Generixcare Luton

Updated 3 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by three inspectors and an expert by experience

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission who was also the provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period of notice for the inspection site visit. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.

Inspection activity started on 21 June 2021 and concluded on 13 July 2021. We visited the office location on 21 June 2021 and between 22 June and 13 July we reviewed documentation and made calls to staff, people who use the service and relatives.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed the last inspection report and all the information we had received about the service since the last inspection. We used all of this information to plan our inspection.

During the inspection

We spoke with 11 people who use the service and three relatives about their experience of the care provided. We spoke with eight members of care staff, four senior care staff and the provider who was also the registered manager. We reviewed a range of records. This included five people’s care records and medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 3 September 2021

About the service

Generix Care is a domiciliary care service providing personal care to people in their own homes. 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. At the time of the inspection the service was supporting 60 people, 55 of whom received personal care.

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

People and their relatives told us that care staff were sometimes late or did not stay for the agreed amount of time. This led to some people feeling rushed and other people feeling anxious. Some people were put at risk of not receiving safe care as a result of this. For example, some people said they went too long between meals, were left at risk of developing pressure ulcers due to staying in bed for too long or received time critical medicines late.

People also said that some new and agency staff were not well trained and did not have the skills to provide safe care. The provider was aware of this and was taking action to address the induction of new staff and improving access to face to face training for all staff including agency staff.

Although risks to people’s health and wellbeing were assessed, guidance to staff about how to support people safely was not detailed enough to ensure consistently safe care. Not all staff understood what a risk assessment was, where to find one or how it related to their work.

Some people were not confident that staff were skilled in administering medicines and gave examples of where errors had been made. Although staff were trained in medicines administration, we found checks made to assess their competence following the training were not always robustly carried out.

Although staff received training in safeguarding people from harm or abuse, staff understanding of types of abuse, signs to look out for and processes for reporting concerns was not strong. The provider had not always reported incidents to the care quality commission in line with regulatory requirements.

Systems to monitor the delivery and quality of care were not always used effectively to identify where improvements to the service were needed. However, where the provider had identified areas for improvement, plans were in progress to take action to address shortfalls.

Measures were in place to manage the risks of COVID-19 including policies and risk assessments. Staff told us they had access to sufficient Personal Protective Equipment (PPE) and had received training on how to keep themselves and others safe from the risks of COVID-19.

People were supported 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 policies and systems in the service supported this practice.

The service worked well with other health and social care providers to ensure people received appropriate care, and when shortfalls to this occurred, the provider was proactive in taking swift action to address this.

The registered manager used the views of people who used the service, their relatives and staff to learn and make improvements to the service.

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 17 January 2019)

Why we inspected

We received concerns in relation to care call management, staff skills and practice, risk management in relation to COVID-19 and incident reporting. We undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of the full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to the impact on people of late and shortened care calls, lack of accuracy, detail and awareness of risk assessment and shortfalls in staff skills and knowledge at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Generix Care on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.