Kare Plus Kingston

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• 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

People felt safe receiving care from staff. Staff were aware of their responsibility to safeguard people from avoidable harm and reported any concerns they observed. Care records had been updated and now included detailed risk management plans which informed staff how to support people safely. Staff checked the equipment people used to ensure it was safe and in good working order. Staff supported people as required with their medicines and had improved their processes to ensure safe medicines management. Staff wore personal protection equipment to protect themselves and others from the risks of infection. People felt their care workers had the skills and knowledge to support them. Staff completed a range of training courses to ensure their knowledge and skills stayed up to date with best practice. Staff adhered to incident reporting procedures and there were processes in place to share learning from any incidents that occurred.

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.

People and their relatives felt there was a learning culture in place. They felt any incidents were learnt from and the management team ensured action was taken to improve practice. One person told us, “We do feel safe with the staff who come to us, we are both in wheelchairs, so need their help. If I were concerned at all I would speak to the manager, who is very understanding.” A relative said, “The manager is very good, I only have to ring her, and she will sort things, she will then remind the staff of what they need to do, and check.”

Staff were aware of the reporting procedures for any incidents that occurred, and learning from those incidents was shared across the staff team. The management team told us, “We are confident that our care workers are raising all concerns. Once we have reviewed incidents and complaints, we discuss the learning with all staff and address any particular concerns with individual staff, whether that’s a need to redo their training or a one to one supervision. We discuss themes through regular meetings with staff.”

Processes were in place to ensure continuous learning from incidents and accidents. We saw that incidents and accidents were appropriately recorded, investigated and learnt from to reduce the risk of recurrence.

Safe systems were in place when people transferred their care to Kare Plus Kingston. A relative said, “Kare Plus provide additional support for my relative, providing five hours of care a week. When I approached them, they replied promptly, they listened to me in order to find a way to work with me and my relative.” A person told us, “When I decided to use Kare Plus, they came out and spoke with the old care company to get to know the routine. All the staff just got it and understood what I needed.”

Staff worked with partner agencies to ensure people had a smooth transition into care. This included liaising with other social care providers who had previously cared for the person. The registered manager told us, “We had one client who had received care in a care home. We involved the care manager of the care home in the care planning process as well as the family and the person.”

We contacted the health and social care professionals working with the service about safe systems but we did not receive any feedback.

Assessments were undertaken and accurate records were maintained to ensure safe transition between services, and where more than one service provider was supporting a person. This included the development of a care passport which outlined people’s needs in a short and concise way and could be used to help inform healthcare professionals about people’s needs, should they need hospital admission.

People felt safe and free from discrimination when receiving support. A relative told us, “My relative feels very safe and happy with the carers, she is practically blind and deaf, also physically very frail. The carers have got to know her well, they understand her and communicate with her amazingly well.” One person said, “I feel very safe with the staff as they are very thorough, very caring and are on the ball.”

Staff were aware of their responsibilities to safeguard people from avoidable harm. Staff told us, “We call the office if we have any concerns about safety” and “If I can see that someone is unsafe then I need to tell my manager. So, they can get the support in place that is needed.”

Safeguarding adults’ policies and procedures were up to date and staff had been trained in safeguarding adults. Processes were in place to record and learn from any safeguarding concerns should they arise.

People felt safe with staff and staff were aware of any risks to their health and welfare. They told us staff supported them to minimise those risks and ensure their safety. A relative said, “The care workers know she can fall, they keep close and keep a close eye on her.” A person told us, “The care workers support me when I am moving, they are aware of the dangers as I have fallen previously. They know what they are doing; they help me to transfer from my bed to the commode. They also keep a close eye on my bottom and put cream on to prevent it from getting sore.” Another person said, “The carers keep a close eye on my pressure areas, if they see anything they flag it up to each other to observe.”

Risks to people’s safety were identified during the assessment process. The management team said, “During the risk assessment, we identify needs of the client. We first talk about mental capacity and that helps us to take things forward and identify what understanding they (people) have around risks.” Staff were aware of any risks to people’s safety and how to support them to minimise those risks. They informed us people’s care records included detailed information about risk management plans. They told us, “Specific risks about clients are included in their care plan” and “The company offers regular safety talks and reminders to us. The company has a safety protocol which we are required to read and apply.”

Risk assessments now contained sufficient detail to identify any risks to people’s safety and welfare and inform staff about how to support people to manage and mitigate those risks. Risk management plans were reviewed and updated in line with any changes in people’s health.

People told us staff used equipment safely in order to meet their needs. One person said, “I have a slide board to help me in and out of bed, the care workers know exactly how to use it.

Staff supported people to maintain the safety of their environment and ensure they had the equipment they required to support their needs. The management team told us, “We go through an environment assessment and look at the aids they require and whether it meets their needs. When we feel the equipment doesn’t meet their needs, we advise them who to contact and what equipment to get in place.” Staff said, “People usually have the equipment they already need to support with their risks. If there were any concerns about the safety of the equipment, then I will tell the office and advise the person not to use it until it was serviced.”

Processes were in place to ensure people were supported using safe equipment. Systems were in place for staff to liaise with healthcare services who provided the equipment should they identify any safety concerns.

People received care from consistent care workers who had the time to carry out their duties. People and their relatives told us, “[My relative] generally sees the same few care workers, and they always arrive on time at about 07.00hrs and stay the full 30 minutes. If there is ever a time the care worker is running late the office will ring and let us know” and “I always get the staff I need; they arrive on time and never leave early. I have a very high opinion of the service; they are very adaptable. If I need extra help, they will arrange things straight away and send care workers we like. If my husband has a hospital appointment, they will arrange for care workers to sit with me.” People had confidence that their care workers had the skills and knowledge to support them safely. Relatives we spoke with said, “The care workers absolutely meet the needs of my family member. She always tells me what the care workers do for her and how well they do” “The care workers are very well trained and know exactly what they are doing.”

Staff felt there were sufficient numbers of staff and this gave them the time to undertake their duties and provide person centred care. They said, “Our rotas give us enough time to do our duties.” The registered manager told us, “The care management system helps us a lot with staff management and ensuring systems are in place to ensure safe staffing levels.” Staff confirmed they were required to undertake regular training to ensure they had the knowledge and skills to undertake their duties. Feedback received included, “Continuous and refresher training is provided by the company”, “The Kare plus management team provides me with all the support I need to do my job well” and “I have completed all mandatory training as required, and additionally, I have undergone extra training sessions tailored to specific client needs.” The management team told us, “We would review during shadowing that care workers have the skills and knowledge to meet people’s needs.”

Processes had improved to ensure there were sufficient numbers of staff to support people with their needs, and ensure staff had appropriate breaks between shifts. The provider’s systems ensured consistency in the care worker allocated to support a person. Safe recruitment practices were in place to ensure suitable staff were employed. Staff received regular training and supervision to ensure they had the skills and knowledge to undertake their duties. Processes were in place to ensure staff completed refresher training at regular intervals to ensure they stayed up to date with best practice guidance.

Staff protected people from the risk of infections and followed good practice regarding infection prevention and control. One person told us, “The care workers are very good with hygiene; they wore masks when they were supposed to and now wear just gloves and aprons and change them when required.”

Staff were aware of their duties and the processes they needed to follow in order to protect themselves and others from the spread of infection. They confirmed they had access to personal protection equipment (PPE).

Infection prevention and control policies and procedures were in place, and systems were in place to ensure staff’s practice was in line with these. Staff had access to appropriate PPE to protect them and others from cross infections.

People received support with their medicines. People told us, “The care workers remind me to take my medicines; they will pass me my pills, give me a glass of water and make sure that I have managed to take them okay” and “The care workers give me my tablets out of the blister pack as it is fiddly for me.”

Staff were aware of how to support people safely with their medicines, should they require this level of support. They told us they had received training and were aware of processes to follow. Comments included, “For those who lack capacity, I administer their medication as prescribed or as packed in their blister packs.” and “We use an application called One Touch Health for managing clients' medications for any client requiring medications. The app provides a detailed list including the name, dosage, concentration, route of administration, time and form of administration. This information is added to our call schedule which guides me through the medication administration process during client visits, the medication task will appear, and should be completed before clocking out.”

Practices had improved to ensure accurate medicines administration records were maintained for those people who required support with their medicines. Appropriate processes were in place to ensure safe medicines management.