Bkind Care Ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective- this means that we looked for evidence that people’s care, treatment and support achieved positive outcomes and promoted a good quality of life. At the last inspection, this key question was rated good. This key question has now changed to requires improvement. This meant that the effectiveness of people’s care, treatment and support did not always achieve good outcomes or people had inconsistent outcomes.

People did not have effective care. We found care plans were lacking in detail, specific information on how the person wanted to be cared and plans were not reliably kept up to date.

This service scored 42 (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 told us they were not always involved in the planning of their care. We found no evidence to demonstrate people were involved and were consulted about the creation and development of their care plans. However, people told us they felt happy with the carers who visited them. One person told us, “I do know most of the carers, I think the company do try and keep the same ones.”

Staff told us they found the care plans gave them the information they needed to provide person-centred care. One staff member told us, “The care plans are very good. I follow what the care plans say.”

People’s care plans were not personalised. Although people told us they had an initial meeting with the registered manager, care plans were basic and lacking information which would identify what the wishes of the person were.

People had choice and control over their meals and drinks. People told us they were consulted when staff were preparing meals and drinks. One relative told us, “They ask [relative] what they want, this is usually tea and toast. This really helps.” Another person told us, “I like to be independent. I call the shots. They will ask me what I want for breakfast and they help me when I need it. I always choose what I want.”

Staff supported people to have the meals and drinks of their choice. Staff made sure people had enough to eat and drink, although it was not recorded if these were eaten or drunk. A staff member told us, “I always ask what they want. They tell me, and that is fine.”

People’s care plans were not always personalised and person-centred to what support the person wanted. The records failed to consistently provide staff with details of the service user’s wishes, preferences and routines to provide person-centred care. Care plans were not consistently reviewed and therefore information was inaccurate and out of date.

Most people were happy with the care they received from the carers. However, one person told us, “Staff hardly do anything. I can manage most things myself.”

The nominated individual told us there were regular staff meetings. These took place virtually and updates were sent through messaging services. Staff felt they were given updates from leaders and they had the information needed to do their role.

We did not receive any feedback from partners.

There were regular team meetings but these were not robust in sharing vital information. For example, we found issues regarding arrival times, medication management and staff conduct. The themes, trends and learning from these incidents were not shared during team meetings or on a one to one basis with staff so the staff team as a collective could improve from incidents.

People and relatives told us they were supported to access healthcare professionals to prevent deterioration in their health and independence.

Staff were confident on how to escalate medical concerns and when to appropriately contact health care services. One member of staff told us, “If I have a worry, I will call my manager or call 111 for help.” Staff completed training which gave them the skills to respond to unexpected medical emergencies.

People’s care plans and risk assessment were not always up to date and personalised to show the health and care needs they had. There was a lack of clear guidance to staff on how to manage health needs and information in some people’s care plan contradicted the health needs they had.

People told us that they did not have regular reviews of their care needs. People told us they had an initial assessment before care was provided but they did not have follow up meetings or reviews consistently.

The Nominated Individual told us there was a system in place to review people’s care every year or sooner, if there had been a change in need. We did not find evidence this was being consistently completed. We identified some people who had fallen repeatedly over several days but a review or reassessment was not completed by the provider. was no monitoring or oversight of the person’s mental health needs to improve outcomes.

Effective processes were not in place to monitor and improve outcomes for people. People did not benefit from either routine or responsive reviews of their care needs to promote good outcomes. While some people had reviews after a hospital admission, this was not consistent for all changes people experienced. We found care plans had not been updated following a change in their situation which then failed to give staff the clear and up to date information they needed to provide effective high quality care.

People told us they were involved in decisions about their care. One relative felt confident their relative was given choice and control over their meal and drink choices.

Staff told us they asked for verbal consent. One member of staff told us, “I always ask what [person] wants me to do, and I do it.” Another member of staff told us, “If the person says no, that’s fine.” Staff had training in the Mental Capacity Act 2005 and staff demonstrated a good understanding of the need for consent.

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 and legally authorised under the MCA. 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. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. While people signed a contractual agreement with the service, leaders were unaware of the requirement to have written consent for vital aspects of care, such as medication administration or consenting to personal hygiene tasks. We found no evidence that people had given written consent and, while we were satisfied people had given verbal consent to their care, this was not consistently documented.

The failure to have written consent is a breach of Regulation 11 (Need to Consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.