Archived: Kimberley Residential Home Limited

Kimberley Residential Home provides accommodation and personal care for up to 22 older people. At the time of the inspection there were 21 people living at the service. There were eight single rooms and seven double shared rooms. Many people were independently mobile or needed the assistance of one staff member, some were frail with poor mobility and some people were living with the early stages of dementia. The home was set in an urban area, close to shops and public transport. There was an enclosed garden and paved seating area.

At the last Care Quality Commission (CQC) inspection, the service was rated overall Good, and Requires Improvement in the 'Safe' domain.

We carried out an unannounced comprehensive inspection of this service on12 December 2016. We found two breaches of legal requirements in relation to medicine management and poor maintenance and decoration of the premises. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 12, Safe care and treatment and Regulation 15, Premises and equipment, of the Health and Social Care Act Regulated Activities Regulations 2014. We undertook this focused inspection to check that they had followed their plan and to confirm that they have now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kimberley Residential Home on our website at www.cqc.org.uk

At this inspection we found the service remained Good overall and is now rated Good in the Safe domain.

The provider had dealt with the priorities identified at the last inspection to make the premises safe and more visually pleasing. However, more work needed to be carried out to ensure an even safer and more pleasant environment for people living at the service. We have made a recommendation about this.

People now received their medicines safely and when they should. There were systems in place to ensure medicines were stored and recorded correctly and safely.

People and relatives told us the staff were good and did their best at Kimberley Residential Home.

Staff knew their responsibilities in keeping people safe and had raised concerns appropriately with the local authority.

Risks were assessed and staff took steps to keep people safe while at the same time being aware of people’s rights. Accidents and incidents were recorded and appropriate action taken to reduce the risk of further occurrences.

People had their needs met by sufficient numbers of staff. People were protected by safe recruitment procedures.

Kimberley Residential Home provides personal care for up to 22 people. On the day of the visit there were 21 people using the service. The service is spread over three floors and has a chair lift access. There service has eight single rooms and seven shared rooms.

There was a registered manager in place on the day of our visit. A registered manager is a person who has registered with the Care Quality Commission 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.’

We noted that the flooring in the kitchen and some bathrooms needed to be replaced as they were worn in places and stained. Tiling and skirting boards in some bathrooms needed replacing. In addition, the walls in the conservatory had chipped paint and damaged wall paper needed redecorating. We asked the registered manager and provider about these and they told and showed us a maintenance plan was in place but they had no time frame. The above did not ensure that people were cared for in a properly maintained environment.

Medicines were administered and stored safely. However, we found shortfalls in the recording of medicines and in the checking of controlled medicines. Although the same issues had been identified in a recent medicine audit, they had not yet been fully addressed. This meant that controlled drugs were not checked in accordance with the policy to ensure that any discrepancies were identified and rectified.

People told us they felt safe living at Kimberley Residential. Staff were aware of the safeguarding procedures in place and had attended safeguarding adults training to ensure they understood how to protect people from avoidable harm. Risks to people and the environment were assessed and appropriate steps were taken to mitigate them. Incidents and accidents were managed safely and learning from incidents was shared during handovers and staff meetings.

People told us they were treated with dignity and respect and felt there were enough staff to look after them. They were supported to take part in activities that suited them and told us they were able to raise any concerns about their care. We saw staff interact with people in a polite and pleasant manner.

Staffing levels had been reviewed recently with the appointment of another cook and a second housekeeper being considered in order to ensure staff had enough time to support people effectively.

Staff received appropriate support, training, appraisal and supervision. They understood their responsibilities under the Mental Capacity Act (2005) and ensured they sought for consent before care was delivered.

Care plans were reviewed regularly and reflected people’s current support needs. People were involved in planning their care and told us they could choose when to wake up or go to bed.

People, their relatives and staff told us the management was approachable and listened to any suggestions to improve the care delivered. There were effective quality assurance processes in place to ensure people’s views about quality were heard. However, although there was an audit system in place more time was required to complete the actions identified. We made a recommendation about record keeping.

You can see what action we told the provider to take at the back of the full version of the report.

Below is a summary of what we found. Some people using the service had communication difficulties. This meant they were not always able to tell us their experiences. The summary is based on our observations during the inspection including a Short Observational Framework for Inspection (SOFI), discussions with people using the service and the staff supporting them, comments from a relative and a review of records.

This is a summary of what we found -

Is the service safe?

People's health was monitored in order to ensure that they received prompt treatment when required. Where it was identified that additional support from healthcare professionals was required this was arranged and records showed what treatment had been received. People were cared for in an environment that was safe, clean and hygienic. We found that appropriate systems were in place for the prevention of the spread of infection. We saw that the kitchen was clean and had suitable equipment in place to ensure that food was stored and prepared safely.

Is the service effective?

People we spoke with told us that they were happy living at the home and their needs were met. One relative told us that their family member was happy at the home and they were pleased with the proactive approach taken by staff to ensure physical health needs were met. They said they have been asked for their views and that communication with the home was 'Good'.

Staff told us that they had received the training they needed to do their jobs well. We saw evidence that staff were being regularly supervised and staff told us they felt well supported by the managers at the home.

Is the service caring?

We saw that staff were attentive and responsive to the needs of people living at the home. We observed a person being supported to move around the home and saw that they were able to move at the own pace. We heard staff address people respectfully. We saw that people were provided with drinks throughout the day and offered additional snacks.

Is the service responsive?

People's needs were assessed before they moved into the home to ensure that they were suitably placed at the home. We saw that care plans included information about people's needs, preferences and interests. Care and support had been planned in accordance with their wishes. We saw that people were engaged with activities they enjoyed and the home had implemented an activities timetable to ensure people had access to a range of activities.

Is the service well-led?

We saw evidence that the provider was regularly seeking the views of people using the service or their representatives. Staff told us they felt they could approach the managers if they wanted to make suggestions about the way the home operated. One staff member told us that the home was a good employer and they had been supported to gain further qualifications to help them do their job.

Our inspection of 10 October 2013 found that people who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises. This was because there was insufficient storage and corridors were crowded with wheelchairs and presented a trip hazard. We also found that the home did not have a system in place for monitoring the quality of the service.

At our visit on 10 April 2014 we found that the home had taken action to ensure that the premises were safe and additional storage space had been created. A system for monitoring the quality of the service had been implemented. We also saw that window restrictors had been fitted to upstairs windows to ensure the safety of people living at the home.

We found that the provider had taken action to ensure people experienced care, treatment and support that met their needs and protected their rights.

We found that although the provider had taken some action, people who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises.

We found that although the provider had taken some action, there was not an effective system in place to assess and monitor the quality of service that people receive.

We found that there were enough qualified, skilled and experienced staff to meet people's needs.

We found that that the provider had an effective complaints system available. Comments and complaints were responded to appropriately.

We found that the provider had taken action to ensure that people were protected from risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We found that the provider had addressed our concerns and taken action to involve people who used the service and their relatives in making decisions about their care, and ensured that care plans recorded people's life histories, and spiritual needs.

We found that the provider had purchased new equipment but had not carried out an environmental risk assessment for some areas of the home to protect people against the potential safety risks these posed.

We also carried out a routine inspection to check that essential standards of quality and safety referred to on the front page were being met. We sometimes describe this as a scheduled inspection.

We saw people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We found that the provider had not taken action to ensure the service had sufficient numbers of suitably qualified staff to meet people's needs.

We found the provider did not have an effective system in place to assess and monitor the quality of service that people receive.

We also reviewed the home's complaints system and found that the provider did not have an effective complaints system available.

We found people were not protected from the risks of unsafe or inappropriate care and treatment as people's personal records were not accurate and fit for purpose.