Archived: Kingsmead Care Centre

We considered our inspection findings to answer questions we always ask. Is the service safe?, Is the service effective?, Is the service caring?, Is the service responsive?, Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff who supported them and from records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People using the service told us that they felt safe and secure. Their comments included "I trust the staff and they make me feel safe'. Another person stated, 'Staff are always nearby if I need them'.

Records showed that people experienced safe and appropriate care. Their needs had been assessed and their care and treatment planned and delivered in accordance with individual care and risk-management plans.

We inspected staff rotas and spoke with staff. The information gathered from these sources showed that people received consistent, safe levels of support because sufficient nursing and care staff were on duty to meet people's needs. Records showed that staff were suitably qualified, skilled and experienced.

A system of regular audits was in operation. These ensured people and others who may be at risk were protected. Records showed that the registered manager and staff learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the home to continually improve.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS authorisations were in place or applications made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

Safeguarding procedures were robust and staff understood their role in protecting people they supported from abuse.

Procedures were in place for dealing with emergencies and staff found to be trained in these procedures. This ensured the safety and welfare of people.

Is the service effective?

We spoke with six people who were overall positive about the standard of care and treatment they received. Their comments included, 'I am happy with my care, staff are very nice and good. They ask you to tell them how you like things."" One person told us, 'I was in a wheelchair when I was first admitted some weeks ago and used a frame on wheels to get around in my own home. Since admission I have been assessed by a physiotherapist and have been given a tripod to get around with. This is much easier to use".

We looked in depth at the care records of four people. We found these were person centred, placing the needs, wishes, preferences and decisions of people or those representing them at the centre of assessment, planning and the delivery of care and treatment. We saw that assessments and care plans were holistic, addressing people's physical, communication, emotional, psychological and social needs. They promoted and respected people's diversity, privacy and spiritual beliefs. Assessments included needs for equipment, mobility aids and specialist dietary requirements. We saw that care plans had been reviewed monthly or more frequently, if necessary. People told us that they or those acting on their behalf had been involved in the assessment of their health and care needs and had contributed to the development of their care plans. This meant that people were sure that their individual care needs and wishes were known and planned for. Also, that they had the equipment they needed to meet their individual needs.

A visitor told us that they were able to see their relative living in the home, in private and could visit at any time. They appreciated that numbers of visitors the person could have were not restricted as they felt visits from family to their relative to be essential to their health and wellbeing.

Is the service caring?

People who use the service told us that staff respected their privacy and dignity. They told us that intimate personal care was always carried out in private. Their comments included, 'Staff are very good, kind, caring and helpful'. 'Staff always respect my privacy and independence. They are flexible in the way they meet my needs'.

We observed people were dressed in clean clothing appropriate to their age and for the weather conditions. Attention had been given to their personal hygiene and grooming. The staff we spoke with were knowledgeable about people's preferences and lifestyle choices. We saw that they were attentive to people, with high levels of engagement and were warm and caring in their general demeanour.

Is the service responsive?

People told us that they were supported and encouraged to participate in a range of social and education activities in the home and the community. This was evidenced by photographs displayed in communal area, records and discussions with staff. Records showed that people's interests and hobbies had been explored and effort made to incorporate them within individualised or group activities. For example, an activities coordinator told us that they organised and accompanied a person on visits to a relative living in the local area. They also supported another person to maintain friendship links with people at their church, which was very important to their wellbeing.

Systems were in place for analysing incidents/accidents, complaints and safeguarding alerts. Discussions with the registered manager and records showed complaints and concerns had been taken seriously. Learning from complaints had been fed back to complainants and action planned to address their concerns. For example, is was stated that maintenance staff would be carrying out work to trim tree branches in response to a recent complaint. This meant that people could be assured that their concerns and complaints would be investigated and any necessary action taken.

Effective systems were in place for monitoring the quality of services and assessing and managing risk. Feedback from quality surveys and learning from incidents and complaints had been constructively used to promote continuous service improvement and development.

Is the service well-led?

The service employed a registered manager and deputy manager who were both registered nurses. They were positive about the training opportunities available to them within the company. Their continuous training had enabled them to perform their roles and manage the home effectively. They felt well supported by the provider's representative who visited regularly and was always accessible for advice and guidance.

Records indicated that the service worked well with other agencies and services to ensure people received their care in a joined up way.

The registered manager and the provider's representative monitored and assessed quality within the home in various ways. Staff demonstrated they were clear about their roles and responsibilities. They had a good understanding of the home's ethos and of quality assurance processes. This helped ensure that people received a good quality service.

We met and spoke with 14 of the 31 people who were using the service at the time of our inspection.

People we spoke with told us they were satisfied with the service they received. Their comments included,

'It's very nice. They're very kind to me.'

'I've never felt so happy in a place.'

Some people using the service had complex physical and learning disability needs, which meant they might have had difficulty describing their experiences of the service. We gathered evidence by spending time watching how people spent their time, the support they got from staff and whether or not they had positive experiences.

We saw that staff addressed people by their preferred names. Personal care was carried out in private and staff were discreet when asking about care needs. We observed that staff were familiar with the needs of people using the service and were able to interpret the non-verbal prompts or body language people used to express their feelings.

All the people we spoke with were happy with the care provided and felt safe living at the home. They were confident in the staff's ability to provide good care. One person told us that staff were, "very friendly and knowledgeable".

We also spoke with two visitors who were both satisfied with the care provided by the home. One said, "I looked at a few homes before I came here and this is the best". The evidence we gathered and our observations made during the inspection support the comments made by people and their visitors.