Archived: Kendal House

We found the following examples of good practice.

¿ The provider had good practices to prevent the spread of infection by visitors. The home had its’s own NHS barcode for track and trace at the entrance. People were prompted to consider if they were symptomatic before entering the home.

¿ The provider made sure staff had enough personal protective equipment (PPE) such as gloves, aprons and masks. Staff knew when to wear these to keep people safe. There were PPE stations and posters around the home reminding staff how to use PPE in the right order.

¿ The home benefited from a small, static staff team and people were familiar with the staff and providers. People who lived at the home had become used to staff wearing masks at all times.

¿ Staff had training in infection prevention and control and in Covid-19. Due to the age and layout of the building, people were not always able to achieve two metres social distance so staff assisted them with good hygiene practices. When new people came to live at the home they were supported to stay in their room for a safe period.

¿ The home looked very clean and housekeeping staff confirmed they had plentiful supplies of appropriate cleaning products. They made sure they frequently cleaned touch points, such as handrails and door handles.

¿ Staff and residents had regular testing for Covid-19. Staff said the provider and registered manager were also very supportive of the emotional well-being of people and staff.

Further information is in the findings below.

Kendal House is a residential care home providing personal and nursing care to 21 people aged 65 and over at the time of the inspection. The service can support up to 22 people.

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

People continued to receive highly personalised care from especially caring and considerate staff. People’s feedback was overwhelmingly positive, and we heard about numerous occasions when staff had gone above and beyond to ensure people had what they needed.

People said they were safe living at Kendal House. Staff knew about the safeguarding and whistle blowing procedures including how to raise concerns if needed. There had been no recent safeguarding concerns raised.

There were sufficient staff to meet people’s needs. People confirmed staff responded quickly to their requests for help. New staff were recruited safely. People received their prescribed medicines on time. Incidents and accidents were monitored to help identify lessons learnt. Health and safety checks and risk assessments were carried out to maintain a safe environment.

Staff received good support and the training they needed. They confirmed they were very well supported. People were supported to have enough to eat and drink and to access health care services.

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.

People's needs had been fully assessed. This information was used to develop personalised care plans. People were able to participate in a wide range of activities suited to their interests.

People, relatives and staff gave positive feedback about the management of the home. There was a structured approach to quality assurance which was effective in identifying areas for improvement. People, relatives and staff were encouraged to share their views about the home.

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 28 March 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 14 February 2017 and was unannounced. This was the second rated inspection of the service since its registration with the Care Quality Commission (CQC) in October 2010. We previously inspected the service in December 2014 and rated the service as ‘Good’, although identified one breach of regulations which related to accurate record keeping. Following the inspection the provider sent us an action plan which detailed how they planned to improve the service. At this inspection, we found improvements had been made.

The established registered manager was still in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We were inundated with positive comments about the way the staff treated people and the bearing this had on those who lived at the home and their families. Staff were described as kind, caring and considerate of people's multiple and varying needs. People were treated with the utmost of respect and dignity. The provider showed exceptional kindness towards both people and staff which went beyond the normal expectations of a provider or employer.

People told us that they felt safe with the support they received from staff at Kendal House. There were safeguarding policies and procedures in place. Staff were knowledgeable about what action they should take if they suspected abuse. The local authority safeguarding team informed us that were no on-going organisational safeguarding matters regarding the service.

Records were kept regarding accidents and incidents, including any historical issues of a safeguarding nature. Incidents were recorded, investigated and reported in a timely manner to other relevant authorities such as the local council or CQC.

The service continued to manage risks associated with the health and safety of people, including the completion of regular checks of the property, equipment and utilities, in line with their legal responsibilities as the landlord. People’s individual care needs had been assessed for risks related to aspects of daily living and these were reviewed regularly.

Medicines were administered and managed safely and medicine administration records were well organised, detailed and correct. Medicines were stored in a safe and secure place. The staff followed a policy and procedures regarding the receipt, storage, administration and disposal of medicines which would benefit from an update to reflect current best practice. We have made a recommendation about this.

There were sufficient numbers of staff deployed to meet people’s needs. Staff records showed the recruitment process was robust and staff had been safely recruited. Training was up to date, and the staff team were supported through supervision and appraisal sessions.

The Care Quality Commission (CQC) is required by law to monitor the operations of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have the ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. In England, the local authority authorises applications to deprive people of their liberty. We found the provider was complying with their legal requirements and applying the principals of the MCA.

People’s specific nutritional needs were met. We observed people enjoyed a variety of meals which were prepared by the cook. People had choice around mealtimes but often ate one of the planned meals from the menu; we saw people could chose different food if they preferred. The service involved external health professionals, as necessary, to meet people’s varying needs and to support their general health and welfare.

Person-centred care plans were in place. People’s individual needs continued to be assessed and care plan’s reflected this. Some people did not have an in-depth plan of care around the medicines they required; however the registered manager addressed this immediately.

An activities coordinator provided a wide variety of stimulating activities which people and their relatives enjoyed. One-to-one and group support was available to people to reduce social isolation. Visitors were welcomed into the home at any time.

The service had not received any complaints since our last inspection. The registered manager told us how complaints would be investigated and managed. The complaints procedure was on display and had been shared with people, relatives and external professionals. The service had received many compliments.

Regular quality assurances checks were undertaken by the providers, although they were not always recorded. The registered manager also checked daily, weekly and monthly care monitoring tools to ensure people received high quality, appropriate care which met their needs.

Surveys had been issued in April 2016 to gain the opinion of people, staff, relatives and professionals about how the service was managed and how it could be improved. We observed a positive response in those surveys which the provider evaluated. Staff spoke highly of working for the provider and registered manager and told us they felt valued and appreciated.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that people were provided with a choice of suitable and nutritious food and drink.

People's health, safety and welfare were protected when more than one provider was involved in their care and treatment. This was because the provider worked in cooperation with others.

We found that appropriate pre-employment checks were undertaken before staff began work.

People's personal records, staff records and other records relevant to the management of the home were accurate and fit for purpose.