The Care Quality Commission (CQC) has placed Geocare Services Limited, a domiciliary care agency based in the West Midlands, into special measures after re-rating the service as inadequate. The provider, which supports people with dementia, physical disabilities, and sensory impairments, was found to have put some patients at risk of harm due to failures in safe care and treatment, consent management, and overall leadership.
At the time of the CQC inspection, which concluded in May, the service was supporting 59 individuals. This inspection was a follow-up to a previous one that had already raised serious concerns, resulting in three warning notices for breaches of regulations relating to safe care and treatment, consent, complaints, and good management. Despite these warnings, the latest inspection found that the service was still in breach of three regulations in the same areas.
Ratings downgraded across the board
Geocare Services Limited has been rated 'inadequate' for being effective, a downgrade from its previous rating of 'requires improvement'. The ratings for how safe and well-led the service is were also re-rated as 'inadequate', while caring and responsive were re-rated as 'requires improvement'. These ratings reflect a systemic failure to address previously identified issues and ensure the safety and wellbeing of vulnerable people.
The CQC has now placed the service into special measures, which involves close monitoring to ensure people are safe while improvements are made. Special measures also provides a structured timeframe for the service to understand when improvements need to be completed and what action the CQC will take if they are not. Additionally, the CQC has begun regulatory action to address the concerns, a process the provider has the right to appeal.
Inspectors find ongoing risks and leadership failures
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." She noted that 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 reported delays, a lack of continuity, and difficulties contacting leaders when issues arose, leading to frustration and difficulty maintaining regular routines.
Inspectors found multiple specific failures. Staff sought consent in day-to-day personal care, but systems and records did not demonstrate that consent was consistently obtained, assessed, or managed in line with legal requirements or the Mental Capacity Act 2005. There was no evidence that mental capacity assessments or best interest decisions were carried out where capacity may have been in question, limiting people's involvement in decisions about their care and reducing opportunities for staff to promote autonomy and wellbeing.
Some care plans lacked detail and did not consistently reflect people's current 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 inconsistent and unsafe care. Additionally, not all staff had completed training relevant to people's assessed needs, such as oxygen management, and staff didn't always listen to or respond effectively to safety concerns raised by partner organisations.
Medication errors and ineffective leadership
Leaders failed to ensure medicines were managed safely. One person did not always receive time-sensitive medication as prescribed, placing them at risk of harm, including deterioration in their long-term health condition. Leaders also lacked effective systems to ensure lessons were learnt and good practice was embedded. The CQC found that leaders did not have the skills, knowledge, experience, and credibility to lead effectively, and did not lead with integrity, openness, or honesty.
Despite these serious concerns, people were generally positive about the support they received from staff. They felt safe and that their health and wellbeing needs were met. However, the overall failings have led the CQC to take decisive action. Lyndon added: "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."
Impact on service users and next steps
The special measures designation means the CQC will closely monitor the service, with regular inspections to ensure improvements are made within a specified timeframe. The regulatory action taken could include further enforcement if the provider fails to comply. For the 59 people currently supported by Geocare Services Limited, the immediate priority is to ensure their safety and that they receive consistent, reliable care. The CQC's findings highlight the importance of robust consent processes, detailed care planning, and effective leadership in domiciliary care settings.
Geocare Services Limited has the right to appeal the CQC's decision, but as of now, the service remains under special measures. The CQC has committed to returning to check on progress, and the outcome of these checks will determine whether the provider can improve or faces further regulatory action.
