Kingsthorpe Grange

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to safe care and treatment. Significant improvements had been made, and the provider was no longer in breach of this regulation.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had developed a positive approach to learning within the service, which included the development of a culture based on openness and willingness to learn.

People and relatives told us they felt able to raise concerns and felt confident appropriate action would be taken to address them. A person said, "If I mention concerns they do seem on the ball to sort them.”

The majority of relatives told us they were involved in discussions about people’s care plans and risk assessments and had been offered opportunities to provide feedback via questionnaires and relative’s meetings.

Staff told us the management team were open and shared learning with them. They felt able to raise concerns and said incidents were reported with openness and honesty. Staff were confident that actions would be taken where necessary to manage risks and make improvements.

The provider and management team had made improvements to how overarching themes and trends were reviewed and monitored. Records showed when accidents and incidents were reported by staff, action was taken to mitigate the risk of events taking place again.

The management team responded openly and proactively to our feedback about areas for improvement identified during the assessment.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had systems and processes in place to support admissions and transfers of care. They had reviewed pre-admission assessments to ensure these were sufficiently robust and captured the information needed to ensure people’s needs could be met by the service.

Staff supported people and their families to identify safe transitions where people’s needs changed. Staff worked closely with health and social care partner agencies to ensure effective communication and people received timely care and treatment.

Feedback from health and social care professionals did not raise any concerns. Professionals were complimentary about how the service worked with them to ensure people were safe and received the care they needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

People told us they felt safe living at the service. One person said, “Yes I do feel safe.”

A relative said, “My [relative] has been there for a number of years and I know that [they are] safe because I trust the [care staff] who are looking after [my relative]. The care staff are amazing.”

People appeared relaxed and comfortable with the staff who supported them. People and their relatives told us they would speak with staff if they were unhappy or had concerns.

Staff received training about how to recognise and respond to safeguarding concerns. The registered manager carried out regular competency assessments to ensure staff had the skills to keep people safe from harm and risk.

Staff understood their roles and responsibilities in raising safeguarding concerns and following procedures. We saw recent potential safeguarding concerns had been escalated in a timely manner.

Staff received training and support. A staff member told us,” If a resident discloses something worrying, I listen carefully and report it immediately to the manager or the nurse in charge, and record the facts clearly. I follow the care home's safeguarding policy. We make sure a safe, open, and respectful environment where residents feel comfortable speaking up”.

Staff were observed to be attentive and mindful of people’s safety, ensuring they did not face unnecessary risks. People were able to move freely around the building, but they were kept safe because staff were present, and equipment was appropriately used.

The provider had effective systems, processes and practices to make sure people were protected from abuse and neglect. Safeguarding materials were displayed for people, visitors and staff to see. The Mental Capacity Act 2005 provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff assessed people’s capacity to make decisions and ensured decisions were in the individual’s best interests. Assessments were discussed with other parties and outcomes recorded. If needed, they had appropriate legal authorisations to restrict people for their own safety. In care homes these are called Deprivation of Liberty Safeguards (DoLS).

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Where possible, people were informed about risks and supported to keep themselves safe. Staff were proportionate in their approach to risk and respected people’s choices.

People and relatives felt staff worked well to keep people safe. One person told us, “Staff check my oxygen machine every day. The nurses check on it.”

A person described how they felt staff were supportive of their complex health condition.

Staff knew people well and demonstrated a positive approach to managing risks and respecting people’s dignity. The registered manager told us people’s care plans and risk assessments were reviewed with them and their relatives. The team worked alongside the local GP surgery as well as mental health teams and speech and language therapists to manage risks safely. Staff had access to up to date information about people’s risks and responded to changes.

The environment was safe and met people’s needs. The provider had made improvements in how they detected and controlled potential risks in the care environment. Staff made sure equipment, facilities and technology supported the delivery of safe care.

We observed a comprehensive system to ensure routine and specific safety checks were completed with management and provider oversight. An emergency action plan was in place in case of events that required the service to be evacuated. This included scenario-based fire drills and personal evacuation plans, which provided staff with the knowledge and training to support people safely.

People had a range of communal areas they could access throughout the day. We spoke with people and their relatives who all spoke positively about the environment and cleanliness.

One staff member told us, “Residents’ rooms are decorated to feel personal, with their own belongings, photos, and decorations. We have quiet rooms, garden, and activity areas to support emotional wellbeing and offer choice for individual needs. We also have signage with pictures and words that is used to help identify rooms like toilets or dining areas and personalised room doors that help residents recognise their rooms.”

Staff received training to keep people safe, such as fire safety and the use of different types of equipment. They told us about safety measures for individual people with regards to first aid, fire safety, manual handling, and infection control.

The provider had an ongoing programme of maintenance and improvement to ensure the building, fixtures and equipment continued to be kept in good working order. We reviewed evidence that demonstrated the provider had necessary checks and certificates.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider completed a dependency tool to calculate the staffing required to meet peoples' care needs safely. This was updated when there were changes in people’s needs and new admissions. Staffing rotas demonstrated staff levels were generally maintained to the current dependency tool.

People and most relatives we spoke with had no concerns over staffing levels at the service. One person told us, ”I use the call bell and staff come.”

Some staff told us there were times when they felt staffing levels were not sufficient to meet people’s needs in a timely way. One staff member told us, “Rumours are circulating saying that [the provider] want to reduce the staff again. A second staff member said, “Generally, we have enough staff to meet residents' needs, but there are times especially during busy periods like mealtimes when it can be more challenging. This is often because many residents need more support at the same time, and some residents have behaviours that require extra attention.”

We shared these concerns with the registered manager who told us the provider recognises that some staff are still familiarising themselves with their dependency approach, and they will continue to support staff to understand how staffing is aligned to dependency levels and acuity.

They confirmed there were no plans to reduce staff levels. Areas of the home were monitored to ensure safe staffing levels, and they maintained strong oversight of staffing patterns, particularly during peak times such as mornings and mealtimes.

On the day of our visits, we saw there were enough staff to provide people with the support they needed and there was a calm atmosphere in the home.

Staff completed a comprehensive range of training to meet people’s needs. Training records showed staff were up to date with essential training in subjects such as moving and assisting and safeguarding. Staff attended regular refresher courses to ensure their knowledge and skills remained up to date. New staff followed an induction process which included essential training, shadowing more experienced staff.

Staff had received regular supervision. Staff told us they were able to regularly speak with their line manager who provided support and guidance. The provider followed safe recruitment procedures to ensure staff were safe and suitable to work in the service. This included checks with the Disclosure and Barring Service (DBS) prior to staff commencing work.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The premises were clean. Housekeeping staff completed cleaning according to schedules to ensure all areas were maintained and good infection control was achieved.

Staff used personal protective equipment (PPE) appropriate to the task they were completing. For example, gloves and aprons were worn when supporting people with personal care.

Staff received training and had a good awareness of infection prevention and control principles. The registered manager told us there were measures in place to keep people safe. This included the effective use and disposal of PPE, cleaning, laundry management, staff training and competency assessments such as hand washing.

The premises was an older, adapted building. During our visit, we found the service to be clean and free from clutter and bad odours. Staff used appropriate PPE to keep people safe during mealtimes. We were assured that the provider was protecting people, relatives, staff and visitors from the risk of infection.

Staff conducted regular audits to ensure the home remained clean and met hygiene standards. Staff maintained records of daily and deep cleaning which were regularly checked by the management team. The service had an infection prevention and control policy which reflected relevant national guidance.

The provider had made improvements. Medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People received their medicines safely and as prescribed. People and their relatives told us they were satisfied with the support they received with medicines. However, one relative asked a question during the inspection in relation to the medicine their family member was prescribed. The registered manager assured inspectors, in response to this, staff would ensure that relatives were kept informed of any changes to medicines by the nurse in charge or the resident’s GP, and that this was communicated in a clear and timely manner.

Staff who gave medicines had received training and their competency was checked by the registered manager to ensure their practice was safe. The staff we spoke with had a good awareness of safe medicines processes and practice.

The provider had quality assurance measures to ensure medicines were managed safely. This included staff training and competency assessments, weekly audits and stock checks.

The medicines policy was up to date and reflected current and relevant best practice and professional guidance. Protocols were in place for the use of, ‘When Required' (PRN) medicines, especially for the management of pain, for example, anticipatory medicines for controlling symptom at end of life. These were seen to be regularly updated. Where people received their medicines in a covert way, appropriate safeguards were in place to assess teir mental capacity and documentation demonstrated best interest outcomes and recommendations by the pharmacy for staff to follow.