Archived: Kingsgate Residential Home

Kingsgate residential home provides accommodation and care for up to 33 people, many of whom would be living with dementia. At the time of our inspection 29 people were living in the home.

A registered manager was in post, who was also the provider. 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.

During this inspection, we found that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.

We found that there was a breach of the regulations because there were no in depth audits of people’s medicines and staffs’ competency was not regularly assessed in this area. The registered manager was also in breach of the regulations because risks to the environment were not always monitored and people’s individual risks were not always documented in their care records. There were plans in place to address these concerns and the registered manager was already in contact with a management consultant in health and safety.

A further breach of the regulations was found because the registered manager did not notify us of significant events relating to the people who lived in the home. A notification is information about important events which the provider is required to tell us about by law.

During our inspection visit we found that there was a lack of effective systems in place to monitor and assess the quality of service being delivered. There was a lack of auditing in a number of areas such as health and safety, people’s care plans and medicines. Since our visit improvements have been made with regards to auditing.

There were no meetings for people who lived in the home but the registered manager would speak with people and people felt able to approach staff if they had any concerns or suggestions about the service. Staff meetings did not take place regularly but there were plans to implement more regular meetings.

Accidents and incidents were recorded appropriately and the necessary post-accident observations took place where people had suffered an accident.

Staff knew what constituted abuse and what procedures they would follow if they were concerned that someone was being abused. There were safe recruitment practices in place and all staff had the relevant safety checks to ensure that they were suitable to work in a caring environment.

All new staff completed an induction to their role and there was ongoing training for all members of staff. Staff were further supported through regular supervisions and appraisals.

Mental capacity assessments were not always in place for those people who lacked capacity but we saw that no one was being unlawfully deprived of their liberty. Staff understood the principles of the Mental Capacity Act 2005 and had received training in relation to this.

People were able to make choices about how their care and treatment was delivered. Where people needed support with decision making, staff would support people with this.

People were supported to maintain a healthy intake of food and fluid and people were consulted about what meals they would like to eat. People were able to choose where they would prefer to eat their meals.

Where concerns arose regarding a person’s health or wellbeing, prompt advice and referrals were sought from the most relevant healthcare professional.

Staff were kind and attentive to people’s needs. Staff knew people’s care and support needs well and supported people to access and maintain their interests and hobbies. People’s privacy was respected and their dignity was consistently upheld.

No complaints had been made about the service but there was a complaints procedure in place and people felt able to make a complaint if needed.

Care plans demonstrated that people were involved in making decisions about how they wished to be cared for and supported. We noted that people's bedrooms were individually furnished according to what people wanted, including their own pictures, ornaments and soft furnishings.

We saw evidence that the care given by staff reflected what was documented in people's care plans, and that care plans were regularly reviewed and updated.

There were choices from the menu at meal times and all of the people we spoke with said that they enjoyed the food. Nutritional assessments had been completed and there was evidence that people's nutritional needs were being met.

During this visit we observed staff approaching their duties with confidence and competence. Staff were well supported and there was an adequate training and education schedule in place to ensure staff were able to meet the needs of people who used the service.

We reviewed the records held by the service and noted they were accurate and fit for purpose. We saw evidence that records containing confidential information were stored securely.