Bkind Care Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At the last assessment this key question was rated good. This key question has been changed to inadequate. This meant there were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was not well led. We found reviews, audits and monitoring were not reliably and robustly completed to identify the widespread concerns we found at this inspection. However, the nominated individual is passionate and focused to improve the quality of care to benefit people using the service.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found widespread concerns as part of our assessment which included care records monitoring staff, a lack of feedback being sought from people and minimal reviews being completed. The nominated individual recognised improvement needed to be made to ensure the quality of governance and oversight of the service was improved.

We found widespread concerns of a lack of oversight by leaders at the service. Fundamental systems and processes were not in place to ensure safe care was provided. For example, provider audits and monitoring failed to identify that staff arrived late to care calls or logged in to a care call when they were not at the persons house. Medication audits were ineffective.

The nominated individual advised new staff had been recently recruited and had been inducted to work within the provider’s systems and expectations. Staff told us the nominated individual was kind, supportive and was responsive to requests for support.

The nominated individual was clear on their vision for the service and where they wanted the service to be in providing high quality care and support consistently. We found limited evidence of consistent and robust auditing to monitor the quality of the service provided. Audits were completed at an individual person perspective and did not consider the wider overall view, which gave a different outcome. We also found audits were not successful in identifying the shortcomings found as part of the assessment. We were not assured leaders had a good oversight of the care provided.

Staff told us they were able to speak up. All staff we spoke with felt confident they could ring the nominated individual to raise any concerns they had. One member of staff told us, “[The nominated individual] is really good. They will help me if I was unsure.” Another member of staff said, “[The nominated individual] is always available at the end of the phone.”

The provider had systems and processes in place for staff to whistle blow and raise concerns however, there was not a clear record of times staff may have spoken up.

There was a policy in place to protect staff from harassment and bullying and a focus on protected characteristics under the Equality Act. Staff told us they had not witnessed any form of bullying, harassment or discrimination.

The nominated individual had developed an inclusive workforce and recognised the value of diversity amongst the team.

Staff told us they were aware of their role and the role of leaders. Some staff told us they had spot checks and supervisions but could not recall when or what was discussed. Staff felt the service was well run and leaders were open, available and supportive.

Spot checks, audits, seeking feedback from people and their relatives, staff competency checks were not being robustly and consistently completed. Where they were completed, these had basic information in and did not highlight any of the issues found during this assessment. There was no formal monitoring of learning lessons when things had gone wrong. Although leaders had been raising concerns to the Local Authority, they had not always informed CQC, which is a legal requirement. These have now been submitted retrospectively. There was minimal documentation on how safeguarding concerns were being investigated with little evidence of enhanced monitoring where there was a suspicion of potential abuse or neglect.

The lack of robust and high quality monitoring of the quality of care coupled with the lack of learning of lesson when things went wrong put people at risk of harm. This failure is a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The nominated individual had developed good working relationships with partners such as the Local Authority, GP and pharmacies to promote positive working to benefit people receiving care.

Staff understood the importance of informing the provider if there had been a change in a person's care needs to seek medical attention. Staff consistently told us that they would contact the nominated individual if they had a concern or query to seek their advice and guidance. We observed on both site visits when inspected that the nominated individual was contacting partners to share information or request additional support. For example, from the GP.

We did not receive any feedback from partners.

The management worked with the local authority to improve the service when directed, but they were not considering how to involve the community and other partners with the service. We found a lack of evidence the provider had included feedback and input from partners and community services within care records.

Leaders and staff shared the same goal to provide positive outcomes for people. The nominated individual understood improvements were needed and staff were encouraged to discuss and share ideas for improvement and innovation. The nominated individual was passionate about making improvements in the service.

The organisation was clear about their vision and values and were aware they had more work to do to ensure all processes were communicated clearly and embedded to support learning and innovation. Improvements were needed to ensure care was joined up, working towards delivering a high quality and consistent service to people with a strong audit trail and management oversight of the care provided to people. We found widespread practices which were not in line with the provider's policies and procedures and the service’s own systems did not identify this.