The Care Quality Commission (CQC) has re-rated Geocare Services Limited in Wolverhampton as inadequate and placed it in special measures to protect people following an inspection which finished in May.
Geocare Services Limited, which is run by a provider of the same name, is a domiciliary care agency which provides personal care to people with dementia as well as people living with physical disabilities and sensory impairments. At the time of inspection, 59 people were being supported by the service.
CQC carried out this inspection to follow up on concerns found at the previous inspection, during which Geocare Services Limited was served with three warning notices due to being in breach of four regulations in relation to safe care and treatment, the need for consent, complaints and good management. At this inspection, the service was still found to be in breach of three regulations in relation to safe care and treatment, the need for consent, and good management.
CQC has rated Geocare Services Limited as inadequate for how effective it is, down from requires improvement. The ratings for how safe and well-led it is, were re-rated as inadequate, while caring and responsive were re-rated as requires improvement.
CQC has placed the service into special measures which involves close monitoring to ensure people are safe while they make improvements. Special measures also provides a structured timeframe so services understand when they need to make improvements by, and what action CQC will take if this doesn't happen.
CQC has also begun the process of taking regulatory action to address the concerns which Geocare Services Limited has the right to appeal.
Amanda Lyndon, CQC’s deputy director of adult social care for the West Midlands, said:
“When we inspected Geocare Services Limited, we found that leaders hadn’t made the necessary improvements and we couldn’t be sure that people were receiving safe care and treatment.
“While people described staff as kind and respectful, they weren’t always sure when staff would arrive to help them which reduced their confidence in the reliability of visit timings. People also told us about delays, a lack of continuity and difficulties they had contacting leaders when issues were raised. This led to people feeling frustrated and made it difficult for them to maintain a regular routine.
“Staff told us they sought consent from people in their day-to-day personal care, but the systems and records in place didn’t demonstrate this was consistently obtained, assessed, or managed in line with legal requirements or the Mental Capacity Act 2005. In particular, we found no evidence that mental capacity assessments or best interest decisions were carried out in situations where people’s capacity may have been in question. This limited people’s ability to be involved in decisions about their care and reduced opportunities for staff to promote people’s autonomy and wellbeing.
"Some care plans also lacked detail and didn’t consistently reflect people’s current care needs. For example, one person’s records identified the need for equipment to manage continence, but staff had no guidance on how to manage this, putting the person at risk of receiving inconsistent and unsafe care.
“Overall, we have been clear with leaders about what we expect to see moving forward to ensure they are no longer in breach of regulations. We will return to check on their progress and have proposed using our regulatory powers further to ensure people are receiving the care they have a right to expect.”
Inspectors found:
- Leaders supported staff through training; however not all staff had completed training relevant to people’s assessed needs such as oxygen management.
- Staff didn’t always listen to or respond effectively to safety concerns raised by partner organisations.
- Leaders didn’t work effectively with people to understand and manage risks associated with their healthcare needs. This meant staff didn’t have always have guidance to support them in managing these risks.
- Leaders failed to ensure medicines were managed safely. For example, one person didn’t always receive a time sensitive medication as prescribed, placing them at risk of harm, including deterioration in their long-term health condition.
- Leaders didn’t have effective systems in place to ensure lessons were learnt to continually identify and embed good practice.
- Leaders didn’t have the skills, knowledge, experience and credibility to lead effectively. They didn’t lead with integrity, openness or honesty.
However:
- People were generally positive about the support they received from staff. They felt safe and that their health and wellbeing needs were met.