Kensington Home Care

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

People were kept safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. Their liberty was respected and protected in line with legislation. When people raised concerns about safety and ideas to improve, they were listened to and the registered manager took action. The registered manager had a strong awareness of the areas with the greatest safety risks. They ensured there were enough skilled people to meet people's basic needs. They recognised the potential risks to people caused by some late calls, the need to improve staff understanding of basic meal preparation and better communication with people.

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.

People felt listened to when they raised issues. They stated that all issues they raised had been resolved, except for some people who had ongoing concerns about the arrival times of care staff on some occasions, and food preparation concerns – these have been addressed in the safe staffing evidence category. One person said, “It’s a safe service. They could improve timings and some staff understanding but it’s safe.”

The service responded well to external advice and could demonstrate how it had learned lessons from incidents and feedback. External professionals felt the service had worked well with them to improve the service.

The provider had appropriate policies in place to ensure incidents were acted on and lessons could be learned. Complaints were acted on openly and comprehensively.

People felt their basic needs were well supported by staff and had confidence in the service to escalate any changes or to seek help when required.

The service sought advice and support from external partners and explored ways of meeting people’s needs. They ensured people had access to the right short and long-term care.

The registered manager worked well with a range of external teams to ensure people experienced well planned pathways to and from other services. They demonstrated an awareness of the risks across the broader health and social care landscape and advocated appropriately for people where needed.

Policies and processes were aligned with good practice and practices of recognised local partners. This meant people received a consistent approach from the service. It also meant partners better understood how the service used their own care records and other systems to support people.

People had confidence that staff kept them fundamentally safe and took their safeguarding responsibilities seriously. They raised some concerns about the timeliness of calls but these had not had a significant impact on people’s safety. The registered manager was responsive to the potential ongoing risk here and was taking steps to improve in this area.

Staff understood their safeguarding responsibilities. The registered manager led by example and was proactive in dealing with safeguarding matters. External partners had confidence in the ability of staff to keep people safe through their actions. One said, “Kensington staff communicated all concerns to me but also communicated with GP, 111 and housing support to ensure that the service user received the appropriate support and services.” Safeguarding training was in place.

Safeguarding processes and policies were clear and up to date. They were informed by good national practice and local working arrangements, for instance the guidance set out by the local safeguarding adults board.

People confirmed they were consulted on the best ways to manage the risks they faced, and that staff adhered to these plans for the most part. Care planning set out ways to help people achieve their aims and set out what they could do, rather than simply set out what they were unable to do, or was risky to do. People raised some concerns about the timeliness of some calls, which is addressed in the Safe and Effective Staffing evidence category. There was a level of collaboration that people were happy with. One person said, “I have given these details to the agency and there are important telephone numbers to call in an emergency on the kitchen door.”

People and their relatives, and external professionals where relevant, were asked range of questions to enquire risks were known and managed appropriately.

Processes, such as care plan reviews, were set up to ensure risks were identified and reduced where possible.

People did not raise any concerns about how staff supported them to remain safe in their home environment.

Initial visits to people before they began using the service assessed environmental risks. These were considered alongside people’s preferences and rights to choose how they wanted to live. The registered manager and office staff demonstrated a strong understanding of potential risk linked to self-neglect.

Policies and procedures supported the comprehensive early assessment of possible environmental risks, and the ongoing review of them.

People gave mixed responses about staffing levels and whether there was a suitable mix of competence and experience to consistently and safely meet their needs. Their main areas of concern were the regularity with which carers arrived late and how safely staff were able to prepare their chosen meals. One person said, “No not always. I have had these carers now for about a year and at the beginning up until recently I was rushed and the carers cut the times of my visits which should be 2 x 1 hour calls per day, by at least 20 minutes. It is improving now.” Another said, “No not always do the carers arrive on time – they have been late by over half an hour before, which causes me problems as I have to leave for work.” Some people gave positive feedback about staffing levels. The registered manager recognised these concerns and demonstrated they had already started to address them.

The registered manager recognised that they had not always been able to ensure staff arrived at the right times, as planned with people, and that this had impacted on people’s experiences. The registered manager was able to demonstrate the analysis they had undertaken to understand the reasons, and were working with staff to improve in this area. Partners recognised there were instances were care staff were delayed, but gave a balanced view – there was recognition that the provider faced the same challenges of recruitment that the whole of social care was facing, and that within that context they were doing well. Partners felt the service minimised the impacts on people.

The provider had an electronic call monitoring system in place, which meant any calls that were delayed or at risk of being missed, were identified. This allowed the registered manager and office staff to take action and also to ensure staff were safe.

A number of people we spoke with raised concerns about the consistency with which staff adhered to hand washing regimes and safe practices in relation to food preparation. We fed this back to the registered manager who took action during the assessment.

The registered manager ensured there were ample supplies of appropriate PPE and related equipment available for staff.

IPC policies and processes were up to date and in line with current practice.

People gave positive feedback about this aspect of care. Where people had raised concerns about staff timings, they had concerns about the effect this could have on people who needed time sensitive medicines administered. The registered manager assured us their ongoing review of call times and delays, and the implementation of the new electronic records system, would reduce this risk of people missing medicines at the appropriate time.

The registered manager had responded positively to feedback from external partners regarding some inconsistencies and improvements needed in relation to medicines management. When the medicines optimisation team returned the service had improved significantly. Staff had been trained in medicines management and had their competence assessed regularly, through formal review of unannounced spot checks. Where errors were noted or improvements required, this was shared with staff.

Processes were informed by national good practice, such as the National Institute for Health and Care Excellence (NICE), and the local medicines optimisation team.