Kardinal Healthcare Ltd

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 72 (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.

People and staff were engaged in developing and updating care plans.

Accidents and incidents were being reviewed and there were plans in place to improve this system to provide a better overview and further capture any trends developing.

A complaints policy and procedure were in place which identified the provider was responding appropriately to issues people raised. Staff told us they felt confident speaking with the managers about changes in care plans where they were identified contributing to continuing change to reflect people's needs.

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 provider worked with partners to gather relevant information needed to assess if they could meet people's needs. Health professionals spoke positively about the service, highlighting their prompt response when completing people's assessments. People were supported to transition between child and adult services. We were shown examples of sharing information between relevant partners to facilitate continuity of care.

Care plans were accessible to staff using an electronic system which they accessed using devices at the point of care.

Staff explained that they could use the device to check previous notes, providing them with the information they needed to give ongoing, consistent care and support.

The provider did not always share concerns quickly and appropriately. However 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 did not always notify the regulator when concerns were raised. However, the provider told us this was an oversight due to a change of personnel. The provider did follow all other appropriate procedures when issues were raised and then completed outstanding notifications retrospectively.

The provider had safeguarding policies and procedures and provided the relevant training for staff to follow. They worked with the local authority safeguarding team for both adults and children when concerns were identified; staff were able to describe signs of abuse and knew how to report concerns. A staff member said, when describing potential signs of abuse they would look for, “Any visual bruising, not being their usual self, quiet they could be different around certain people”. Another staff member said, “Marks with no explanation.”

People and their relatives told us that they feel safe around the staff. One relative said, “Totally safe, never had an issue and my loved one trusts the carers.” Another person said, “Yes I feel safe when they are here, I'd tell the office if something was wrong.”

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.

People were involved in managing risks and had their views and choices taken into account allowing them to continue to do the things they liked in daily life. One relative said, “They have supported them to do the things [Name of loved one] likes and even supported them to go to Legoland and places like that.”

During discussions, managers recognised falls risk assessments would be better separated from the mobility risk assessment to give clearer guidance to staff. These new risk assessments were put in place during the inspection. Staff had received appropriate training to meet people's needs safely. One staff member said, when talking about managing risks, “Depends, for example, a person I support can refuse to drink sometimes and I talk with Mum who gave advice, and I try go back later. We tried new flavours, jellies, and the gentle approach to encourage them to take on fluids.”

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

We were shown examples of risk assessments about managing safety in people’s homes with clear guidance for staff to follow. People’s wants and likes were considered, for example, a person preferred to eat breakfast and lunch in different areas of their home. Another example was how to heat food safely, avoiding a certain appliance due to its condition and potential risk. One staff member said, “Even a dog can pose a hazard when you're using the hoist." Staff explained that risk assessments were readily available to view on the devices they have access to.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

People and their families told us that they have regular staff who know them and their loved ones well. They arrived at consistent times that suited people's needs and stayed for the correct amount of time; records confirmed there were enough staff in relation to people. Comments from people and families included, “Same staff often, only if someone is sick, I might get someone different, but it’s ok and they’re always nice.” Another person said, “One carer went, and they could find another to support my loved one, but yes generally the same staff and never a surprise about who's coming.”

Staff were recruited through a recruitment process which ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Records showed staff were receiving an effective induction including shadowing opportunities, with a training schedule in place; they were supported to develop their knowledge. One person said, “Yes they know what they are doing.” Another said, “Definitely they show this when they support [name of relative], for example, with training, the lady that supports my loved one most is so over educated, absolutely amazing, understands my relative, all the carers are really good.” Staff explained that they felt confident providing support and received appropriate training for their role. They went on to say if a person has specific support needs, they received additional training. Staff practice was regularly assessed in people’s homes to ensure competency.

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.

Staff were trained in infection prevention and control and had access to sufficient personal protective equipment (PPE) supplies. One staff member said, “We do training on this and have PPE available at the office. In my case I visit mostly one home. I get the gloves, aprons and masks I need for the month.” Another staff member said, “Aprons and gloves have to be worn for all personal care.” People and relatives said, “Yes, wear gloves and aprons if needed, no issues there.”

Staff received training in basic food hygiene which supported them to prepare food safely in people’s homes.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff were trained in the administration of medication and where further training was required to meet people's specific needs, this was provided. One relative said, “The staff have been trained to give my [Name of loved one] as required (PRN) medication.” A staff member said, “We have training online and face to face with scenarios to find the issue it's done when you start. You have your competencies checked and we’re trained specifically for emergency medication.”

The provider carried out spot checks on staff to ensure they complied with the training and policy.