Kenbrook

Kenbrook is a nursing home for up to 51 older people. At the time of our inspection, 51 people were living at the service. Some people were living with dementia.

People’s experience of using this service and what we found

People were well cared for and received personalised care and support. They were happy living at the home, had good relationships with staff and were given choices about their care. Their relatives were also happy.

People were supported to stay safe. The risks to their wellbeing were assessed and planned for. They received their medicines safely and as prescribed. People were supported to access healthcare services. They had enough to eat and drink and they were offered chances to participate in a range of activities.

The provider considered people's equality and diversity needs, promoting different cultures, religions, and LGBT+ (Lesbian, Gay, Bisexual and Transgender) rights. They organised celebrations of people's different needs and provided information to help educate people living at the service and staff about these. There was a Chaplain attached to the home who supported people living there and staff to make sure their wellbeing and spiritual needs were considered and met.

There were enough suitable staff. There were systems for selecting and recruiting staff, as well as good training opportunities. Staff felt supported and worked well as a team.

There were effective systems for monitoring and improving quality at the service. These included recognising, reporting, and investigating when things went wrong. People told us the registered manager was approachable and supportive. There were clear actions, improvements and lessons learnt following adverse events, complaints and feedback from stakeholders.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (Published 19 December 2017).

Why we inspected

We undertook this inspection based on the date of the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection on 30 November 2015 the home met regulations and was rated good.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Some people in the home had complex needs and were therefore unable to provide us with feedback. We therefore spent time observing interaction between people and staff. On the day of our inspection we observed people were well cared for and appeared relaxed and comfortable in the presence of care workers. We observed positive engagement between staff and people. Staff were respectful to people and showed a good understanding of each person’s needs and abilities.

People we spoke with told us they felt safe in the home and around staff and this was confirmed by relatives we spoke with. There were systems in place to keep people safe. Staff had received training on how to identify abuse and understood their responsibilities in relation to safeguarding people, including reporting concerns relating to people’s safety and well-being.

Risks to people had been assessed, updated and regularly reviewed to ensure people were safe and risks to people in relation to treatment or care were minimised.

Medicines were managed safely and staff were appropriately trained. Appropriate infection control procedures were followed to minimise the risk of spreading infection. Accidents and incidents were documented appropriately and action was taken to prevent future incidences from happening.

Staff we spoke with told us there were sufficient numbers of staff to safely meet people’s individual care needs. On the day of the inspection, we observed staff did not appear to be rushed and were able to complete their tasks. We discussed staffing levels with the registered manager and she told us staffing levels were assessed depending on people's needs and occupancy levels.

People’s needs were regularly assessed to ensure the home was able to provide treatment and care appropriate to people’s individual needs. Staff received ongoing training and spoke positively about the training they received. Regular planned supervisions and appraisals ensured staff performance was monitored. All staff we spoke with told us they were well supported by management at the home and said that morale in the home was good.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The home operated within the principles of the Mental Capacity Act 2005 (MCA).

Where people were unable to leave the home because they would not be safe leaving on their own, the home had made applications for the relevant authorisations called Deprivation of Liberty Safeguards (DoLS).

People’s health and social care needs had been appropriately assessed. Care plans were person-centred, detailed and specific to each person and their needs. Care preferences were documented and staff we spoke with were aware of people’s likes and dislikes and preferred routines.

People and relative’s spoke positively about the food in the home. During the inspection, we observed people having their lunch and saw there was a relaxed atmosphere. We noted that lunch on the ground floor took approximately an hour and 15 minutes and we discussed this with the registered manager. She explained that this occurred occasionally because a large proportion of people had complex needs and therefore required longer for lunch.

Some people in the home had low weight and a low body mass index. We saw there was clear information about how to support these people with their nutritional needs, preferences and clear guidance for staff detailing how to encourage the person to eat.

The home had a varied activities programme which included music and movement, church service, manicures, flower arrangements, music therapy and afternoon movie. There was a therapeutic programme for people who were unable to participate in group activities and staff ensured they spent time interacting with these people.

People and relatives spoke positively about the Christmas fete that took place in November 2017. Relatives told us that the home made every effort to celebrate events and ensure people felt involved with these.

Procedures were in place for receiving, handling and responding to comments and complaints. We saw evidence that complaints had been dealt with appropriately in accordance with the policy.

The home carried out a formal satisfaction survey in 2016 in order to obtain feedback from people and relatives. The feedback obtained was positive and it was evident that the home had reviewed and analysed the results.

There was a clear management structure in place and staff told us morale within the home was positive and staff worked well with one another. Staff told us management were approachable and there was an open and transparent culture. They said communication in the home was good and they were informed of changes through staff and handover meetings.

Management consistently carried out checks and audits to monitor and improve the quality and safety of the home and took appropriate action when areas for improvement were identified.

People told us that the staff treated them with respect and were polite. One person said, 'Staff are wonderful. They are always helpful and they talk to me. They make me feel wanted.'

People told us that there were a lot of entertainments and activities available. One person said, 'There is lots going on. Working to make something and then displaying it, it's worth a month of Sundays.'

Support plans provided information and guidance on each aspect of the person's personal and healthcare needs. Staff told us that they received training that supported them to meet people's needs. We saw evidence that all staff had training in understanding dementia and in end of life care. One staff member said, 'I am very well supported by my manager and the other staff. I feel part of a team.'

The results of the provider's satisfaction survey for 2013 showed that 96% of people were happy living in the home, and 100% were satisfied overall with the quality of the service they received. One person who we spoke with said, 'The facilities are first class.' Two visiting relatives told us that Kenbrook met their expectations for providing good care. One relative said, 'The care couldn't be better.'

Some of the people using the service had limited communication abilities and so we could not interview them to seek their views. However, we were able to observe people's mood, their behaviour and how they interacted with staff.

Friends and relatives told us that the staff were caring, skilled and experienced, and friendly. People using the service told us that they felt well cared for and safe from harm.

We found that people using the service were being cared for by appropriately qualified and competent staff. Staff were supported in their roles by knowledgeable and experienced managers.

We saw that people's personal and health care needs were being met appropriately, and according to their support plans on the whole.

We saw that people were cared for in a clean environment and that they were protected from the risk of infection.

We saw that people were supported to eat and drink well with respect and dignity. The food looked appetising and choices were freely available. Two people told us that they enjoyed the food served and the ability to have a drink whenever they wanted.