Archived: Kingswood Lodge Care Centre

People's experience of using this service

People told us they felt safe. The service had systems and processes which ensured any concerns were reported to appropriate authorities without delay.

Risks to people's health and wellbeing had been assessed. There was guidance for staff on how to minimise risks to people. Staff had received training on how to safeguard people and were aware of the procedure to follow if they suspected that people were subject to abuse.

People received their medicines as prescribed. Staff had received medicines administration training and knew how to administer medicines safely. Lessons were learnt when things had gone wrong.

The premises were clean and tidy. There was a record of essential maintenance carried out. Fire safety arrangements were in place and equipment had been regularly serviced.

We spent time with people during our visits and feedback received from people living in the service was positive. We observed staff interacting with people and we saw that staff showed empathy and understood the needs of the people they supported. People said the service was of a good standard and that staff were kind. Managers and staff created a warm and relaxed environment.

Peoples healthcare needs had been assessed and continually reviewed. People were supported to access the services of healthcare professionals when needed. Peoples nutritional and hydration needs were met in line with their individual needs and preferences.

There were quality assurance systems in place to help monitor the quality of the service and identify any areas which might require improvement.

The registered manager was committed to developing a service where people received person-centred care. This was evident throughout our visit. 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 13 May 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

The registered manager for the service was on leave and not present for this inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The deputy manager and regional manager supported the inspection process.

People were safe. This was because the staff team had all received safeguarding adults training and were knowledgeable and protected people from being harmed. The staff knew how to raise and report concerns if they witnessed, suspected or were told about any bad practice or abuse. Any risks to people’s health and welfare were assessed and appropriate management plans put in place to reduce or eliminate the risk. Where people needed to be assisted to move, their moving and handling needs were assessed and a moving and handling plan was written. Medicines were well managed and administered to people safely.

Checks to ensure the premises and facilities and all the equipment were completed regularly to safeguard people from being harmed.

The provider used a formulae to calculate the staffing numbers required for each shift to ensure each person’s care and support needs could be met. Staff were provided with regular training and were supported by their colleagues and their managers to do their jobs.

The staff team were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were asked to give consent to care, support and treatment. Where people lacked the capacity to do this, staff worked within best interest decision making procedures.

People were provided with sufficient food and drink. Food and fluid intake was monitored where risks of weight loss or dehydration had been identified. Arrangements were made for people to see their GP and other healthcare professionals as and when they needed to do so.

The staff had developed kind and caring working relationships with people who lived in the home. Staff spoke well about the people they were looking after. Relatives talked about caring and friendly staff. People’s privacy and dignity was maintained. Where possible people were involved in making decisions about their care and support. Families were included where this had been agreed upon.

People received personalised care which met their specific needs. They were encouraged to express their views and opinions, the staff listened to them and acted upon any concerns to improve the service. The improvements we had asked the service to make in respect of do not resuscitate decisions had been made and these were now recorded correctly.

A new registered manager and deputy were now in post. They provided good leadership and management for the staff team. The quality of service provision and care was monitored and, there was an on-going improvement plan in place to raise the quality of the environment and improve experiences for people.

We found that the required improvements had been made. There was now a robust programme of audits and checks in place. This ensured that people received a quality service and that their care and support needs were met. Improvements had been made with people's care records. This removed the risks of them receiving unsafe or inappropriate care, because accurate records were maintained.

Some people had dementia and were unable to tell us about the way they were looked after but comments included 'they are very good to me', 'I like things done my way and they help me' and 'we get a choice of what we would like to eat'. Relatives were complimentary about the way their loved ones were looked after.

We found staff were knowledgeable about the people they looked after and were able to relate the individual needs, choices and preferences of people.

We spent time watching whilst the midday meal was served. This helped us see how people were treated, the type of support they received and what types of interaction they had with the staff and other people. We found that people had positive experiences and there was good interaction between people and staff. We saw people being supported with their meals, being encouraged to continue eating their meals or eating their meals independently.

We looked around the home and found it to be clean and tidy. People lived in a clean environment. An ongoing programme of refurbishment and redecoration was in place and the home was smarter then when we had previously visited.

We have asked the provider to make improvements in the way they assess and monitor the quality of the service provided, and the standard of record keeping.

We did not involve people who lived in the home or the staff team during this inspection but spent time primarily with the home manager and some time with the regional manager.

We found that sufficient improvements had been made in respect of how the staff team were supported to fulfil their job roles. We found that measures had been taken to ensure that the staff team had completed their mandatory training and a programme of supervision had been instigated.

We found that the arrangements that the provider had now ensured were in place to assess and monitor the quality of service provision, enabled people who lived in the home and/or their representatives, to feedback their views and opinions. We found that senior managers also monitored the staff teams compliance with mandatory training requirements.

We did not involve people who lived in the home or the staff team during this inspection but spent time with the home manager and the regional manager.

We found that improvements had been made in the way that the staff involved people and their relatives in making decisions about how their care to be delivered. The quality of care planning documentation and other care records had improved, and where appropriate the person had signed their agreement to their care plans.

However improvements had not been made in respect of how the staff team were supported to fulfil their job roles. We found that the staff team continued not to be properly trained, supervised or appraised. This meant that people could not be assured of their competence to meet their safety, health and welfare needs. The arrangements that the provider had in place to assess and monitor the quality of service provision were not robust enough. The improvement action plan that they had submitted to us in August 2012 had not been followed through.