Bkind Care 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 inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service continued to be in breach of legal regulation in relation to the management of people’s medicines. 

This service scored 56 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

Accidents and incidents were recorded, and appropriate actions were taken when incidents happened. Staff knew how to safely deal with accidents and incidents such as a medical emergency or a fall. However, accidents and incidents were not analysed for patterns and trends to support continuous learning and improvement.

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.

People's needs were assessed before the service began to provide care and support. This ensured the service was able to meet people’s needs and there was appropriate guidance for staff to follow. However, some improvements were required in the level of detail and consistency in some risk assessments and care plans.

A relative told us, “Both managers came to do the assessment, went through [person’s] health needs, discussed [their] likes and dislikes and talked about our routine. [Managers] checked that the hoists were safe, the bathroom was safe and wheelchairs were working and serviced regularly.”

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.

The provider had safeguarding policies and procedures in place. Staff were knowledgeable about signs of abuse and neglect and what action to take, as well as how to whistle blow, if required, by following internal policies and procedures, contacting local safeguarding teams or CQC.A staff member told us that before whistleblowing they would continue “reminding [managers], ask for a follow up” but if no action was taken, they would “speak with authorities, such as the local council or CQC”.

Generally, the registered manager and nominated individual were aware of their responsibilities under safeguarding, however we identified a safeguarding concern which, although had been dealt with appropriately, had not been reported to the local authority safeguarding team or CQC. After we discussed this issue with the management team, a referral was completed and learning was implemented to ensure all concerns were reported in line with requirements.

The provider did not always work well with people to understand and manage risks. Staff did not always have clear, consistent and robust guidance to ensure the care provided was safe, supportive, and enabled people to do the things that mattered to them.

Most risks to people's care were identified and plans put in place to manage those risks. However, we found examples where risk assessments were not in place or required additional detail. For example, a person using the service had a catheter in place to manage their continence needs, this was being managed by staff but a detailed risk assessment highlighting the main risks and how to mitigate them was not in place. We discussed this issue with the management team during our first site visit and on our second visit this had been put in place. In our conversations with staff, they described to us the main risks when supporting someone with a catheter, signs to look out for in case of infection and who to contact if they had concerns. Another person had had a fall, but we did not find evidence that their falls risk assessment has been reviewed in a timely way. The lack of detailed and person-centred risk assessments can put people at risk of not receiving the care they require.

People and relatives told us they felt safe with the care provided. A person told us, “Carers give me confidence when I shower. They check the water to make sure it is not too hot for me. ”A relative said, “Most definitely safe, they know what they are doing. [Person] needs hoisting, carers make sure that [person] is comfortable and secure before they start moving [them].”

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The provider did not always have good oversight of the safety of the equipment used to transfer people. Some people using the service required staff to use a hoist to safely move them. When requested, the registered manager and nominated individual could not provide us with the details of when the equipment used by staff to lift and move people had last received their safety check, under the Lifting Operations and Lifting Equipment Regulations. It was only at a later date after our feedback that the management team was able to locate this information and confirmed the equipment was safe to use by staff.

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

Staff had received training to meet the needs of people who were being cared for at the time of our assessment.

The provider was registered to care for children. However, the provider did not have the required policies and procedures in place to care for children. The provider told us if they had a request to look after a care package for a child, they would assess it and provide staff with the required training. No children were being supported at the time of this assessment.

Staff were not receiving supervisions and appraisals in line with the provider's development policies and procedures. However, staff told us they felt well supported and were able to seek advice and support from the managers when required.

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.

People were protected against the risk of infections. Staff had completed training in infection control and food hygiene and told us protective equipment was available.
Relatives told us staff used the equipment appropriately which helped to protect people against risks of cross contamination. A relative said, “Carers always wear blue overshoes over their shoes. Fresh PPE every visit, and staff are particular about their hand washing before every task.”

We continued to find ongoing improvements were required with medicines management. There was a risk of people not receiving their medicines as prescribed.

We found gaps in medicine administration records completed by staff. When reviewing these gaps and cross referencing with care documentation, we were assured that medicines had been administered by relatives. However, medicine care plans did not always detail how staff and relatives were sharing the responsibilities for supporting people with their medicines. This posed a risk of people not receiving their medication as prescribed or a medication error not being actioned.

Some people using the service required medicine to be administered on a ‘when required’ basis. We found protocols for these medicines were in place but needed further information to ensure staff had the appropriate guidance to support people in a timely and person-centred way. Additional detail was required to make it personalised to the needs and requirements of people. For example, a person required a PRN medicine to manage the risks of constipation and asthma. The protocols for these medicines lacked relevant details to ensure staff supported the person in a timely and person-centred way.

Medication audits completed had not been effective in identifying the issues we found during our assessment.

Improvements had been made in relation to the management of creams and lotions, including the implementation of appropriate risk assessments, and body maps were in place showing where creams should be applied.