Genuine Carers - Kirklees

Updated 25 August 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors on 24 April 2023 and 1 inspector on 27 April 2023. On 26 April 2023 an Expert-by-Experience made telephone calls to people and their representatives to gather their feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were 2 registered managers in post. Following our inspection, we were notified that 1 registered manager had left their role.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people in the office to speak with us.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from Healthwatch, the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all this information to plan our inspection.

During the Inspection

We spoke with 4 people who received a service and 9 relatives of other people who received a service.

We spoke with the nominated individual, 2 registered managers, a care manager, a registered operations manager and 3 care workers. The nominated individual was responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 4 people's care records, as well as medication records. We looked at the recruitment of 3 staff members as well as records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at further quality assurance and training records.

Updated 25 August 2023

About the service

Genuine Carers – Kirklees is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection, 32 people were receiving a 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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people and providers must have regard to it.

Right Support

Staff had been trained and were assessed as competent to administer medication. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice, although records required improvement.

Right Care

Risks assessments were not always consistently recorded to ensure safe practice. The management team and staff understood people’s care needs. Staff understood how to protect people from poor care and abuse.

Right Culture

Feedback we received was positive around the care people received.

At this inspection we saw minor improvements in the service people received. Feedback from people and relatives was more positive, although people still reported experiencing missed calls. The management team did not have sufficient oversight of this. Office staff over-relied on people reporting late or missed calls and were not proactive in responding to electronic call monitoring, which identified when care tasks did not appear to have taken place.

Quality systems remained ineffective as systems of audit were not routinely carried out. There was little evidence of oversight of the service in key areas.

People and relatives were consistently asked for their feedback through telephone calls, spot checks and satisfaction surveys. However, concerning responses in relation to a recent satisfaction survey had not been acted on.

People said they received suitable support with their medication needs. Improvements were needed to records to demonstrate the safe management of medicines. Risks to people were fully understood by the management team and staff were reasonably confident. However, this information was not always included in risk assessments we looked at.

People and relatives said they were mostly satisfied with their call times and staff stayed for the full duration of the call. They provided positive feedback about the caring nature of staff who they said understood their care needs.

Some improvements had been made since our last inspection. Suitable travel time had been allocated between calls, consent was being recorded and mental capacity assessments had been put in place.

Formal staff support was not detailed in records we looked at, although staff said they were given plenty of time to cover what they needed and felt well supported.

People largely felt safe with this service. Records relating to safeguarding investigations showed these events had been looked at. Healthcare partners were clearly involved in people’s care as referrals were made because staff identified concerns and the management team acted on these needs. People said staff were good at identifying when they were unwell and acted on this.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 6 June 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made, although the provider remained in breach of regulation.

Why we inspected

We carried out an announced inspection of this service on 16 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the reliability and punctuality of visits to people's homes, the safe management of medicines, recording consent and mental capacity, plus systems to ensure oversight and quality of care provided.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

We have identified a breach of regulation in relation to the management and oversight of the service.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Requires improvement’. However, we are keeping the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over 2 consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.