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Archived: Kingsmead Lodge

Reports


Inspection carried out on 4 August 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

The 18 people living at the home at the time of our visit had complex physical and learning disability needs and most were not able to speak to us about their experiences. We did speak with three people who use the service and in order to get a better understanding of the care and support provided we also spoke with the relatives of four others. In addition we observed care practices, reviewed a selection of records and spoke with four staff, the manager, the area manager and the provider’s quality lead. Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

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

Is the service safe?

Representatives we spoke with told us they believed that the service provided for their relatives was safe. We saw that care plans detailed people’s personal preferences and information to keep them safe. The risks people were likely to face in daily living had been assessed and reviewed regularly. Up to date guidance was in place with the measures staff needed to take to minimize the risks while enabling people to do what they wanted safely.

The service had policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The manager told us that there was no one subject to DoLS at the time of the inspection but relevant staff had received training to understand when an application should be made and how to submit one.

Procedures for the safeguarding of vulnerable adults were robust. We saw that staff received regular mandatory safeguarding training and those we spoke with told us that would not hesitate to report suspected abuse or concerns about poor practice in order to keep people safe.

From our observations and discussions with staff we found they received the appropriate training and had the knowledge and skills to support people safely.

Regular checks were made to make sure that the environment was clean, hygienic and safe. Quality assurance systems were in place so that the manager and staff learnt from events such as incidents, complaints, concerns and investigations. This minimised the risks to people and helped the service to improve and ensure people’s safety.

Is the service effective?

People's rights were protected in line with the Mental Capacity Act. When people did not have the capacity to make a decision for themselves, procedures were followed to ensure that the decisions made for them were done in their best interest, in consultation with their representatives and involved health and social care professionals.

People’s individual health and care needs were assessed and recorded in their care plans and these were reviewed and up dated regularly to ensure that they reflected their needs. Most people living in Kingsmead Lodge were unable to communicate verbally but representatives we spoke with told us that they were satisfied with the care provided by the service and felt their relative’s needs were met. Evidence showed that staff received the appropriate support and training to provide effective care and treatment for people with complex physical and learning disability needs. It was clear from our observations and our discussions with them that they had an in depth knowledge of the people they were supporting. In addition we saw they were able to communicate with them effectively and could recognise early signs of change in behaviour or well-being and act appropriately.

One relative told us, “They have done well with my relative in a short time and they are now more responsive and mobile”. Another said, “Since they arrived here the change in them is amazing. They are so happy and I feel I have my relative back again”.

Is the service caring?

People were cared for by attentive and sensitive staff who were positive and friendly in their approach and encouraging when offering support. There was a relaxed homely atmosphere in the home and we observed that staff supported people in a calm, unhurried manner and used communication methods conducive with their individual assessment of needs.

Several staff we spoke with told us that they had been working in the service for several years and liked working in Kingsmead Lodge and enjoyed caring for people and making a difference to their lives.

Relatives’ comments included, “The care is perfect and the staff are wonderful” and, “The care is excellent, our relative looks smartly dressed and clean whenever we visit and they always create a good atmosphere”.

Is the service responsive?

Everyone had a person centred care plan which included information about how they wished to communicate with others, their interests, preferences and support needs. We saw that these were reviewed and up-dated regularly and in response to any changes in their needs. Records confirmed that people received the care and support as described in their plans. We saw that people’s health care needs were monitored closely and if necessary the support of additional health care professionals was obtained. This helped to ensure that the delivery of care was responsive to people’s needs based on up to date information and guidance.

People were given one to one support from staff in order to participate in a wide range of activities of their choice both in and outside the service. One relative told us, “There is something happening all the time. They really enjoy themselves and staff more than meet their needs”.

Relatives we spoke with told us that they had regular contact with the home, visited frequently at any time and attended activities such as the forthcoming family barbeque. They told us they could also speak to staff or the manager at any time and were confident that any concerns they raised would be taken seriously. We looked at how complaints were managed and found the responses to be open, thorough and timely.

Is the service well led?

The service had a quality assurance system in place which included audits carried out by the manager and the provider. The evidence showed that any concerns or shortfalls identified were addressed quickly and that improvements were implemented when required.

People who use the service, their representatives and staff were asked their views about the care and support provided and we found examples where action had been taken to improve the service provided as a result of their responses.

Staff we spoke with were clear about their roles and responsibilities and said they were well supported in their roles by the manager and a good team of staff who all worked effectively together.

Inspection carried out on 7 June 2013

During a routine inspection

During our visit we met and spoke with nine of the 15 people using the service and two of their relatives.

We also spoke with the manager, a nurse, and three care staff.

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 addressing people by their preferred names. Personal care was carried out in private. Staff were discreet when explaining to people the tasks they were undertaking to support their care needs.

Staff were familiar with people’s preferences and lifestyle choices. For example, staff noticed one person becoming agitated so a staff member played music to soothe them. We saw the person becoming calmer. They smiled and moved their body in time to the music.

Inspection carried out on 11 September 2012

During a routine inspection

We spoke with two people who live at the home. One person told us that the home was “good”. The other person was unable to communicate verbally but was able to express themselves through the interpretation of facial expressions. We asked if they liked living at the home and they indicated that they did.

We also spoke with two visitors. One told us that their family member was “thriving”. Another told us that their relative had managed to put on much needed weight since living at the home. Both expressed confidence in staff to deliver good care and felt that they were kept informed of any changes or developments. They also told us that their family members were safe living there.

To help us understand the experience of people using the service, we used our Short Observation Framework for Inspection tool (SOFI). This allowed us to spend time watching what was going on in the service and to record how people spent their time, the support they got and whether or not they had positive experiences. We also observed those who were unable to express their needs. Using this tool, we found that staff had the necessary time and skills to care for people appropriately and safely.

Inspection carried out on 25 October 2011

During a routine inspection

We were able to speak to one person during our visit. This person told us that they liked living at the home, that staff looked after them, and that they could make choices about their care.