This inspection was carried out on 2 and 3 February 2016 and was unannounced.
Kimberley Residential Home provides accommodation for up to 36 older people who need support with their personal care, some people are living with dementia. Accommodation is arranged over two floors. A lift is available to assist people to get to the upper floor. The service has 26 single bedrooms and 5 double bedrooms, which people can choose to share. There were 32 people living at the service at the time of our inspection.
A registered manager was leading the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The provider’s recruitment procedures were not being followed. Information about the character and conduct of staff in their previous employment had not been checked to make sure staff did not pose a risk to people. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.
Staff were supported to provide good quality care and support. Staff had completed most of the training they needed to provide safe and effective care to people. Some staff held recognised qualifications in care. Staff met regularly with the registered manager to discuss their role and practice and any concerns they had.
The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS authorisations have to be applied for if people, who lack capacity, are at risk of being deprived of their liberty. Arrangements were in place to check if people at risk of being deprived of their liberty and apply to the supervisory body for a DoLS authorisation when necessary.
People’s needs had not been consistently assessed to identify the care they required. This did not impact on people as staff recognised changes in their needs and provided the care they required in the way they preferred. Care and support was planned with people and reviewed to keep people safe and support them to be as independent as possible.
People’s capacity to make decisions was not always assessed. This did not impact on people because staff made decisions in people’s best interests with people who knew them well. Consent to care had been obtained from people. People were supported to make decisions and choices. The requirements of the Mental Capacity Act 2005 (MCA) had been met.
People were treated with dignity and respect at all times. One person’s relative had commented, ‘Staff are aware of [person’s name] as an individual and always accommodate their funny little ways’.
The registered manager provided leadership to the staff and had oversight of the service. Staff were motivated and felt supported by the registered manager. The registered manager and staff shared a clear vision of the aims of the service. Staff told us the registered manager was approachable and they were confident to raise any concerns they had with them.
There were enough staff, who knew people well, to meet their needs at all times. The needs of the people had been considered when deciding how many staff were required on each shift. Staff were clear about their roles and responsibilities and worked as a team to meet people’s needs.
Staff knew the signs of possible abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team. Plans were in place to keep people safe in an emergency.
People received the medicines they needed to keep them safe and well. Action was taken to identify changes in people’s health, including regular health checks. People were supported by staff to receive the care they needed to keep them as safe and well as possible.
People were supported to participate in a wide variety of activities that they enjoyed, including day to day household tasks. Possible risks to people had been identified and were managed to keep people as safe as possible, without restricting them.
People told us they liked the food at the service. They were offered a balanced diet that met their individual needs. A wide range of foods were on offer to people each day and they were provided with frequent drinks to make sure they were hydrated.
People and their representatives were confident to raise concerns and complaints they had about the service with the registered manager and provider.
The registered manager and deputy worked with people and staff and checked that the quality of the care was to the standard they required. Any shortfalls found were addressed quickly to prevent them from happening again. People and their representatives were asked about their experiences of the care and these were used to improve the service.
Accurate records were kept about the care and support people received and about the day to day running of the service. These provided staff with the information they needed to provide safe and consistent care to people.
The quality of the care was regularly assessed. People and their relatives were asked for their feedback about the quality of the service they received. Everyone said it was ‘good’ or ‘excellent’.
We made recommendations to improve practice in relation to effective recruitment processes and consistently assessing people’s capacity to make decisions.