Genesis International Solutions

Genesis international solutions is a home care service providing personal care to people in their own home. The service provides support to people with a range of needs including older adults who may be living with dementia. At the time of our inspection there were 6 people receiving a live in care service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

The provider did not always ensure they met their legal duty to safeguard people when information of concern was raised in an effective or timely way. The provider did not ensure they completed all required pre-employment checks when recruiting new staff. People were supported with their health and social care needs, including medicines, by staff who knew them and their needs well. There were multiple examples where people's care and medicines records were not always complete, up to date or accurate to reflect the care they received.

Records relating to people’s fluid intake could be improved. People’s nutritional needs were met. Staff supported people to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The provider did not demonstrate they considered the principles of the Mental Capacity Act 2005 to consistently support this practice. We received positive feedback from staff that they felt supported in their role.

We received consistent positive feedback from relatives that their loved ones were provided with kind, caring and compassionate support. People were treated with dignity and respect and staff promoted people’s independence where possible.

Most people’s care records were person centred and included information on their personal history, the things that were important to them and their preferences. The provider had a complaints procedure in place and valued people’s feedback. People were supported with their end-of-life care needs, however records about people's wishes were not in place.

The service was not always well-led. Governance systems were not effective or robust to ensure the provider consistently met their requirements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 04 March 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We have identified breaches in relation to safe recruitment practices, taking appropriate action to consistently safeguard adults at risk including upholding principles of the Mental Capacity Act 2005 and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Genesis International Solutions provides domiciliary care services for four people. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Relatives told us people were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff knew the people they supported and provided a personalised service. Care plans were in place detailing how people wished to be supported and families were involved in making decisions about their care.

Staff received regular training in topics the provider considered mandatory and were knowledgeable about their roles and responsibilities.

There were suitable recruitment procedures and required employment checks were undertaken before staff began to work for the service. Staffing levels and skill mix were planned, implemented and reviewed to keep people safe at all times. Any staff shortages were responded to quickly and appropriately.

The staff understood their role in relation to the Mental Capacity Act 2005 (MCA). People told us staff gave them choices and respected their decisions.

People were prompted by staff to take their medicines safely. The manager completed regular checks to ensure medicines were safe. People managed their own meals, however staff had information in care plans about peoples eating and drinking requirements, to ensure people’s nutrition and hydration needs were met.

Assessments were undertaken to assess any risks to the person using the service and to the staff supporting them. This included environmental risks and any risks due to the health and support needs of the person. The risk assessments we read included information about action to be taken to minimise the chance of harm occurring.

Staff told us the provider and manager were accessible and approachable. Staff felt able to speak with them and provided feedback on the service during staff briefings.

The registered manager and the provider undertook regular audits and spot checks to review the quality of the service provided.