Archived: Kernou Residential Home

We carried out this unannounced inspection on 12 May 2017. At the last inspection, in February 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe living at Kernou and with the staff who supported them. People told us, “I like it here” and “I am really happy.” Relatives told us they were, “Very happy” with the care provided and that, “The manager is the best one they have had, she is on the ball.”

Care and support was provided by a consistent staff team, who knew people well and understood their needs. People were supported to access the local community and take part in a range of activities of their choice. Staff supported people individually and in groups to attend work placements and activities of their choosing.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People were supported to eat and drink enough and maintain a balanced diet and were involved in meal planning. Menu planning was done in a way which combined healthy eating with the choices people made about their food.

People were supported to maintain good health, have access to healthcare services and receive on-going healthcare support. Staff supported people to arrange and attend appointments to see their GP and other necessary healthcare appointments.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. People, who received care, or their advocates, were involved in decisions about their support and consented to the care provided. Risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

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 support this practice.

People and their families were given information about how to complain. The registered manager and operational director were visible in the service, regularly working alongside staff to provide care and support for people. There was a positive culture within the staff team and staff said they were supported by the registered manager.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families were involved in the running of the service and were regularly asked for their views through on-going conversations with staff and surveys.

Further information is in the detailed findings below

This inspection was unannounced and was carried out by one inspector on the 11 September 2014.

We considered our inspection findings to answer our five questions; 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 using the service, their relatives, the staff supporting them ad looking at records.

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

Is the service safe?

The service was safe because staff had received training in safeguarding and knew how to report any concerns regarding possible abuse.

We found the location to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards. This helped to ensure people's rights were respected.

We found the service managed risk well whilst ensuring people led a full life. However, some risk assessments documents had not been reviewed since 2013.

Is the service effective?

The service was effective. In addition to training essential to the service staff received additional training in areas specific to the people they supported.

People had access to a wide range of healthcare services which meant their day to day health needs were met.

Is the service caring?

The service was caring. We found there was a calm relaxed atmosphere within the home and staff helped people to maintain their privacy. This showed us people's dignity was protected and respected.

People were encouraged to maintain and develop their independence. We saw relationships between staff and people were strong and supportive.

Staff knew the people they were caring for well and communicated with them effectively.

Is the service responsive?

The service was responsive. Care plans were personalised and reflected people's individual needs. This meant staff knew how people wanted to be supported.

People had access to a wide range of meaningful activities and were supported to be involved in their local community. Staff were aware of what mattered to people and ensured those social needs were met.

Staff views were sought at regular staff meetings.

Is the service well-led?

The service was well-led. We found there was an open and positive culture within the home. People who lived at the service told us the new acting manager and staff were approachable if they had any concerns or suggestions.

The views of people connected with the service were not formally sought out but people told us they felt listened to and told us they felt able to talk with staff at any time.

The service had links with other health care professionals who visited the home. This showed us people had access to appropriate care services .

As part of our inspection we spoke with the new manager and with care staff who were on duty. Since our previous inspection of Kernou Residential Home [Kernou] the new manager had been working to make improvements to become compliant with the Essential Standards of Quality and Safety.

We spoke with people, who lived at Kernou; people we spoke with told us they were happy and staff were kind. One person told us, 'Things are okay'.

We spoke with people about how they felt since the new manager had been appointed. People told us they 'liked' the new manager, and provided us with examples of how the new manager had been helping them, for example taking them to their work placement and arranging time for them to go out shopping.

We found, people were not always able to maintain their independence and be encouraged to take an active part in their community because transport was not always available to take people to work placements and social engagements. Arrangements were not in place regarding finances, for example for someone to act on the behalf of the person, where the person who used the service agreed to it or it was legally authorised or required.

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.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received.

Records were kept securely.

We found, people's privacy, dignity and independence were respected and people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People who used the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were not supported to deliver care and treatment safely and to an appropriate standard.

Records were not kept securely.

People who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received. The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We spoke with three people who used the service, who all told us that they were happy at the home. One person told us they liked to live at Kernou and said the staff were nice.

We heard that staff were respectful in the way in which they spoke with people who used the service.

Staff told us that people chose how they spent their day when they were at home and not at their work placement. During our inspection we saw people who used the service were involved in various activities both within the home and going out. Three people went out in the home's mini bus to St Ives for a drive, one person went for a walk and two others watched television and chatted to each other and to the staff.

We found each person who used the service had written documentation in place that provided detailed information for the staff and visiting professionals about the person's assessed health and social care needs and associated risks (risk assessments). This information was personalised, clearly identified the person's preferences and choices and provided clear guidance and direction for staff on the action they had to take to meet people's assessed care needs.