We carried out a review of the data available to us about Kcare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kcare, you can give feedback on this service.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.
At the time of inspection, there were 20 people receiving personal care services from the provider.
The service had a registered manager in place at the time of our inspection. 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.
People told us they were happy with the care they received from the provider and that staff were friendly and caring. They said the service was reliable and they received their care calls as planned.
There were enough suitable staff in place to meet people’s needs. The provider had systems in place when recruiting new staff to assesses that their experience and character was appropriate to the role. Senior staff were available to cover care calls when required and the provider had systems in place to minimise disruption to the service during emergency situations such as severe weather.
Staff had access to training which was appropriate to their role. The registered manager monitored staff’s ongoing working practice and training needs to help ensure staff were competent and confident in their role.
The registered manager had a good insight into the day to day running of the service. There was an organised structure within the provider’s senior team, where senior staff were confident and focussed in their role.
The registered manager had implemented a series of audits and checks of the quality and safety of the service. They had also commissioned an external care consultant to assist them with audits and action plans which encouraged improvements.
The service had implemented an electronic care planning and monitoring system which enabled senior staff to monitor the care being deliver in real time. People’s care plans and staff rotas were updated through this system, which meant that staff had access to the most up to date information.
The provider assessed people’s needs to help ensure they received appropriate care. Care plans were developed and reviewed in partnership with people. They were based on delivering positive outcomes for people and incorporated information about people’s needs and preferences. Care plans covered a range of areas including the support people needed with their medicines, nutrition and healthcare.
When people’s needs changed, their care plans were reviewed and the provider sought appropriate input from external health and social care professionals to help ensure people’s needs were met.
Risks to people were assessed and mitigated. When incidents took place, the provider reflected on events to help reduce the risk of reoccurrence. There were systems in place to help prevent the risk of infections spreading.
People were safeguarded against the risks of abuse and harm. The provider had worked with the local safeguarding teams to investigate individual concerns when they arose and put plans in plan collaboratively to keep people safe.
People received personalised care which reflected their equality, diversity and human rights. Staff understood the need to gain appropriate consent to care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s communication needs were considered in the planning and delivery of care.
The registered manager sought feedback about the service from people to help make improvements to the service.
There were appropriate systems in place to handle complaints and concerns.
At the time of the inspection a registered manager was 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.
Staff knew how to keep people safe by reporting concerns promptly through a procedure that was taught as part of the induction process and further followed through in the staff handbook. Systems and processes were in place to recruit staff that were suitable to work in the service and to protect people against the risk of abuse. There were sufficient numbers of suitably trained and experienced staff to ensure people’s needs were met. Staff were matched to meet people’s needs as per experience, knowledge, age and interest.
People using the service were generally happy with the support and care provided. Time keeping was raised by some people as a concern. People and where appropriate their relatives confirmed they were fully involved in the planning and review of their care. Care plans focussed on the individual and recorded their personal preferences well. They reflected people’s needs, and detailed risks that were specific to the person, with guidance on how to manage them effectively. We found that the new documents contained detailed specific guidance and were person centred in their writing style.
People were supported with their medicines by suitably trained, qualified and competency checked staff. Medicines were managed safely and securely. We were unable to find the protocols for PRN (as required) medicines; this was raised with the registered manager, who forwarded us a document evidencing new guidelines.
People who could not make specific decisions for themselves had their legal rights protected. People’s care plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests.
People received care and support from staff who had exceptional skills and knowledge to care for them. All staff received comprehensive induction, training and support from experienced external consultants. Training was tailor made to meet the needs of the people with the trainer completing a needs analysis for all people using the service bi-annually. This ensured training delivered was in line with people’s needs. In addition the trainer assessed each staff member on level of competency, developing a plan for future goals.
The quality of the service was monitored regularly by the provider, and external consultants. A thorough quality assurance audit was completed annually with an action plan being generated, that further informed the business plan for the following year. The registered manager advised shorter audits were completed monthly. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. We found evidence of compliments and complaints that illustrated transparency in management.
As part of this inspection we spoke with the registered manager, the operations manager, four members of staff, three people who use the service and three relatives of people who use the service. We reviewed records relating to the management of the service which included, six staff personnel files, eight care plans, daily care records, risk assessments, audits and policies. We also spoke to the local authority commissioners.
Below is a summary of what we found. The summary describes what we were told, what we observed and the records we looked at.
Is the service safe?
There were effective recruitment and selection processes in place. Appropriate checks had been undertaken before staff began work and staff told us they had not been allowed to work until all relevant checks had been completed.
Staff had undergone induction training which included working for a period of time with an experienced member of staff. Staff told us they felt they had received good and adequate training which enabled them to be able to do their job safely.
We reviewed the recruitment files of six members of staff. Records we looked at were accurate and fit for purpose and contained the information required by schedule three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
We looked at eight care plans and saw that risk assessments were relevant to the care planned and reflected the individual person's needs. We saw that care plans contained risk assessments in areas such as bathing, falls, moving and positioning . We noted these risk assessments were evaluated annually or if a person's condition or circumstances changed.
Is the service well-led?
People we spoke with told us they were asked for their views regularly and if they requested something to be changed said this happened. For example, one relative told us: '(they're) very flexible (with call times) if doing anything special.'
We saw responses to the most recent quality questionnaire during the visit and noted that there were many positive comments made. For example: 'Very happy, no changes needed' and 'very pleased with care.'
Audits had been carried out on care plans, staff personnel files and complaints. The manager told us these were used to ensure the quality of the service, to monitor trends and find solutions for any issues found.
We spoke with six people who use the service, three relatives, seven care workers and three members of managerial or office staff during the inspection.
People who use the service and their relatives said they were satisfied with care staff. They said the service met their needs. However, some people reported late or missed care calls. People said they could report concerns to the service and the service was responsive to concerns.
We saw systems used to monitor the service were not used appropriately by the service. In particular monitoring of the timing of care calls was not sufficient. This meant there was a risk people would not receive care at the time they needed it and the service may be unaware. We found inconsistencies and inappropriate risk assessments in some people's care records.
Staff received appropriate training and support from the service. However, the service did not follow all its recruitment procedures. Not all the checks required by the regulations were carried out before staff began work with the service.
People told us the service met their needs. They said care reviews were undertaken periodically to ensure any changes in people's care needs were considered by the service. The 10 care plans we looked at were reviewed within the last year.
Care plans included risk assessments on environmental risks and manual handling. People's medical conditions were recorded for staff to refer to if necessary.
People told us they were asked to provide feedback on the service they received through phone calls or questionnaires. They said they were made aware of how to contact the service in order to make a complaint.
The service had monitoring systems to assess the quality of care provided. The time staff spent with people who use the service was monitored. The agency undertook spot check on staff to ensure they provided care appropriately.
We saw care plans contained individualised information on people's needs, personal preferences on how people liked their care to be delivered and appropriate risk assessments.
Staff told us they followed the medication instructions in care plans when administering or prompting people to take medicine. One care worker told us they were assessed in administering medications every two months by a manager to ensure they were following the correct procedures.
We looked at four staff files and they contained some but not all the information required related to the recruitment of workers who undertake regulated activities.