8 June 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection team consisted of two inspectors and a member of the CQC medicines team.
Service and service type
Kenwyn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and the information we had requested when the inspection was announced.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people living at the service and a visiting healthcare professional. Some people were not able to tell us verbally about their experience of living at Kenwyn. Therefore, we observed the interactions between people and the staff supporting them. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We also spoke with seven care staff, two nurses, the registered manager, the deputy manager and the regional manager.
We reviewed the care records of six people. We checked 20 people’s medicines records and looked at arrangements for managing medicines. We also looked at a variety of records relating to the management of the service, including four staff recruitment files.
After the inspection visit
We continued to seek clarification from the provider to validate evidence found. We reviewed the additional documentation we had requested from the registered manager. We spoke with two healthcare professionals, who work with the service, and five relatives.
8 June 2021
About the service
Kenwyn provides accommodation with personal care for up to 109 people. There were 72 people using the service at the time of our inspection. Some people were living with physical disabilities, long term physical health and mental health conditions including dementia. Kenwyn occupies a large detached purpose-built building over two floors and is divided in to four units, two on each floor.
People’s experience of using this service and what we found
At our last inspection we made recommendations in relation to staffing levels, how staff were deployed, guidance for the use of agency staff and the provider taking advice about the development of a consistently open culture.
At this inspection we found there were enough staff on duty to meet people’s needs. Staff were allocated to work in specific units, which meant people received care from a consistent staff team. Staff told us there were occasions when staffing levels were lower than planned, when short notice sickness occurred. However, staff were re-deployed between units, to cover for absences, to ensure there was the appropriate skill mix in each unit.
The service had not used agency staff since the start of the pandemic, to reduce the risk of cross infection. This had resulted in people being cared for by permanent staff who had the skills and knowledge to meet the needs of everyone living at the service.
There was a positive culture within the staff team and staff told us they felt supported by the management team. The registered and deputy managers had built open and trusting relationships with staff and this had helped bring about the culture change since the last inspection.
Staff were recruited safely. The service had continued to recruit throughout the COVID-19 pandemic, to ensure there were enough staff to cover for sickness or for staff who needed to shield or self-isolate. Staff were supported by a system of induction, training, supervisions, appraisals and staff meetings.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Care plans were accurate and up to date. They provided staff with comprehensive guidance to ensure people’s needs were met. Risks were identified and staff had clear instructions to help them support people to reduce the risk of avoidable harm.
People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Staff were informed about people’s changing needs through effective shift handovers and informative records of the daily care provided for people.
Medicines were well managed, and people received their medicines safely as prescribed for them.
Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID testing for people, staff and visitors was being followed.
Visiting arrangements for people’s families had been facilitated, in line with government guidance at any given time, throughout the pandemic. Recently nominated relatives were making regular visits to see their loved ones, and this was welcomed.
People, their relatives and staff told us management were approachable and they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement. (Report published on 5 September 2019) and there were two recommendations. At this inspection we found improvements had been made.
Why we inspected
The inspection was carried out to follow up on the action we recommended the provider take at the last inspection. As a result, we carried out this focused inspection to review the key questions of Safe, Effective and Well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kenwyn on our website at www.cqc.org.uk.
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.