses, and records showed some instances where professional advice had been sought. However, due to a lack of detailed and consistent recording, we could not be assured that professional advice was effectively followed or embedded into care delivery. For example, there was limited information recorded regarding district nurse involvement in wound care and specialist guidance for oxygen use.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.People told us they were aware care plans were in place; however, they did not routinely have access to them following the move to digital records, despite the provider telling us they had paper care plans in people’s property. This limited people’s ability to view key information about their care, including daily support, changes in needs, and any missed tasks.People told us they were not always informed when care plans were reviewed, which limited their involvement and awareness of changes to their care.Feedback indicated that staff were not always aware of people’s needs, and records contained gaps, including incomplete assessments and missing follow-up documentation. This meant information was not always reliable or up to date to support effective communication.

There was a system in place to enable people to feedback or complain about their care. However, some people were not assured this system was effective.People told us they knew who the manager was and how to raise concerns. However, they sometimes felt they were not always equipped to respond to concerns raised. One relative told us,“Management and office staff are not hands on with the people. They are in the dark as to what we really need”. There were formal opportunities for people using the service to regularly share their views or be actively involved in shaping their care. The manager told us there was a complaints policy in place and investigations were carried out in line with this and we saw a complaints policy. Complaints were dealt with appropriately and a root cause analysis was also completed.

People and their relatives reported inconsistent communication, with 1 person stating, “The office is not passing on the right instructions to the carers to grant our requests. It causes problems and it’s not an isolated case.” This reflected a wider concern that information was not always shared appropriately to ensure care was delivered in line with people’s needs and preferences.

This demonstrated a lack of effective learning from feedback, as repeated concerns about communication had not resulted in sustained improvements to information sharing processes or staff understanding. The provider had not consistently used feedback from people and relatives to identify themes, address root causes, and implement changes to prevent recurrence, which limited opportunities to embed a positive learning culture and improve outcomes.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.We were not assured staff had received sufficient and robust training and care plans did not contain information for staff about how to recognise when people may be unwell and when to refer people to health professionals. People did not have specific care plans in place to provide guidance to staff on how to safely support them with some diagnosed conditions such as Epilepsy. We found no impact on people during our inspection; however, there was a risk staff would not always recognise signs of deterioration and when to refer people to other health professionals.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

For example, we could not be assured outcomes for people were being effectively monitored and met. People had initially been involved before care was commenced with Geocare Services Limited, but following that initial assessment, they were not involved in any reviews or updates to their care plans. Although some care records demonstrated consideration to people such as mobility needs, staff did not always have access to missing guidance to provide responsive care, such as the use of oxygen therapy and the management of seizures. Staff did not all have the skills and training required to support some of these needs and care plan systems did not assist them.

People's rights were not always protected. Where there were concerns about a person's ability to make decisions, appropriate mental capacity assessments had not always been completed. This meant there was not always assurance that care and treatment were provided with lawful consent or in people's best interests, which may have placed them at risk of experiencing inequitable outcomes.

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 no one receiving end of life care. Staff had not received any training in end of life care training and there was no policy provided to us in relation to this. Not everyone had care or support plans in place that reflected their preferences for future care. The provider confirmed that they had not considered people’s future preferences, wishes or needs. This meant that people’s future end of life care may not be delivered in line with their wishes or preferences.