Kingswood Mount

Kingswood Mount is a care home providing accommodation, personal and nursing care for up to 45 people; some of whom lived with dementia and physical disabilities. At the time of our inspection 36 people were living at the service.

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

The home's environment was unclean and unsafe. Infection prevention and control practices were inadequate and did not protect people from the risk of infections.

Relatives told us that staff members had a kind and caring approach towards their family members; but described the staff team as overstretched and under stress.

Records used to monitor, and review people's care were not fully completed and kept up to date. We found many examples where sections of care records were incomplete and where people's care plans had not been updated to reflect changes in their needs.

There were systematic and widespread failings in the way the service was led and managed. The systems in place for monitoring the quality and safety of the service were not used effectively. They failed to identify and mitigate risk and bring about improvements to the service people received. Daily checks of the environment, aspects of people's care and staffing had not taken place as required.

Medicines were administered safely and there were enough staff who knew people well to provide support.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Staff were confident about how to raise concerns to safeguard people.

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

Rating at last inspection

The last rating for this service was good (published 08 February 2019)

Why we inspected

The inspection was prompted in part due to concerns received about the safe care and treatment of people. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Please see full details in the individual sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, infection prevention and control and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection we rated the service overall, as good. The well led domain have been rated as requires improvement. At this inspection we found the evidence continued to support the overall rating of good and well led had improved to good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

We found that the home was a safe environment for people, who were supported by staff who had been recruited appropriately. Staff administered medication correctly and followed the policies and procedures of the provider. There were appropriate staffing levels to meet people’s needs. People were treated without discrimination and their human rights were protected and promoted. Staff knew how to safeguard people from abuse and how to report any concerns about this or any other accident or incident.

The building had been purpose-built and it was safe and well maintained.

Staff were well-trained and supervised and had the skills and knowledge to deliver effective support to people living in the home. They understood the Mental Capacity Act 2005 and worked with other agencies to ensure that people had the right support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff treated everybody with kindness and compassion and involved them in decision-making about their day-to-day lives. They promoted people’s equality and diversity, gave explanations and information in a way that people could understand and respected people’s well-being and right to privacy.

We observed that the staff treated people as individuals. The records we saw demonstrated that each care plan was individual to the person. People and their relatives told us they were involved in any reviews about their family member’s care plans.

The people who lived in Kingswood Mount could join in with various activities throughout each day.

The home worked well with other health and social care professionals to provide support to each individual person who lived.

The home completed various quality checks and audits including questionnaires to people using it, their relative’s and health and social care professionals. The service was improving some of its systems, such as ensuring annual appraisals for staff and was introducing new documentation.

Further information is in the detailed findings below.