Kenwith Castle Country House Care

Updated 24 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors visited the service on the first day and one inspector on the second day. On the third day, we gave feedback to the management team on a Teams call.

An Expert by Experience called relatives to gather their feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Kenwith Castle Country House Care is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Kenwith Castle Country House Care is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day. It was announced on the second day.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service since the home had been registered. We used all this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the inspection, we spoke with eleven members of staff which included the registered manager and the regional director. Nine staff completed questionnaires sent out by CQC.

We met with 17 people who lived at the service, and spoke with ten in more depth, and observed interactions between people and staff. During our site visit we spoke with one visitor and spoke with ten relatives on the phone.

We reviewed a range of records, including people's care records, staff recruitment files, records relating to safety checks including fire safety, complaints records, accident and incident records. We also reviewed medicines records and records relating to monitoring and quality assurance.

Updated 24 February 2023

About the service

Kenwith Castle Country House Care is a residential care home that provides personal care for up to 59 people aged 65 and over. There were 43 people living there at the time of the inspection; some of whom were living with dementia. The original building is a period country house with a new wing. It faces a lake and is surrounded by grounds with parking.

The location is also registered for the regulated service to provide support in people’s own homes. For example, the extra support housing in the grounds. However, this support is now provided by another service.

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

People's quality of life was enhanced by the leadership of the registered manager and her commitment to a culture of improvement and inclusivity. Staff praised her approach, they said, “The team is mindful of the wellbeing of the people that live here and do their best to ensure that their individual needs are met. The home and surroundings are used in a beneficial way to enhance the lifestyle of the people that live here.”

Feedback from relatives showed the registered manager was held in high esteem. Every relative who spoke with us praised the registered manager’s approachability and friendliness. Relatives noted how their leadership style impacted on the staff group as a whole. People living, visiting and working at the home said they had or would recommend the home to others. A staff member said, “The manager is amazing and has made such a difference to the atmosphere and general aura in the home since taking over.

Since being appointed, the registered manager had reviewed the staffing structure at the service with staff. New roles and working patterns had been created to ensure unit leaders covered every day of the week to provide a consistent approach over weekends. People and relatives spoke highly of the way the service was run. Comments included, “Mum is definitely happy, I would definitely recommend Kenwith, the atmosphere is happy and friendly, everyone has a smile on their face, say hello and are welcoming.” And, “Definitely recommend it, I would like to go there if I needed to! She is in a very good place; I would move her if care was not up to standard.”

The registered manager and the staff team worked with a shared purpose putting people's well-being at the heart of their practice. A relative said, “Mum has been cared for with dedication and sensitivity right from the first day. On the day she moved in, she was given a warm welcome and efforts were made to make her feel at home. Her preferences were noted, and a flexible approach has been taken to ensure that she is comfortable and feels at ease.”

The service recognised the importance of promoting social inclusion to improve people's quality of life. They ensured everyone living at the home had equal access to enjoy social events and the grounds of the home. A relative said, “This is the perfect home for (Name) and her lifestyle. She looks so much better now and is enjoying the company of other residents and has made friends.”

The registered manager had promoted the right for everyone to be able to access outdoor space with an awareness of people living with dementia and people using a wheelchair or mobility equipment. A new visual and auditory sensory garden had been created at the front of the building which had been planned with people living at the home and their families.

The service promoted an inclusive community. A social hub was the home’s pub which resembled a traditional bar. It was open on Friday nights, but this was due to be extended to another night due to demand. A relative said, “The team have made Mum happy and given her a new lease of life - for this we will be ever grateful.”

People’s well-being was prioritised. Our conversations with the registered manager showed her passion for ensuring the adaptations to the home benefitted people’s social needs. For example, they advocated for people living at the home regarding changes to the dining room to ensure it met their needs rather than changes being made on a purely aesthetic basis. People's views were gathered through surveys and regular discussions and were acted upon.

Consideration was given to how people with additional sensory needs were supported during different types of activities. Staff explained this meant adapting their approach and gave examples, they said, “It’s all about dignity.”

Staff explained how people were supported to have a comfortable and dignified end of life care by the care team and the community nursing team. Staff described how they changed their approach to support people nearing the end of their life, for example the way food and drink was offered and prepared. Activity staff also ensured they spent time with people cared for in bed ensuring they still felt in touch with the world around them, including recognising the importance of tactile objects for people to interact with. There was recognition of people’s religious and spiritual beliefs and the impact this might have on their preferences and how they were cared for at the end stages of their life.

People had access to information about how to make a complaint and felt confident raising any concerns. For example, a person told us, “There is nothing I could change, if something cropped up, I would say.”

Despite national staffing shortages, the management team had worked hard to ensure they recruited new staff. Recruitment checks helped ensure staff were suitable to support people. Newly recruited staff, and the existing staff team were extremely positive about the supportive environment created by the registered manager. For example, staff were valued, treated with respect which positively influenced their own approach with people living at the home. A staff member said, “… it's made me who I am today. So, I owe them a lot for that.” Relatives and people living at the service commented on the caliber of staff. For example, a relative said, “Yes, she is kept very safe, especially through lockdown, staff are excellent, could not fault them, security is good, …good care, bells answered quickly.”

People were complimentary about the staff group who they said worked closely as a team, which benefited them as their care was provided in a consistent manner with a focus on their dignity and individuality. For example, one person said, “Staff are great, very helpful and kind, very nice. I can talk to them” and another said, “The staff are exceptional.” A relative said, “Yes very caring staff, it is lovely to hear them say that they love my Mum.”

People were relaxed with one another and the staff group. People commented on the importance of companionship and their friendships within the home. Visitors said they were reassured by their relative's appearance and contentment. For example, relatives said, “She generally expects it to be her forever home, which is down to staff” and “Can’t talk highly enough as to how they make Mum’s life enjoyable, everything from day one makes us and her feel comfortable.”

Measures to manage risk were as least restrictive as possible to protect people's freedom. People's rights were protected because the service followed the appropriate legal processes. Care files were personalised to reflect people's personal preferences. People's views and suggestions were provided with the opportunity to feedback on their experience, which was taken into account to improve the service.

People were supported to maintain a balanced diet with a weekly menu and choices. One person told us, “The food is very good. I have put on half a stone since being here.” Their relative said, “Food is excellent, great choice, she is well nourished and has put on half a stone, drinks on offer, water jug always topped up…” Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.

Staff followed current hygiene practice to reduce the risk of infections. Visitors and people commented positively on the standard of cleanliness, for example, “Everywhere is beautifully clean” and “Clean, very clean.” Health and safety checks of the premises and equipment were carried out at regular intervals. People received their medicines in the way prescribed for them.

Before people moved to Kenwith Castle Country House Care an assessment was completed to identify the level of support they needed. This assessment included risks to their health and well-being. People’s care needs were regularly reviewed and updated.

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

Rating at last inspection

This service was registered with us on June 2021 and this is their first inspection

Why we inspected

This was a planned inspection.

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.

You can read the report from our inspection, by selecting the 'all reports' link for Kenwith Castle Country House Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.