Kenilworth Care Home

We found the following examples of good practice.

¿ Good testing regimes were in place. This had supported staff to act quickly when an outbreak occurred.

¿ People were supported to maintain contact with their loved ones. Procedures around visiting the home had been communicated to relatives.

¿ Staff had received and implemented their training to manage the risks of cross infection. They had worked flexible to maintain safe staffing levels throughout the pandemic.

At our last comprehensive inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this comprehensive inspection we found the service remained good.

People were safeguarded from the risks of abuse. Staff understood and managed the risks to people to make sure they remained safe, however records relating to risk needed to be improved. Staff did not always recognise the risks posed from the environment. We asked the registered manager to take action to ensure the kitchen door always remained closed because the cooker was next to the door where people and staff regularly passed. A cooling fan was put in place to protect staff from excess heat in the kitchen. Staff followed infection prevention and control procedures and the registered manager took action to put toilet roll holders in place when we asked them to during inspection. Recorded water temperatures showed they were above safe temperature limits without action taken to address this. No harm had come to anyone as a result of these risks to the environment.

Accidents and incidents were recorded and analysis carried out. Certificates to maintain the safety of the building were up-to-date. Fire safety checks had been completed regularly. Staff were recruited safely and there were enough staff on duty at all times. Good systems were in place to manage people’s medicines. There was evidence that lessons had been learned when incidents had taken place.

Detailed assessments were carried out before people moved into the service. People were supported with their health care needs and care records detailed guidance from health professionals. People were involved in planning menus and referrals for nutritional support were made when needed. Staff were supported by way of induction, supervision, appraisal and training.

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 environment was in need of updating. Some improvements had been carried out and an improvement plan was in place.

People told us they were cared for by staff who knew them well. Nothing was too much trouble and their privacy and dignity had always been maintained. Although the care records did not detail people’s involvement in their care, people told us they had been involved in planning and reviewing their care. Care records detailed people’s communication needs and information was given in people’s preferred formats.

Staff provided person-centred care to people which supported them to be as independent as they could be and to live fulfilled lives. Care records supported staff to do this. An activities co-ordinator supported people with activities of their choice and people were complimentary about these. Everyone we spoke with knew how to make a complaint and told us they had confidence that appropriate action would be taken to address their complaint. No-one was receiving end-of-life care.

People and staff were very supportive of the registered manager and of each other. They all worked together to deliver safe care to people. Feedback had been sought via meetings and surveys. The auditing process had been reviewed and more robust audits had been put in place. The provider regularly visited the service and sought feedback from people and staff during this time. Action plans were in place to continue to develop the service. The service had good links with their local community and worked alongside health and social care professionals.

Further information is in the detailed findings below.

At the last inspection on 27 April and 1 May 2015 we found the service was not meeting all the requirements of the Health and Social Act 2008. There were gaps in the records for maintenance, planned fire drills and health and safety records. There was no evidence that checks of emergency call bells and water temperatures had been carried out. Personal Emergency Evacuation Plans (PEEP) for people living at the home were not up to date. Staff training, supervision and appraisals were not up to date. Meetings for people, their relatives and staff had not taken place. Records of quality assurance visits by the registered provider were limited and no action plans had been produced where changes needed to be made. Some audits were not in place where needed. Some records looked at were inaccurate or incomplete.

Kenilworth care home provides care and support for up to 20 people in Loftus and is located off the main high street. At the time of inspection, there was 20 people living at the service. The service is set in its own grounds with gardens and there is parking available on-site.

The registered manager had started at the service as a care assistant and had worked their way up to manager before applying to become registered manager in 2010. 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.

Safeguarding alerts had been made when needed. Staff understood the procedure they needed to follow if they suspected abuse might be taking place.

Risk assessments were in place for people who needed them and were reviewed regularly. Staff understood that people could take reasonable risks.

Staff were recruited safely. There were sufficient staff on duty to provide appropriate care and support to people. The management team was also on-call out of hours to support staff.

Medicines were managed safely. Staff understood the requirements of managing medicines safely and followed procedures to make sure people had the medicines they needed.

Certificates were in place to ensure the safety of the service and the equipment used. Maintenance and fire checks had been carried out regularly by the service.

Supervision, appraisal and training was up to date and staff told us they felt supported. People told us they felt staff had the knowledge and skills needed to care for them.

People spoke positively about the nutrition and hydration provided at the service. Staff understood the procedures they needed to follow if people became at risk of malnutrition or dehydration.

Some people had Deprivation of Liberties Safeguards in place to keep them safe. The service followed the correct procedure to make sure this process was carried out appropriately and in the best interests of people.

Each person was involved with a range of health professionals and this had been documented within each person’s care records. From speaking with staff we could see that they had a good relationship with the health professionals involved in people’s care.

The service was spacious and people told us they could spend time in private or with other people. People had spacious bedrooms which included their personal possessions.

People spoke positively about the care and support they received from staff. They told us staff always had time for them and felt listened to.

Some people were involved in their care and made decisions about their care. Other people told us they did not want to be involved in planning their own care; they told us they were confident that staff would provide the care and support needed.

People told us their privacy and dignity was maintained at all times and staff always asked for permission before care was provided.

The service worked closely with health professionals when someone was nearing the end of their life to ensure their needs, wishes and preferences were met.

We asked the registered manager to review all care plans to check whether they remained relevant because some people had care plans in place where there were no care needs identified.

Records of life stories and care plan reviews contained limited information.

Everyone spoken with was aware of how to make a complaint if needed. People told us the registered manager came to see them every day and they could speak to them about anything they needed to.

Staff told us they enjoyed working at the service and felt supported by the registered manager. We could see from our observations and from speaking to people and staff that the registered manager had a visible presence at the service.

The staff team in place at the service worked together to meet the needs of people. All staff spoken to told us they felt listened to and saw a future at the service.

Quality assurance processes were in place at the service. The registered provider visited regularly. Meetings for people, their relatives and staff were in place which meant all were kept updated about changes occurring at the service.

The registered manager kept CQC notified of all events which had occurred at the service and was aware of the duties expected of them as registered manager.

People who used the service expressed satisfaction with the care and service they received. One person told us, 'You do get well looked after, it's all very good.' They also said, 'The staff are very pleasant.' A relative we spoke with told us, 'Everything is fine, they look after mam well.'

There was a friendly and relaxed atmosphere between people living and working at the home. We observed staff interacting well with people and supporting them, which had a positive impact on their wellbeing. We saw that staff worked in collaboration with other health and social care professionals.

Staff responded quickly when people called for help and people were provided with the care they needed.

We found that people lived in an environment that was homely and clean.

Processes for the administration and management of medicines were being followed.

Overall we found medicines were not always safely handled and improvements are needed.

People who used the service expressed satisfaction with the care and service they received. One person told us; 'The lasses are lovely, they can't do enough for you.' Another person told us; 'The girls are lovely, they look after me well.'

One of the relatives we spoke with told us; 'It's a friendly, homely place.'

We observed staff interacting well with people and supporting them, which had a positive impact on their wellbeing.

We found that arrangements were in place to ensure people's nutrition and hydration needs were met.

We found processes for the administration and management of medicines were not always been followed.

There were appropriate arrangements in place for the recruitment of staff.

The home had a complaints procedure in place and this was accessible to people and their relatives.

We found that people's care records were kept up to date and contained required information.

We saw that staff interacted well with people living at the home and they provided support and encouragement in a sensitive and dignified manner. The atmosphere in the home was relaxed and staff frequently smiled at people. Staff got down to eye level, spoke clearly and at a steady pace so people could understand them. People who used the service were observed to be well presented and were dressed appropriately.

We found that people's views were taken into account in the assessment and care planning process. Staff were receiving regular supervision. We also found that some assessments and care plans were not being evaluated regularly and plans were not always developed to meet people's identified needs.