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Inspection carried out on 9 January 2019

During a routine inspection

The inspection took place on 9 and 10 January 2019 and was unannounced.

The last inspection took place 11 December 2017, when we found breaches of Regulations relating to safe care and treatment, person centred care and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of ‘Is the service safe?’, ‘Is the service effective?’, ‘Is the service responsive?’ and ‘Is the service well-led?’ to at least good. The provider supplied us with an action plan on 22 January 2018 telling us that they would complete the necessary improvements by July 2018. At this inspection we found that improvements had been made and the provider was meeting all the Regulations.

Kolbe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kolbe House provides accommodation and personal care for up to 25 older people predominantly from the Polish community. There were 22 people living at the service at the time of our inspection.

There was a registered manager in post at the time of our inspection. 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.

Staff followed the procedure for the recording and safe administration of medicines and people were receiving their medicines safely and as prescribed.

The risks to people’s wellbeing and safety had been assessed and there were detailed guidelines on people’s records about how to mitigate these risks.

There were procedures for safeguarding adults and staff were aware of these. They knew how to respond to medical emergencies or significant changes in a person’s wellbeing.

People were protected from the risk of infection and cross contamination and staff received training in infection control.

The provider ensured that lessons were learnt when things went wrong. There were systems in place to manage incidents and accidents and appropriate action was taken to minimise the risk of reoccurrence.

The provider employed enough staff to meet people’s needs safely and there were contingency plans in the event of staff absence. Recruitment checks were carried out to ensure that new staff were suitable before they started working for the service.

People’s needs were assessed prior to receiving a service and care plans were developed from the initial assessments. Assessments and care plans were person-centred and contained the necessary information for staff to know how to support people and meet their needs.

The registered manager was aware of their responsibilities in line with the requirements of the Mental Capacity Act 2005 (MCA) and staff had received training in this. People’s capacity to make decisions about their care and treatment had been assessed. Processes had been followed to ensure that, when necessary, people were deprived of their liberty lawfully.

People’s health and nutritional needs had been assessed, recorded and were being monitored. People gave positive feedback about the food and told us they were offered choice. People had access to healthcare professionals as they needed, and their visits were recorded in people’s care plans.

The provider had consulted relevant guidance and taken steps to improve and develop the environment to meet the needs of people who used the service, in particular those living with the experience of dementia.

People were supported by staff who were appropriately trained, supervised and appraised. The registered manager sought guidance from a range of healthcare professionals and attended meetings and provider forums in order to keep abreast of developments within the social care sector. Important information was cascaded to staff to ensure they were kept informed and felt valued.

People told us they were happy and well cared for. They said that staff treated them with kindness, dignity and respect at all times. Relatives and professionals we spoke with confirmed this. People’s end of life wishes, cultural and religious needs were respected and met.

There were organised activities and these were person-centred and met the needs of people who used the service, including those living with the experience of dementia.

There was a complaints procedure which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.

The provider had effective systems in place to monitor the quality of the service and put action plans in place where concerns were identified.

People, staff and relatives told us the registered manager and senior team were approachable and supportive, and there was an open and transparent culture within the home. There were regular meetings and people and staff were supported to make suggestions about how to make improvements.

Inspection carried out on 11 December 2017

During a routine inspection

We undertook an unannounced inspection of Kolbe House on 11 December 2017. The service was last inspected on 7 December 2015, when we rated the service Good overall.

Kolbe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kolbe house provides accommodation and personal care for up to 25 older people predominantly from the Polish community. There were 22 people living at the service at the time of our inspection.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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.

Staff did not always follow the procedure for recording and the safe administration of medicines. This meant that people were at risk of not receiving their medicines safely.

The provider had a number of systems in place to monitor the quality of the service and put action plans in place where concerns were identified. However, audits had failed to identify the areas for improvement that we found during the inspection.

The risks to people's wellbeing and safety had been assessed, but there was not always enough information on people’s records about how to mitigate these risks.

People's needs were assessed prior to receiving a service and care plans were developed from the assessments. However, assessments and care plans did not always contain the necessary information for staff to know how to support people and meet their needs and were not always written in a person centred way.

There were organised activities. However these were not always person-centred and did not always meet the needs of people living with dementia.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to Safe Care and Treatment, Person Centred Care and Good Governance. You can see what actions we told the provider to take at the back of the full version of this report.

There were procedures for safeguarding adults and staff were aware of these. Staff knew how to respond to any medical emergencies or significant changes in a person's wellbeing.

Staff received training in infection control and there were systems in place to protect people from the risk of infection.

The provider ensured that lessons were learned when things went wrong. They had systems in place to manage incidents and accidents and took appropriate action to minimise the risk of reoccurrence.

The service employed enough staff to meet people's needs safely and had contingency plans in place in the event of staff’s absence. Recruitment checks were in place to obtain information about new staff and ensure they were suitable before they started working for the service.

The registered manager was aware of their responsibilities in line with the requirements of the Mental Capacity Act 2005 (MCA) and staff had received training on this. People’s capacity to make decisions about their care and treatment had been assessed. Processes had been followed to ensure that, when necessary, people were deprived of their liberty lawfully.

People's health and nutritional needs had been assessed, recorded and were being monitored. People gave positive feedback about the food and told us they were offered choice. People had access to healthcare professionals as they needed, and their visits were recorded in people’s care plans.

Staff received effective training, supervision and appraisals. The registered manager sought guidance and support from other healthcare professionals and attended workshops and provider forums in order to keep abreast of developments within the social care sector and shared important information with staff.

People told us they felt safe at the home and trusted the staff. They told us staff treated them with dignity and respect when providing care and treated them with kindness. Relatives and professionals we spoke with confirmed this. We saw people being cared for in a calm and patient manner.

There was a complaints procedure in place which the provider followed. People felt confident that if they raised a complaint, they would be listened to and their concerns addressed.

People, staff and relatives told us that the registered manager and senior team were approachable and supportive. There was a clear management structure, and they encouraged an open and transparent culture within the service. People and staff were supported to raise concerns and make suggestions about where improvements could be made.

Inspection carried out on 7 December 2015

During a routine inspection

The inspection took place on 7 December 2015 and was unannounced. The service was last inspected in October 2013 and at the time was found to be meeting the regulations we checked.

Kolbe House provides accommodation and personal care for up to 25 older people predominantly from the Polish community. There were 22 people living at the service at the time of our inspection.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection. 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.

People and staff told us they felt safe and we saw there were systems and processes in place to protect people from the risk of harm. There were sufficient staff on duty to meet people’s needs and where required staff numbers were increased to ensure people’s safety.

Staff had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). They ensured people were given choices and the opportunities to make decisions.

There were arrangements in place for the management of people’s medicines and staff had received training in the administration of medicines.

People’s nutritional needs were being met and people gave positive feedback about the food. The food was cooked using fresh ingredients and people were offered a choice at the point of service.

Staff received effective training, supervision and appraisals. The registered manager sought guidance and support from other healthcare professionals and attended conferences and provider forums in order to keep abreast of developments within the social care sector. Important information was cascaded to staff, to ensure the staff team were kept informed and received training to deliver effective support to people.

Staff were caring and treated people with dignity and respect. Care plans were in place and people had their needs assessed. Care records contained detailed information and reflected the needs and wishes of the individual so staff had the information they required to meet people’s needs.

A range of activities were provided and the registered manager told us they were starting to develop more specific activities for people living with dementia. We saw people were cared for in a way that took account of their diversity, values and human rights.

People, staff, relatives and healthcare professionals told us the registered manager and staff were supportive and approachable. The registered manager told us they encouraged an open and transparent culture within the service. The service supported people to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and ensured that areas for improvement were identified and addressed.

Inspection carried out on 6 December 2013

During a routine inspection

We saw that people and their family were involved in making decisions about their care and treatment. We saw evidence from five care records that consent had been obtained from people who use the service. Staff we spoke with were aware of gaining consent for care and treatment with people they were supporting.

We found that care and support was planned and delivered, in line with people's individual care needs and preferences. One person who used the service told us "The staff are there to help with everything, they do my hair and that is very important to me.� Another person told us �The staff will sit and talk with me if I am worried about anything.�

We found that staff had received training in relation to safeguarding vulnerable adults and knew what to look out for and how to report such matters should they arise.

The management of medicines was carried out in accordance with safe practices. We saw that there were appropriate arrangements in place to ensure people received prescribed medicines in accordance with their needs.

We found that there was an effective recruitment process in place so people could be confident the right people were employed in the service.

Inspection carried out on 7 September 2012

During a routine inspection

People were positive about the care and treatment they received at Kolbe House, where they spoke about the kindness of the staff and of getting the support they wanted. The staff we spoke with said they enjoyed their work and they demonstrated a genuine caring approach towards the people who use the service.

People told us that staff had time to spend with them, and we observed this happening at the service, where staff took people for walks around the garden and sat talking with people. Some people spoke about the support they received with personal care, where they said they were supported to do what they could for themselves, and staff would assist them only where necessary.

Reports under our old system of regulation (including those from before CQC was created)