KYN Hurlingham

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.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 84 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. Staff described a positive, proactive approach to learning and addressing concerns, underpinned by an open, responsive culture. They were confident to raise concerns, knowing management would respond promptly and were receptive to feedback and new ideas. We saw that any query, concern or need was attended to immediately it was raised. The impact of this was people's needs were attended to very promptly.

Commitment to learning was also evident in leadership practices with the home holding monthly values reviews to identify if and how the provider’s values and philosophies were followed and maintained. This included how they found the positive in the way people’s needs were met and their lives fulfilled. Examples included the whole staff team being onboarded and trained together in the provider values and how to work towards them together as a team. This included recognising individual staff contributions nominated by other staff.

The provider had state of the art systems in place to detect any hazards or risks to people that were continually monitored and recorded. This was with their permission and consent was recorded in their care plans. The home had installed a night time Artificial Intelligence (AI) electronic monitoring system where each person had an individual monitor. Once switched on it alerted staff if people were calling for help, awake and active, unusually restless or in discomfort. This was sent to a smart phone which could also review audio samples and other sensor data to assess if people required staff assistance. The impact of this was that people could receive staff support quickly.

A relative shared, “Overall, I am very impressed with the service provided. They do respond very well, discussed a complaint I had made, and explained how it was investigated and dealt with and to get my views on the process.” This reflected the provider’s dedication to learning from feedback and embedding good practice across the service.

There were thorough, processes enabled learning from incidents where people may have been put at risk. This promoted people’s safety as a priority whilst not limiting their choices and empowered them to take acceptable risks. Before moving in a person had seldom had the opportunity to go out shopping. After a thorough risk assessment, they accessed shops locally and further afield with staff support and transport provided. They said they were very happy to go out and had not been shopping in 20 years.

The provider worked with people and their relatives to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services. People and their relatives said they were fully involved in identifying the support they needed and informed of what support was available. It was explained to them in a way that they could understand and revisited as many times as required so that everyone knew what they could and could not expect from the provider, registered manager, and staff. There were up to date processes, and systems that were followed, enabling continuity of safe care, and joined up working. The provider's policies, procedures, and processes were in line with current, relevant legislation.

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 and their relatives said they felt very safe using the service, and the support they received was exceptional. They told us staff supporting people understood how to keep them safe. A relative said, “It is a great comfort that [Person using the service] is in the right place with such good, caring, and thoughtful staff.” People and their relatives were confident in raising concerns, always received a prompt response, and if they felt there were safety issues, they were fully, and appropriately investigated, and they received an outcome. The impact of this was that people were reassured that they received care that would keep them safe, and any concerns about their safety would be fully investigated and rectified.

Staff we spoke with showed strong safeguarding knowledge and were confident in both internal and external reporting procedures. They demonstrated a clear understanding of Making Safeguarding Personal (MSP) principles, placing emphasis on individual outcomes and supporting people’s choices. A staff member explained, “I think it’s safe here because the environment is well-maintained and safety procedures are followed.” Another staff member said, “Our procedures and policies are clear, followed and checked.” These comments reflected a well-embedded safeguarding framework that was understood and applied consistently across the team.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. A person who increased their art collection at an online auction was them gradually supported to visit the Tate Britain to make further purchases. The impact of this was to encourage them to improve their confidence, make positive decisions and increase their mobility which was previously very limited. A staff member told us they aim to “stay one step ahead,” by anticipating and responding to individual needs. This was based on having thorough knowledge of people, based on dialogue with them to identifying routines they like to follow from which risks can be identified and minimised. A staff member said, “We take great care to build relationships with people, based on trust so we continually improve our knowledge of them and the support they receive.”

People confirmed that staff regularly sought their views, opinions, and checked that they were receiving the support they required which enabled them to lead the lives the way they wished, within an acceptable risk-based environment. People were assessed by the inhouse physiotherapist once they had moved in to identify what their mobility needs and wishes were. They were then tailored to appropriate physical activities they wished to participate in and felt they could do. The physical activities were available five days per week and included seated kick boxing, music and movement and chair yoga. These took place in small groups based on people's preferences. The impact of this was that people had enhanced independence through choice, received more individualised support and their fitness and mobility where greatly enhanced. A person said, “They are very good, they will sit down and

talk things through with me in my own time.” People told us they were offered copies of their care plans, reinforcing transparency and shared ownership of their care and managing risks. The care plans and risk assessments we reviewed included people’s perspectives on how risks should be managed, with decisions made collaboratively to promote independence, choice, and control. Relatives spoke positively about the service’s approach to risk. A relative commented, “It makes me feel that [Person using the service] is safe.”

The provider had a robust accident and incident reporting policy in place, accessible to all staff. Staff we spoke with demonstrated a clear understanding of the procedures for recording and reporting incidents, and described the systems used to ensure timely and accurate documentation. This structured approach supported a safe environment where risks are actively monitored and addressed.

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 provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care. Staff were thoroughly trained, and this meant they were constantly vigilant regarding people’s safety whilst not being intrusive. Thorough records of checks and drills were recorded, and up to date.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs. At the time of the inspection there were 70 staff to care and support 19 people meaning a ratio of over 3 staff to each person. This was underpinned by a strong commitment to a collaborative multidisciplinary team approach involving all staff irrespective of their job title or seniority. Most staff we spoke with said there was a positive team culture, describing a strong ethic of working together. A staff member said, “It is not about individuals [Staff] within teams working well together. It is about everyone working well together irrespective of their particular team.”

The staff levels meant people were supported to pursue their interests and hobbies whenever and however they wished. Individual staff and teams were dedicated to meeting identified wishes and needs of people as individuals. For example, there was a dedicated taxi service located at the home if people wished to go shopping or for other purposes. People chose staff they wished to accompany them. People told us they frequently made use of this to go shopping, visit friends and family, and go out for meals. A person told us, “I go out of lunch at least twice per week.” There was also a fulltime massage therapist employed by the provider onsite with dedicated therapies that delivered a range of treatments tailored to individual preferences and goals.

Supervision records confirmed that staff had regular one-to-one meetings with management to support professional development and identify further learning needs. Systems were in place to monitor training and supervision, ensuring staff remained up to date and equipped to deliver safe, effective, and person-centred care.

The staff recruitment files contained all appropriate up to date processes and checks. Staff received training that was comprehensive and based on the Skills for Care 'Common induction standards’. They form part of the Care Certificate which is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. They also received specialist training for example in the night time AI electronic monitoring system and how to respond based on people’s sleep patterns. High quality training in best practice and equipment had helped people experience good outcomes for, for example wounds healing. Disciplinary and capability processes were fair and regularly reviewed to ensure there was no disadvantage based on any specific protected equality characteristics.

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. There were efficient systems and training to maximise infection control and ensure a clean, hygienic environment for people to live and staff to work in. A person said, “Everywhere is kept very clean.” A tour of the building demonstrated that it was kept to an exceptionally clean standard by a dedicated team who were very proud of their contribution to the running of the care home.

The provider made sure that if people required support with medicines and treatments it was done safely and met people’s needs, capacities and preferences. This was confirmed by relatives who said staff made sure people received the support they required in a timely way. There were processes that were followed, recorded, and audited. Staff received appropriate training that was refreshed regularly, and their knowledge was good.