Archived: Kind Hearts Care Company Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to staff training and recruitment.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events.

Lessons were learnt to continually identify and embed good practice. The registered manager told us, “We have staff meetings to discuss issues. I write these up and send them to staff with the newsletter. We use texts to let them know what needs to be done, or how to move forward.”

The registered manager understood their role under the Duty of Candour. They explained, “It is about fully disclosing any mistakes or incidents that happen and not cover them up. We can then look at what has happened and what needs to be put in place to make sure it does not happen again.”

The registered manager had procedures for dealing with incidents, accidents and complaints. They investigated these and developed plans for improvements. These were shared with the staff. The staff confirmed the registered manager discussed adverse events with them so they could learn together. Relatives we spoke with told us they were well informed when things went wrong, and they were confident improvements were made as a result.

The provider had a learning culture which was adopted by all staff. When things happened, there were discussions and meetings to explore what had happened. Any shortfalls and systems were put in place to make improvements.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider carried out thorough assessments of people’s needs, consulting with the person, their representatives and other professionals involved in their care. The registered manager told us, “We liaise with the discharge team when somebody requires care. We look at notes, speak with relatives and do our own assessments. We meet the person themselves wherever they are. We usually want to see the home so we can do an environment assessment.”

The service had up to date policies and procedures in place. Staff were required to read, understand and follow these.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They shared concerns quickly and appropriately.

Although the staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, they did not always receive regular training in safeguarding adults. This meant there was a risk they might not always take appropriate action if a person was being abused. However, the registered manager assured us safeguarding was a regular topic in meetings, and they tested staff’s knowledge and understanding in this subject regularly.

Notwithstanding the above, the provider had procedures to help safeguard people from the risk of abuse and people told us they felt safe. Their comments included, “They are very good”, “I do feel safe with them” and “They are excellent.” Relatives agreed and said, “We have had the service 4-5 months now and I have to say they have been really good, very professional; we have all been impressed with them” and “The [care workers] are all very good. I am sure [family member] is safe with them.”

The provider worked with the local authority and other organisations to help investigate allegations of abuse and to keep people safe.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People said staff knew their needs and met these safely.

The management and staff worked well with people and professionals to manage risks. The registered manager told us, “Each risk is different but based on our assessments, we may refer to occupational health, we liaise with the family and if it is a safeguarding issue, we liaise with safeguarding. We have a fairly good relationship with the local authority. We can discuss issues with them as they arise.”

There were processes to help ensure risks to people were assessed and mitigated effectively. The registered manager reviewed each incident or accident to establish the cause and what actions were needed to reduce the risk of re-occurrence. However, it was difficult to track incidents and accidents to see clear actions taken and outcome on the provider’s electronic system. The registered manager told us they planned to discuss different options to make the system easier to work with.

There were effective systems to review care plans and ensure they were sufficiently detailed and contained key information and guidance for staff.

People were protected from the risk of avoidable harm. Where risks were identified, we saw risk assessments were in place, and these were regularly reviewed and updated.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The management team ensured they carried out a full assessment of people’s living environment to help ensure this was safe. Where risks were identified, the registered manager took appropriate action, which include liaising with the relevant professionals and relatives.

The provider did not always make sure the staff they employed were qualified, skilled and experienced sufficiently. They did not always make sure staff received effective support in relation to their training and development. They did not work together well to provide safe care that met people’s individual needs.

The provider carried out checks on the suitability of staff before they started working at the service. Systems in place included checks on new staff’s identity, eligibility to work in the United Kingdom and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. However, one staff member’s DBS check did not include the adult barred list, which is a mandatory safeguard when individuals are engaging in regulated care activities.

Following feedback, the registered manager told us this had been an oversight on their part, as they had forgotten to tick the relevant box. They provided evidence the staff member had applied for a new DBS which included the adult barred list.

Staff did not always receive enough training to meet the needs of people they supported. A review of training records revealed numerous instances of out-of-date training among staff. In some cases, no training had been completed at all. Furthermore, an administrative team member was found to be providing direct care, including administering medicines to people and undertaking moving and handling tasks. At the time of inspection, they had received no formal care training and held no relevant qualifications. This poses risks to both people using the service and the organisation’s regulatory compliance.

Following the inspection, the registered manager provided evidence they had taken appropriate action. This included meeting with staff and ensuring they completed all relevant training without delay.

Notwithstanding the above, we saw evidence the staff were subject to regular spot checks, supervision and had their competencies assessed to help ensure they were providing good effective care to people who used the service.

People and relatives we spoke with said they were happy with the care workers who provided care. They said they usually had regular staff who knew them well and who they could trust. They told us staff were usually on time for their visits. Their comments included, “They do try to be on time but the traffic is awful at the moment”, “They are on time, and they ring me if they have a problem and are late”, “They have really good standards and a lovely team”, “It’s very good, they turn up when they should and do what is needed” and “They are usually on time."

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The staff received training in infection control and followed safe guidelines. However, some staff had not had a refresher training in this since 2022. The registered manager told us they would ensure all staff completed this training as soon as possible.

People told us they felt safe from the risk of infection and cross contamination. They told us the staff followed safe infection control practices and wore their personal protective equipment (PPE) appropriately. Their comments included, “They all wear their PPE from what I have seen”, “They wear their gloves and things” and “They wear their PPE and overshoes, which is nice.”

The provider ensured the staff had access to PPE which was either delivered to them or they picked it up from the office location. Some people whose immune system was compromised requested for staff to wear a mask, and this was respected.

Although the provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences, they did not always ensure staff responsible for administering medicines were appropriately trained in this.

People told us they received their medicines safely and as prescribed. The provider’s electronic system enabled the care workers to sign for administration on their handset. The management were able to check medicines had been administered in real time. This meant they could take prompt action if they noticed somebody had not received their medicines on time and we saw evidence of this.

We viewed a range of electronic Medicines Administration Records (eMARs) and saw some medicines were recorded as ‘missed’ or ‘not administered’. This had been questioned by the senior staff, and a reason was recorded, but this was not always clear. The senior staff explained that the staff did not always follow correct procedures for recording reasons for not administering a medicine. For example, the system had recorded that a person’s medicines had been missed. Upon investigation, the care worker explained the person had received their medicines, but their handset had not worked and they were unable to sign the eMAR. However, they had not informed the management team of this.

The senior staff member acknowledged this was a problem, and they needed to ensure all staff knew how to use the system effectively and report any concerns. They told us they would discuss this in their management meeting and take appropriate action.

The senior staff undertook regular checks and observations of staff during medicines administration to help ensure this was done safely and in accordance with the person’s care plan. These included if the care worker has gained consent from the person, checked individual medicines, dosage and method of administration, if the medicine was signed correctly and any concerns were identified.

Some people required support to take their medicines, and others required prompting by staff. Staff had their competencies assessed regularly to ensure they maintained their skills and knowledge. There was a medicines policy and procedures in place and staff followed these.