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Archived: Kingston House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 December 2018

Kingston House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 11 older people, some of whom may be living with dementia related needs.

Kingston House is situated in a quiet residential area and is close to the seafront and amenities. The premises are on two floors with each person having their own individual bedroom and communal areas are available within the service. At the time of our inspection, eight people were using the service.

There was a registered manager in post. 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.

At our last inspection in April 2016, we rated the service ‘Good’ with the key question ‘Is the service Safe?’ requiring improvement. At this inspection, we found that the service was no longer rated as ‘Good.’

At this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Improvements were needed to ensure that all risks from the environment and to people's health, safety and welfare were effectively assessed and action taken as required.

People’s needs were met by sufficient numbers of staff, however their deployment required review to ensure that people were stimulated and engaged.

The environment required further development to ensure that it was appropriately designed and adapted to meet people’s needs. We have made a recommendation that the service explores current guidance from a reputable source on improving the design and decoration of accommodation and the engagement of people living with dementia.

Care plans had not been reviewed and updated as people’s needs changed and did not reflect peoples’ current support needs. We have made a recommendation that the service consults guidance to further develop the Accessible Information Standard (AIS).

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, however staff would benefit from additional training to develop their understanding.

End of life planning required further improvement. We have made a recommendation that the service consults a reputable source to further develop end of life planning.

Audits of the service were not being completed to check that the service provided high quality care and that records were up to date.

People were cared for by staff who had been recruited and employed after appropriate checks had been completed. There were systems in place to minimise the risk of infection. Medication was administered safely and by staff who had received training to do so.

People were cared for and supported by staff who knew them well and who had received training to support people to meet their needs. Staff had a good understanding of people’s preferences. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

Staff, people and their relatives spoke very highly of the registered manager.

Inspection areas

Safe

Requires improvement

Updated 12 December 2018

The service was not consistently safe.

Some risks had not been identified or managed.

Staffing levels were adequate to meet the needs of those living at the service, however required further review to ensure staff were effectively deployed.

There were suitable control procedures in place to protect people from the risk of infection.

Medicines were stored and administered safely.

Effective

Requires improvement

Updated 12 December 2018

The service was not consistently effective.

The design and decoration of the accommodation and the engagement of people living with dementia could be further improved.

People’s rights were protected under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards; however, staff would benefit from additional training.

Staff received an induction when they came to work at the service and attended training courses to support them to deliver care and fulfil their role.

People were supported effectively with their nutritional needs and had access to healthcare professionals when they needed to see them.

Caring

Good

Updated 12 December 2018

The service was caring.

Staff knew people well and what their preferred routines were.

People were treated with dignity and respect by compassionate staff.

Responsive

Requires improvement

Updated 12 December 2018

The service was not consistently responsive.

People's care records did not always detail their preferences and choices for end of life care.

Care plans contained inaccurate information and did not reflect people’s current needs.

People had some opportunities to engage in activities to ensure their wellbeing.

A complaints policy was in place.

Well-led

Requires improvement

Updated 12 December 2018

The service was not consistently well-led.

Audits had not been completed recently and areas that required improvement had not been identified or addressed.

People’s views and experiences of the service were gathered and used to make improvements.

People, relatives and staff were complimentary regarding the registered manager.