KML Kare

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. This key question changed to requires improvement. This meant the management and leadership was inconsistent. Leaders processes did not always support the delivery of high-quality, person-centred care.

This service scored 46 (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 clear shared vision, strategy and culture which was based on equity, equality and human rights, diversity and inclusion, and engagement. They understood the challenges and the needs of people and their communities. Some healthcare partners said the service did not have the experience required for some care packages they had taken on. Staff and people felt there was a positive culture at the service. Communication channels between people, staff and management were open.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively.

Due to the range of the responsibilities involved in having a combined registered manager and nominated individual post, the provider did not always have the time to keep themselves up to date on current guidance, legal responsibilities, and the regulations surrounding the running a domiciliary care service. Since the inspection took place, the registered manager/nominated individual has started the process to recruit a deputy manager.

Staff said the registered manager was approachable and supportive. One staff member said, “I am very well supported with the management system, as if I have any issues or concerns I feel comfortable coming to them.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. All but one staff member we spoke to felt their concerns would be listened to. Comments from staff included, “I feel like I can speak up to my managers and I have also felt listen to,” and “I've always felt supported when talking to management. I've always felt happy and comfortable speaking up when needed and, yes, management have always taken the time to listen to my concerns and have always took (taken) them on board.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. We asked staff whether they had ever experienced discrimination, and no one raised concerns with us.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

We found issues with recruitment, risk assessments, care records, management provision and statutory notifications during the inspection. The provider’s governance systems had not identified most of the issues we found.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. However, they did not always share information and learning with partners.

We received mixed comments about how the staff worked with other healthcare services. One healthcare professional said, “[KML Kare] have never reported any concerns directly back to the team, however, we are aware of incidents taking place that should have been reported.” However, another healthcare professional said, “Staff go to their manager and if any guidance is required from ourselves [the registered manager] always follows our advice/guidance.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. Lessons had not been learnt from a number of incidents that had occurred. Lessons learnt were not always shared with staff. During the inspection the registered manager did take on the feedback we provided and started to make improvements.