Kernow House

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 remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

Accidents and incidents were documented and reviewed by the registered manager to identify any areas of improvement or learning.

We identified some areas for improvement as some staff worked excessive hours. The registered manager immediately reviewed this issue and implemented a new system to monitor staff working hours to ensure staff had appropriate rests between shifts and reduced the number of consecutive shifts worked. This evidenced the openness of the registered manager to learn from issues identified and take immediate action.

Daily meetings took place to discuss people's needs and to ensure the overall running of the home was effective. Any changes or incidents were discussed to ensure all staff were up to date.

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 service communicated with external agencies to help ensure continuity of care. For example, key information was available for ambulance crews, paramedics and hospital staff if people needed to be admitted to hospital unexpectedly.

People, their relatives, and other professionals were involved in planning people’s care and support needs.When a person’s care needs had changed these were discussed with the person, relatives and relevant healthcare professionals so consideration could be given to move to a different community within Kernow House or to another care provider. This enabled a smooth transition for the person when their care needs had changed.

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

People were relaxed and comfortable in the service and enjoyed spending time with the staff team.

People and relatives told us they felt safe at the home. Comments included “They really look after me well. I feel safe here” and “It’s so much better here than their last home. I feel that [my relative] is safe here”.

Staff had completed safeguarding training and were confident about the processes to follow if they had any safeguarding concerns.

The registered manager had a good understand of local safeguarding processes and necessary contact information was readily available if needed.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

People’s capacity to make decisions had been appropriately assessed. Where appropriate DoLS applications had been made and conditions complied with. Where the service made decisions on behalf of individuals who lacked capacity these decisions had been consistently made in the person’s best interests.

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.

Risks were identified and mitigated effectively. People’s care plans included clear guidance for staff on how to protect people from identified risks.

People had individual risk assessments relating to the care and support they received. These included risks relating to eating and drinking, moving and handling, skin integrity and falls.

Relatives told us they had confidence in the manager and staff when risks were identified. A relative told us, “They are good at problem solving, if [relative] fell, why, and what can they do to prevent another fall.”

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

A maintenance team oversaw the maintenance of the premises and completed regular safety checks. A maintenance book showed any defects were recorded and quickly attended to.

Some areas of the home had been refurbished. Further planned works for other areas to be refurbished had been approved.

Necessary checks had been completed to ensure the safety of the service’s environment and utilities by appropriately skilled contractors. Firefighting equipment was available if required.

People’s bedrooms were decorated in accordance with people’s individual tastes and interests.

Some staff worked excessive hours, this had the potential to impact on staff wellbeing and care delivery. A staff rota was created in advance, if there were gaps in the rota staff could allocate additional shifts to themselves. This was not audited. The provider had a policy not to use agency staff.

Following discussion with the management team a new procedure was implemented so the registered manager could monitor the number of consecutive shifts a staff member was working each week. If they worked over 6 consecutive days the manager planned to speak to the staff member and ensure a break was taken.

People and relatives told us there were sufficient trained staff that could meet their needs. Comments included “The staff have had the right training to look after people” and “They have enough staff. I’m never alone.”

Staff understood their roles and responsibilities and were positive about how they supported each other and worked as a team.

Staff were positive about the support they received out of office hours as they had a ‘on call’ system. Staff said that on call managers responded to their queries.

Staff received support through observations, supervisions and appraisals with their line managers. This gave them the opportunity to discuss their role, concerns and training needs as well as personal welfare. Staff told us they felt well supported by their leaders.

Prospective staff went through a safe recruitment process which included their right to work in the UK and their fitness for the role. All staff had undergone a Disclosure and Barring Service (DBS) check to help ensure they were suitable to work in the care sector.

All staff completed training relevant to their role. Training included a mixture of e-learning, inhouse and external courses. A member of staff told us, “There’s a lot of training.”

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 environment was visibly clean and tidy. Cleaning schedules showed daily, monthly and deep cleans were completed throughout the service. The laundry area was organised and met appropriate standards. The kitchen was visibly clean and had a food hygiene rating of 5. Daily checks of fridge and freezer temperatures were completed. There was an up-to-date policy on the control of infection, prevention and control (IPC) which staff could refer to.

Staff had access to personal protective equipment (PPE) to use when carrying out personal care.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

An error leading to missed doses of medication had occurred prior to our assessment. This had been reported and was being investigated. We saw suitable processes had been introduced to try to prevent this happening again. We found a gap in 1 person’s Medicines Administration Records (MAR) from the previous day. After we informed staff, this was appropriately followed up, and staff were able to confirm the medicine had been given as prescribed.

Risks had not always been individually assessed for some medicines such as flammable topical preparations. The provider confirmed these had been completed following the assessment.

Generally, people’s records showed they received their medicines as prescribed for them. There were suitable arrangements for ordering, storage and disposal, including for medicines needing cold storage and those requiring extra security.

If medicines were prescribed to be taken ‘when required’ there were person centred protocols to guide staff when these might be needed.

There were suitable systems for recording the administration of topical patches, to show these were applied safely.

Staff told us they felt well supported, and had training and competency checks to make sure they gave medicines safely.

Regular medicines audits were completed, and action was taken when areas for improvement had been identified.