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Inspection Summary


Overall summary & rating

Good

Updated 1 March 2019

About the service: Kivernell Care is a domiciliary care agency that provides personal care, live-in care, respite and domestic services to people in their own homes, some of whom were living with dementia or complex health needs. The service operates in the New Forest, Lymington, New Milton and Christchurch areas. There were 105 people using the service at the time of our inspection.

People’s experience of using this service:

• At our last inspection in May 2016 we rated the safe domain as ‘Good’. This inspection identified some areas where improvements were needed and the domain is now rated as ‘Requires Improvement’. Risk management strategies needed to be more robust. For example, records reflected that staff were giving one person foods that were not in line with their assessed dietary needs. Staff knew who to inform if they witnessed or had an allegation of abuse reported to them. They were confident the registered manager would act upon any concerns. There were sufficient numbers of care workers available to meet people’s needs. Recruitment practice was safe and overall medicines continued to be safely managed. Infection prevention and control processes were in place. Accidents and incidents were documented and monitored for trends.

• At our last inspection in May 2016 we rated the effective domain as ‘Requires Improvement’. This inspection found that improvements had been made and the domain is now rated as ‘Good’. Assessments of people's needs were comprehensive. People said staff were knowledgeable, competent and suitably skilled. Records were now being maintained of the training that staff had completed which allowed the registered manager to have better oversight of this, although we have made a recommendation that the registered manager review the current training programme to ensure it fully reflects the needs of people using the service and provides ongoing assurances about the competency of staff. Staff supported people to have access to sufficient food and drink of their choice. Staff recognised if peoples’ health or wellbeing was deteriorating and appropriately sought medical advice to address this. We have, however, made a recommendation that the registered manager make body maps available to staff to contemporaneously record bruising, marks or skin damage found as an aid to later assessing the cause of these or to monitor the healing process.

The completion of mental capacity assessments needed to be further embedded within the service. Action is being taken to address this.

• At our last inspection in May 2016 we rated the caring domain as ‘Outstanding’. Our inspection findings, and the feedback received, at this inspection now supported a rating of ‘Good’. Staff displayed a genuine desire to enhance people's wellbeing and understood it was a person's human right to have their choices respected and to be able to express their views. People confirmed that staff helped them to stay independent and were mindful of their privacy and dignity.

• People continued to receive care that was responsive to their needs. Care plans were person-centred. This, along with the fact that many people had good continuity of carers supported staff to develop meaningful relationships with people. Overall people were confident that any concerns or complaints would be listened to and acted upon. Staff understood the importance of working with other health and social care professionals to provide end of life care in a person-centred manner.

• The service continued to be well led. People, their relatives and staff were positive about the leadership of the service. There was a clear leadership and management structure in place and staff were clear about their role and responsibilities. Whilst some quality assurance checks were taking place, the management team had already identified that these would benefit from being strengthened and more clearly documented. Action is being taken to address this.

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Inspection areas

Safe

Requires improvement

Updated 1 March 2019

The service was not always safe

Details are in our Safe findings below.

Effective

Good

Updated 1 March 2019

The service was effective

Details are in our Effective findings below.

Caring

Good

Updated 1 March 2019

The service was caring

Details are in our Caring findings below.

Responsive

Good

Updated 1 March 2019

The service was responsive

Details are in our Responsive findings below.

Well-led

Good

Updated 1 March 2019

The service was well-led

Details are in our Well-Led findings below.