Background to this inspection
Updated
23 September 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The site visit was carried out by two inspectors and a pharmacy inspector. One inspector completed the rest of the inspection. An Expert by Experience supported this inspection by making telephone calls to relatives and friends. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Kingland House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We announced the inspection the day before we visited to discuss the safety of people, staff and inspectors with reference to Covid-19.
Inspection activity started on 5 August 2020 and ended on 1 September 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection this included monthly reports the provider had been required to provide. We sought feedback from the local authority, CCG and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with four people who used the service and eight relatives or friends about their experience of the care provided. We spoke with six members of staff including the registered manager and deputy manager, care staff, housekeeping and kitchen staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
During our site visit we looked at three people’s care records and six medication records.
Due to the current pandemic, we reduced the time we spent in the home and continued the inspection remotely: this meant that the registered provider sent us various documents electronically, discussions were via email and the telephone and we contacted all of the staff via email. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, staff training and supervision, quality assurance and some policies and procedures.
After the inspection
We continued to seek clarification from the provider to validate evidence found. 14 staff gave us their feedback about the service and we also received information from four professionals.
Updated
23 September 2020
About the service:
Kingland House is a care home for up to 44 older people, some of whom may be living with dementia. The home was originally four private houses which have been adapted and linked together. There were 36 people living in the home at the time of our inspection.
People's experience of using this service and what we found:
People told us they felt safe living at Kingland House, and that staff were caring and supportive.
Risks to people were assessed and regularly reviewed. Staff understood the actions needed to minimise the risk of avoidable harm including the prevention of avoidable infections.
Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.
Medicines were administered safely by trained staff who had their competence checked regularly.
There were enough trained, experienced staff to meet people’s needs. Safe recruitment practices were in place: appropriate checks were completed to ensure only suitable staff were employed. Staff received induction, on-going training and support that enabled them to carry out their roles safely and effectively.
People spoke positively about the food. We observed home cooked, well balanced meals being served to people and a range of drinks being offered.
People received care that was responsive to their individual needs. Staff understood how people preferred their care and support provided. Care plans were person-centred and reflected both care needs and lifestyle choices.
People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people.
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.
The culture of the service was positive and open. Governance systems and oversight of the service had been reviewed and improved. Issues were identified, and actions taken to address any shortfalls. Staff spoke positively about their own roles and teamwork.
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 25 July 2019) and there was a breach in one regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this targeted inspection to monitor the service.
We inspected and found that improvements had been made and the rating of requires improvement was no longer reflective of the service. We widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.