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Inspection Summary


Overall summary & rating

Good

Updated 5 January 2018

This inspection took place on 1 December 2017 and was unannounced.

Kelso Nursing Home 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.

The care home accommodates 12 people in one detached building. There were 10 people living there at the time of our inspection. Bedrooms are situated on the first floor with two on the ground floor and there are four rooms which could accommodate two people. The first floor is accessed via a main staircase or a lift. People have access to a communal lounge and dining area and accessible rear garden. People had a variety of care and support needs related to their physical and mental health and most were unable to speak with us to tell us their views.

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.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of the risks that people faced and understood their role in managing these to ensure people received safe care.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

Staff had worked at the service for many years and this meant that they knew people extremely well. Interactions were kind and tactile and relatives told us that they had peace of mind that their loved ones were receiving safe, compassionate care.

People received their medicines as prescribed and staff worked with healthcare professionals to ensure that people received joined up, consistent care.

People were supported to make choices about all areas of their support and staff understood the principles of mental capacity. Where decisions were needed in people’s best interests, these were in place.

People were supported to have enough to eat and drink and there were systems in place to ensure that any concerns around weight loss were monitored. People’s preferences for meals were well known and choices were offered if people did not want the meal provided.

People preferred to spend time in their rooms, but there was access to more open areas to spend time with family or other’s if people wanted to use these. Infection control measures were in place and monitored to ensure that people were living in a safe environment.

People and those important to them were involved in planning the support they would receive and also regularly asked for their views about the support and any changes to people’s needs. Reviews identified where people’s needs had changed and reflected changes to the support provided in response to this.

People and those important to them were supported to make decisions about end of life care.

People were supported by staff who respected their individuality and protected their privacy. Staff understood how to advocate and support people to ensure that their views were heard and told us that they would ensure that people’s religious or other beliefs were supported and protected. Staff had undertaken training in equality and diversity and understood how to use this learning in practice.

People were supported to have one to one time with staff in social activities which were meaningful to them. Visitors were welcomed at the home and kept up to date about how their loved ones were.

Staff were confident in their roles an

Inspection areas

Safe

Good

Updated 5 January 2018

The service was safe.

People were supported by staff who understood the risks they faced and how to manage these.

People were protected from the risks of abuse because staff understood their role and had confidence to report any concerns.

People were supported by staff who had been recruited with appropriate pre-employment, reference and identity checks.

People received their medicines as prescribed.

Infection control measures were in place and monitored to ensure that people were living in a safe environment.

Effective

Good

Updated 5 January 2018

The service was effective.

Staff were knowledgeable about the people they were supporting and received relevant training for their role.

People who were able to consent to their care had done so and staff provided care in people’s best interests when they could not consent.

People enjoyed a choice of food and were supported to eat and drink safely.

People were supported to receive joined up care and support from healthcare professionals where needed.

Caring

Good

Updated 5 January 2018

The service was caring.

People received compassionate and kind care.

Staff knew how people liked to be supported and offered them appropriate choices.

People and their relatives were listened to and felt involved in making decisions about their care.

People were supported to maintain their privacy and dignity.

Responsive

Good

Updated 5 January 2018

The service was responsive.

People had individual care records which were person centred and gave details about people’s history, what was important to them and identified support they required from staff

People and relatives knew how to raise any concerns and told us that they would feel confident to raise issues if they needed to.

People were cared for with compassion at the end of their lives.

Well-led

Good

Updated 5 January 2018

The service was well led.

People, relatives and staff had confidence in the registered manager and felt they were approachable and helpful.

Staff felt supported and were confident and clear about their roles and responsibilities within the service.

Quality assurance measures provided oversight and enabled the service to identify good practice and areas for further development.

Feedback was used to highlight areas of good practice or where development was needed. Information was used to plan actions and make improvements.