Kindred Community 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.

This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm. People received safe care from supportive staff who understood their individual needs and risks, including those in their own homes. Staff worked in partnership with key health care professionals and made referrals to services in a timely manner. People received their medicines as prescribed. The provider had ensured systems were in place to keep people safe from abuse and harm. There were enough trained staff to support people.

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.

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 told us they felt safe and knew who to speak to if they had any concerns about their safety. A culture of safety was embedded at the service. Staff spoke confidently about how they would respond to an incident or accident and gave examples of actions they would be expected to take afterwards. The management team monitored and reviewed accidents and incidents, these were also recorded and discussed during quality monitoring visits. A member of staff told us, “All accidents, incidents and near misses are recorded on the system. We discuss them and determine what to do next to keep people safe.”

Systems were in place to record, monitor and learn lessons from accidents and incidents. Staff reported notifiable incidents to external agencies, such as CQC and the local authority.

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 and their representatives told us they had no concerns in the way the service managed transitions in people’s care, such as starting the service in their own homes and visiting other care settings, such as the hospital. One person’s representative told us, “They took [person] to an appointment recently, there are no issues, it just gets organised.”

Staff told us that there were good working relationships with external healthcare professionals, to provide a good standard of care for people within the service. A member of staff told us, “We work closely with all the professionals involved in people’s care, it’s a holistic approach.”

We spoke with local stakeholders. They told us that the service engaged effectively with them to share information and best practice about people’s care to ensure they were safe. A healthcare professional told us, “The staff at Kindred raise issues with me very quickly, they listen and act upon my guidance, advice and recommendations.” Details of people’s medical appointments and input from community professionals was recorded, and staff were made aware of any changes to people's health or care needs.

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.

People told us they felt safe receiving a service from Kindred Community Ltd, and that staff supported them well. One person told us, "Yes, I feel safe with them [staff].” Staff were all very clear about their role in safeguarding people. They had received training and felt confident about raising concerns and who to contact. The registered manager told us, “All staff are trained to level 2 in safeguarding.”

There was an up to date safeguarding policy in place. The provider had followed safeguarding procedures and made referrals to the local authority as well as notifying the Care Quality Commission when required. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. The management team and staff had a good understanding of their responsibilities which made sure people were supported in line with the MCA.

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.

We could not get direct feedback from people in relation to how they were involved to manage risks to their safety. However, detailed risk assessments had identified hazards and guided staff on how to reduce or eliminate the risk and keep people and staff safe. For example, risks around finances and accessing the community. Risk assessments were up to date and appropriate for the activity. The service planned for emergency situations, such as staff shortages and inclement weather. Additionally, the service operated a 24 hour on call service to support both people and staff. Staff knew how to identify and reduce the risk of harm to people living at the service. Staff told us they reviewed people’s needs regularly during care plan reviews, or as soon as a change happened. The registered manager told us, “We assess risk in lots of ways, and there are lots of different types of risk assessments we use. Such as basic ones for clients that have no personal care, up to people that are cared for in bed and use lots of equipment. Each care plan has a risk assessment associated with it, and all have review dates. Most staff input into the risk assessments.” A member of staff added, “Risk management isn’t about restrictions, it’s about balancing safety with independence, ensuring my clients can live as freely as possible with the right safeguards in place.”

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

Environmental risk assessments were completed for people’s homes, these included details about any environmental risk such as lighting, flooring, windows, smoke alarms and steps needed to keep the care environment as safe as possible.

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.

Staffing levels were determined by the number of people using the service and their needs. Feedback from people and staff was they felt the service had enough staff. One person’s representative told us, "They [staff] always show up when they are supposed to be here, we’ve had no issues with them not showing up."

Staff rotas showed there were sufficient numbers of suitably qualified and trained staff consistently deployed to fully meet people’s needs. Staff deployment ensured people’s needs were met in a timely manner and in a way that met their preferences. The provider followed safe and effective recruitment practices. This included checks with the Disclosure and Barring Service (DBS), requesting references from previous employers about their conduct in previous jobs and health checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staff had received relevant training in looking after people. Staff completed an induction when they started working and ‘shadowed’ experienced members of staff until they were assessed as competent to work unsupervised.

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.

We could not get direct feedback from people in relation to infection prevention and control (IPC). However, we received feedback from staff and managers which demonstrated that people were supported by staff who understood the importance of IPC. Staff completed regular training and personal protective equipment (PPE) was available as needed. A member of staff told us, “All staff receive IPC training and we have policies in place for this.”

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

Where people required support with their medicines, this was done safely. This was confirmed in records we reviewed. Medicine records were detailed explaining what each medicine was for. For example, explanations for staff on when and how to administer emergency medicine. Staff were trained in the safe management of medicines and their competency was checked regularly. People and their relatives were supported to be involved in the medicines regime and risk assessments around that were clear and shared with staff to ensure delivery was safe and understood. Regular audits ensured discrepancies were identified and addressed. A member of staff told us, “We oversee staff and clients with their medicines and put in whatever support is needed. We check the records and carry out spot checks if we need to.”