Kivernell Care Ltd

Updated 27 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector. An Expert by Experience contacted people and relatives by telephone following our inspection to obtain feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had commenced in post and planned to submit an application to register.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we already held about the service. We contacted the local authority to obtain feedback from them. We used this information to plan our inspection.

During the inspection

We spoke with 6 people, 3 relatives and 1 advocate by telephone. We also spoke with the manager, deputy manager and a team leader. We emailed requests for feedback to 23 staff and 19 health and social care professionals. We received feedback from 7 staff members and no health and social care professionals.

We reviewed a range of records concerning the management of the service and looked at 3 care records including medicines records and 5 recruitment records.

Updated 27 April 2023

About the service

Kivernell Care is a domiciliary care agency providing personal care to people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People were supported by staff who had completed training in safeguarding and who followed risk assessments and care plans to safely care for them. Most staff had been safely recruited and the provider has addressed concerns found in some recruitment records. The provider only took on new care packages when staffing was in place to do so and people appreciated having small teams of staff to support them as they could form relationships with them.

Medicines were safely managed and staff were trained in how to support with medicines. Personal protective equipment (PPE) was provided and used according to current guidelines. Accidents were reviewed and learning shared.

Comprehensive assessments informed care plans which staff followed so they provided care as per peoples wishes. Care records held detailed information about health conditions to aide staff in working with other agencies.

Staff completed a range of mandatory training when commencing in role and shadowed more experienced staff as part of their induction.

The manager was updating Mental Capacity Act 2005 assessments and ensuring there were relevant best interest decisions in place.

There was a positive culture in the service and staff were complimentary of the new manager believing them to be fair to all. Staff knew they could approach the manager or outside agencies should they have concerns about poor practice.

Audits had not been completed for some months when we inspected however these were in process of being done to provide better oversight for the leadership team. The manager had introduced additional audits and monitoring.

The provider was aware of peoples protected characteristics and made adjustments as needed.

There was some confusion within the management team as to who was responsible for decision making. The manager had reintroduced staff meetings and quality assurance questionnaires were regularly issued to people and relatives

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 1 March 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service and, in part, due to concerns raised in relation to governance, application of the Mental Capacity Act 2005 and staffing. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led to examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kivernell Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.