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Archived: Kingsgate Residential Home Requires improvement

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Reports


Inspection carried out on 9 May 2017

During a routine inspection

This inspection took place on 9 and 10 May 2017 and was unannounced.

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 inte

Inspection carried out on 18 November 2014

During a routine inspection

We inspected Kingsgate Residential Home on the 18 November 2014. This was an unannounced inspection.

Kingsgate Residential Home provides care for up to 33 older people who require nursing or personal care. The home was fully occupied when we inspected.

At the time of the inspection the home had a registered manager in place. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The DoLS are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.

We looked at whether the service was applying the DoLS appropriately. These safeguards protect the rights of adults using the services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed. The registered manager told us there was no-one in the home who was subject to a DoLS restriction.

People we spoke with were able to tell us how and why they felt safe living in the home. Staff were able to identify the different types of abuse, what they would do if they felt abuse was happening. Staff had recently received training in equality and diversity which helped them identify anyone who might be at risk of having their personal preferences abused or ignored, and what they should do about it.

There were enough staff on duty day and night to make sure people’s needs were met in a safe and timely way.

Medication was administered in a safe and appropriate way. We found no issues with either the administration or recording of medicines taken.

People living in the home were confident in the way that staff cared for them. Staff knew the people they cared for and were able to meet their needs. People were treated with respect and that their dignity was upheld at all times.

The provider had a thorough and tested induction period before staff were allowed to work alone. Relevant training and refresher and optional training took place across a broad range of training needs. Staff were encouraged to work towards National Vocational Qualifications (NVQ’s).

People were supported to have enough to eat and drink. We found that mealtimes were pleasant and that people were appropriately supported and had choices available with regard to what they chose to eat and where to eat.

People’s health and social needs were met in a timely way. Direct links with the GP practice and district nurses resulted in any medical needs being met in a timely and professional way. Regular visits by chiropody and physiotherapy services took place and people’s personal preferences for dental treatment were respected where possible.

The choices, likes and dislikes of people living in the home were documented, listened to, discussed with all concerned and acted on by all staff if appropriate. People were supported to carry out their wishes and desires and if this was not possible alternatives were discussed and agreed.

Whilst regular activities took place in the home, management were committed to improving this experience so that everyone could benefit in their own individual way.

At the time of the inspection there were no complaints logged or outstanding. Both staff and people living in the home knew how to make complaints.

Inspection carried out on 11 October 2013

During a routine inspection

People living in Kingsgate told us that they were happy there. One person said, “It’s a very nice home. I am happy here and have nothing to complain about”. Another person said, “They (the care staff) look after me well”.

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.

Inspection carried out on 16 April 2012

During a routine inspection

During our visit to Kingsgate we spoke with four people living at the service, two members of staff and both providers.

People spoke positively about the care and support they receive from the staff team. The majority told us they knew the staff very well.

One person told us, "I haven't been here very long, and the staff are helping me to settle in." Another person said, "I have been here for a few years and think of the staff as my second family. I have been very happy here."

During our visit we saw that a group of people were taking part in an exercise class and game, with the majority of the group taking part looking enthusiastic and competitive. Several people were seated in the various lounges reading their newspapers or watching television. Staff were observed looking after people living there in a way that promoted dignity and respect.

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