KML Kare

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. This key question 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.

This service scored 50 (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 did not always have a proactive and positive culture of safety based on openness and honesty. The management team did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. It was not clear that lessons learnt were identified or shared with staff when incidents had occurred.

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. Information shared about people when they moved to the service was used to plan their care. A healthcare professional said, “I am aware of KML Kare working alongside community teams, highlighting any concerns, sharing information in a timely and appropriate way regarding any changes in presentation.”

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately, statutory notifications about incidents of abuse had not been submitted to CQC at the start of the inspection. We raised this with the registered manager who submitted the notifications in retrospect.

However, when asked whether they felt safe with staff, people responded positively. One person said, “Oh yes, I am safe they are all very nice.”

The provider did not work well with people to understand and manage risks. There was a risk of staff not providing care to meet people’s needs that was safe and supportive due to inadequate documentation.

Risk assessments were in place but did not explore why people may be at risk. Appropriate, person-centred mitigations were not in place to reduce or remove risks to people. People were not always involved in the risk management process.

In relation to care planning (and risk management), a relative said, “I believe a care plan was made with social services and the company. I’ve raised concerns with the social workers about the poor level of care, but nothing happens.”The registered manager explained they had not been made aware of this concern so had not been able to act on it.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Risk assessment relating to the care environment did not include appropriate mitigation to reduce risks. Care documents lacked information about the safe use of equipment such as hoists, meaning people were at risk of receiving unsafe care.

The provider did not ensure recruitment was carried out safely. Checks relating to people’s previous employment were not always in place. The provider had not always sought references from staff member’s last place of employment. In some cases, the provider had written references for people themselves with no input from external sources.

There were enough suitably qualified staff to care for people safely. Staff had received training to carry out their role. One person said, “It’s more or less the same carer. Sometimes they take a break, but the cover is fine. They are also skilled.”

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. People and their relatives raised no concerns regarding infection control. One person said, “[Staff] have gloves and aprons. I’m happy with the hygiene standard.”

The provider made sure that most aspects of medicines and treatments were safe and met people’s needs, capacities and preferences. Records of ‘when required’ medicines were not in line with best practice guidance. Medicines audits had taken place but had not identified the issues with ‘when required’ medicines protocols.

People were generally satisfied with how the service supported them with their medicines.