DKM Healthcare Limited

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

We assessed 5 quality statements in the safe key question and found areas of good practice and concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Though the assessment of these areas indicated areas of good practice and concern since the last inspection, our rating for the key question remains good. People and those important to them knew how to raise concerns when they didn’t feel safe. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers. When concerns had been raised, managers reported these promptly to the relevant agencies and worked proactively with them, to make sure timely action was taken to safeguard people from further risk. Safety risks to people were managed but care plans did not always reflect how to do this clearly. People’s involvement in care planning was not always documented clearly but people told us managers assessed and reviewed safety risks to people and made sure people, and those important to them, were involved in making decisions about how they wished to be supported to stay safe. There were enough staff to support people with their needs. Managers reviewed staffing levels regularly to make sure there were always enough suitably skilled and experienced staff on duty. Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers carried out spot checks and competency assessments on staff to ensure they were able to safely provide people’s care.

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.

People did not indicate they had any concerns about safety events or raising concerns about safety. People told us their safety was proactively considered. One person told us they had difficulty weight bearing, “They [staff] always make sure I am supported and safe.”

Staff felt the organisation had a positive culture of safety based on integrity and honesty. One staff member told us, “We are open and honest if anything goes wrong, or if I make a mistake, I'm able to apologise and take full responsibility and I can raise these issues without any fear.”

The management team were responsive to feedback from the inspection team and appeared keen to learn and improve ways of working. The provider had introduced a new process for staff to provide feedback, we reviewed the documents during our assessment, this was implemented further to concerns being shared with the CQC. This demonstrated the provider learnt from concerns and changed ways of working to address issues.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe from abuse. One person told us, “They [staff] look after me really well. They are very protective. I feel very comfortable in their care.”

Staff understood the importance of safeguarding and how to report concerns including reporting to external agencies, for example, the local authority. Staff knew where to find the safeguarding policy. They were aware of the policy guidance and knew how to follow it to keep people safe from potential abuse. One staff member told us, “I have access to safeguarding policies and I have read them. The management also touches on safeguarding policies during supervision sessions with staff.”

The provider had appropriate policies in place and information for staff on the procedure for reporting any safeguarding concerns both internally and externally. Records showed that incidents were investigated and referred to the local authority safeguarding team if needed. The provider had implemented training for staff in safeguarding, both children and adults, equality and diversity and the Mental Capacity Act.

People felt that the provider worked in a way that met people’s needs and provided care that was safe and supportive. One relative described their loved one’s care needs and risk and told us, “The carer is alert to all [relatives] care needs.” Another person told us that they received care from regular staff and said, “They come in on time and always stay the full duration.”

Staff worked with people in a way that was safe and supportive which included managing risk and emergency situations. Staff were able to tell the inspection team what actions they would take in an emergency including if someone experienced a fall. A staff member said, “Staff check if the individual is ok but they do not move the person, a call is placed to 111 and staff explain everything. The operator may ask to speak to the person but if they can’t they rely on the information provided by the support worker and staff stay with the person until help arrives.” Staff also understood the importance of documenting any risks or emergency issues and told us, “Staff note down any injuries or bruises, everything will be documented by support staff and management notified.”

The provider’s assessment and care planning process involved people in managing risk. Staff had received training on how to support people’s individual needs. People’s communication and how they expressed their feelings was documented meaning staff understood how best to support them and decrease or de-escalate potential risks to people. However, some people’s care plans required additional risk assessment and information.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us that staff were reliable, arrived on time, were well-trained and able to meet their care needs or those of a relative. One family member told us about their experience of the care their loved one received, “When [relative] was in a dementia ward in hospital they deteriorated rapidly. Within 4 weeks of moving to DKM [relative] recovered remarkably due to the excellent care.”

Staff who told us there were enough staff available to meet people’s needs. Staff felt well trained and received guidance from the management team. Staff spoke highly of the training provided to them. One staff member said, “We have been offered extra training depending on the needs of the service user. For example, chest physio, diabetes training, behaviour management training and PEG feeding training.”

The provider had implemented specific training to ensure that staff were appropriately experienced and trained to safely meet people's individual needs. We reviewed training certificates and the service’s training matrix which included specialist training staff had received. Once staff were trained, there were clear ongoing processes to assess their competency. If needed, further support and training was then given to improve staff skills.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People did not raise any concerns about the support they received with medicines. One person described their support which included assistance with medicines. They said, “Staff help me with my medication, they are well trained.”

Staff who administered medicines felt confident and competent doing this and told us they had received training, including person-specific training. One staff member told us, “I have had mandatory training on medication administration and also service user specific training for a service user who is diabetic for the administration of insulin. l have read the policy and it is in the files of all the service users that we administer medication to.”

The provider had an appropriate policy in place to guide staff on the safe use of medicines. Medicines recording records were completed and records were audited by the management team to identify and respond to any issues. People's medicines were reviewed by the management team as well as healthcare professionals to ensure their treatment was safe and met their needs. Staff had received training on how to administer medicines safely. The management team had regularly assessed staff competency, to ensure they were following best practice.