We carried out a review of the data available to us about Kerria Court on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kerria Court, you can give feedback on this service.
We found the following examples of good practice.
Staff wore personal protective equipment (PPE) in line with current government guidelines. The registered manager conducted handwashing and PPE observations as part of a weekly audit of infection control at the home.
Comfort boxes were available for visitors of people receiving end of life care. They included items such as a separate kettle, drinks and a cushion. This meant that visitors could remain comfortable when spending time with loved ones at the end of their lives, whilst also maintaining good infection control practices.
In the event of a COVID-19 outbreak, plans were in place to manage the two floors of the home as separate zones. Staff would be cohorted to a particular floor and separate communal and dining areas would be in place. This would help to reduce the spread of infection within the home.
The provider had trained some staff members in elements of different roles. For example, some carers had been trained to complete domestic tasks. This supported the home to minimise the use of agency staff.
Kerria Court 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. Kerria Court accommodates up to 47 people in one adapted building. At the time of the inspection there were 39 people living in the care home.
There was a registered manager in post, however they were not at work at the time of the inspection, there was however an appointed manager to oversee the home. 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.
People were protected from avoidable abuse. Risks were assessed, identified and managed appropriately. Premises and equipment were maintained to minimise the risk of infection. Staff were recruited safely and staffing levels were sufficient to meet people’s needs. Medicines were managed safely. The manager had systems in place to learn when things went wrong.
People had their needs assessed and had effective care plans in place. Staff were trained to meet people’s needs and were able to offer consistent support to people. People had a choice of meals and they were supported to eat and drink safely. The environment was adapted to meet the needs of people and people were supported to access health professionals. 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.
People were supported by kind caring staff. Peoples communication needs were assessed and care plans supported people to make choices and retain their independence. People were treated with dignity and respect.
People’s preferences were understood and their diverse needs were assessed and planned for. People were supported to access activities and had their needs and wishes for end of life care considered. People’s complaints were investigated and responded to.
People and their relatives were involved in discussions about the service and their feedback influenced developments. We found systems in place to check on the quality of the service people received and the provider used information from these to make improvements. The manager had systems in place to monitor the delivery of people’s care.
There was a registered manager in the home. 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.
At the last inspection in July 2016 the service was rated Good. At this inspection we found the service remained Good.
People and their relatives told us they felt safe at the home. Staff were aware of the provider’s processes for reporting any concerns and understood their responsibilities to keep people safe from harm.
There were enough staff to support people safely and recruitment checks were in place to help ensure staff that were employed were safe to work with people. We reviewed the systems for the management of medicines and found that people received their medicines safely.
Staff had been trained to support people effectively. This included learning about the specific needs the person lived with. Staff told us that they received regular supervision and felt supported.
People were supported to have 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.
People told us they were offered meals which they enjoyed. People were supported to eat enough food and drink by staff who understood their nutritional needs. People's health was supported by access to a variety of health professionals.
Staff were caring in their interactions with people. The staff we met knew people well, and were able to tell us about people including their needs, preferences and people who were important to them. Staff maintained people's privacy and dignity whilst encouraging them to remain as independent as possible.
There were enough staff to support people to participate in the activities they chose. People's visitors were welcomed and there were no restrictions on when they could visit.
There was clear and visible leadership in place and the staff team felt supported by the management team.
There were effective systems in place to monitor and assess the quality of service being delivered.
Kerria Court is registered to provide care and support for up to 47 older people who have needs relating to their age or dementia. Nursing care is not provided. On the day of our inspection there were 43 people at the home.
The home had a registered manager in post who was available throughout our inspection. 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 observed people looking relaxed and at ease within the home, and with the staff who were supporting them. People and their relatives told us they felt safe at the home. Staff were aware of the provider’s processes for reporting any concerns. Staff understood their responsibilities to keep people safe from harm but had not ensured incidents of behaviour were recorded to ensure strategies to manage behaviour were suitable and effective.
We were informed by the deputy manager of concerns that had been raised by the coroner since our visits took place. We were informed these concerns related to an incident prior to our inspection where a person needed to be taken to hospital in an emergency. Staff had only shared verbally important information about risks to the person rather than in a written format. We were informed that at the time of this incident the home was in the process of introducing 'transfer records' but at the time, these had not been completing for everyone. We were given assurances that these had now been completed and reviewed following the coroner inquest. We were informed that the provider would be completing a 'lesson's learnt' report, which would be shared with us, once completed.
There were enough staff to support people safely and recruitment checks were in place to help ensure staff that were employed were safe to work with people.
Staff had been trained to support people effectively. This included learning about the specific needs the person lived with. Staff told us that they received regular supervision and felt supported.
We reviewed the systems for the management of medicines and found that people received their medicines safely. The registered manager had identified and was taking action to further improve the administration of prescribed topical creams and ointments.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions.
People told us that they were supported by staff who were kind, caring, attentive and compassionate. People were able to make decisions about how they wanted their care provided. Staff maintained people's privacy and dignity whilst encouraging them to remain as independent as possible.
People told us they were offered meals which they enjoyed. People were supported to eat enough food and drink by staff who understood their nutritional needs. People's health was supported by access to a variety of health professionals.
People told us that they played an active part and contributed to the planning and reviewing of the care they wished for. A variety of activities were provided to meet the interests of individual people. We saw people were engaged and were consulted about the activities programme.
People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality of the service and there were effective systems in place if people wished to make a complaint. The registered manager was aware of their responsibilities and had the skills and experience required to enable them to effectively lead this service.
The Inspection took place over two days on 23 and 25 February 2015. The inspection was unannounced.
We last inspected Kerria Court in June 2014 when we found the provider had breached the Health and Social Care Act 2008 in relation to the care and welfare of people who used the service and record keeping. Following that inspection the registered manager sent us an action plan informing us of the action they would take to address the breaches we found. At this inspection we found that improvements had been made and that there were no breaches of regulation. Further improvement was needed to ensure people consistently received a good service.
Kerria Court is registered to provide care and support for up to 47 older people who have needs relating to their old age or dementia. Nursing care is not provided. On the day of our inspection there were 42 people at the home.
A registered manager was in post but was on annual leave at the time of our inspection. 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. In the absence of the registered manager the home was being managed by two care managers.
People we spoke with told us they felt safe in the home and the staff made sure they were kept safe. People were supported by staff who had received training on how to protect people from abuse.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with people. Improvement was needed to the staffing arrangements to make sure there were enough staff to meet people’s needs. This had been recognised by the provider prior to our inspection and action was being taken to recruit additional staff.
We reviewed the systems for the management of medicines and found that people received their medicines safely but we were unable to establish if people had received their prescribed creams and ointments when they needed them.
The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including when balancing autonomy and protection in relation to consent or refusal of care. The associated safeguards to the Act require providers to submit applications to a ‘Supervisory Body’ for authority to deprive someone of their liberty. We looked at whether the service was applying the safeguards appropriately. The care managers and staff we spoke with understood the principles of the MCA and associated safeguards. They understood the importance of making decisions for people using formal legal safeguards.
People told us they were supported to eat and drink sufficient amounts to maintain their health but we found systems to monitor that people were getting enough to drink needed improvement. Risks to people’s nutrition were minimised because staff understood the importance of offering appetising meals that were suitable for people’s individual dietary needs. People had access to healthcare professionals when this was required.
People who lived at the home, their relatives and staff were encouraged to share their opinions about the quality of the service. We saw that the provider had a system in place for dealing with people’s concerns and complaints.
We found that whilst there were systems in place to monitor and improve the quality of the service provided, these were not always effective in ensuring the home was consistently well led. We found that some improvements were needed.
In July 2013 we inspected the home and at that time found that the home was non-compliant with three of the essential regulations. We issued compliance actions to ensure these areas of non-compliance were addressed and to ensure the service improved for people living at Kerria Court. We conducted this inspection to follow up on the issues of concern and see what progress had been made. Generally we found that many improvements had been made although the home had not yet achieved full compliance in all of the regulations we assessed.
We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
Staff we spoke with understood their role in safeguarding the people they supported. Staff demonstrated no tolerance for abusive practice and told us they felt confident to raise any concerns with the manager.
People in the home appeared relaxed and comfortable with the care staff who were supporting them. People confirmed they felt safe living at the home and the relatives of two people who lived at the home told us they thought people were safe. One person who lived at the home told us, 'I feel very safe here. If I wasn't happy I would talk to the manager. I've never been unhappy.' Another person told us, 'I've never had any abuse; if I did I would report it straight away. Usually the staff are very good and respectful'.
Records showed that all the equipment and services such as the gas and fire safety
system had been maintained and serviced regularly.
There was sufficient numbers of staff in place to meet people's needs. We observed that people were not left unsupervised in the lounge area and that people who were in their bedroom had a call bell within easy reach.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made under this legislation for any person living at the home , we found that the registered manager understood their responsibilities in relation to the law.
Is the service effective?
People told us that they were happy with the care they received. Comments from people included, 'It's very good, I'm quite happy here, I wouldn't want to go anywhere else.' Another person told us, 'I can't find fault.'
We spoke with the relatives of two people who lived at the home. They told us they were happy with the care provided. One relative told us, 'The home is excellent. This is the fourth home we've tried. I wish we had found it earlier.'
People's health and care needs had been assessed and risks related to people's health had been identified. However some of the care plans and risk assessments lacked details of the support people needed. The care plans were therefore not all able to support staff to meet people's needs in a consistent way.
We found that where people needed support from health professionals this was available. Records showed that people were able to see a doctor, optician or a chiropodist when needed. Assessment of people's nutritional needs had been completed and people were weighed regularly. All of the staff we spoke with were aware of the need to monitor people's weight regularly and advised us they would take action if any unexpected weight loss was observed.
Is the service caring?
We saw that staff were kind and caring in their approach to people. Our observations of interactions between staff and people using the service confirmed that staff knew how to support people. People who lived at the home were complimentary about the staff who supported them. One person told us, 'The staff are all very nice.'
People living at the home were mostly satisfied with the activities on offer but we did receive comments about people wishing they could go out of the home more. Comments from people included, 'The carer is taking me to the shop across the road this morning. They always take me once a week' and 'The care is very good here but I would like to go out more.'
We saw that there were menus offering people a choice of meal. We found that the food choices took account of people's cultural preferences. People were asked to choose the meal they wanted and, if they did not want either choice, we saw that an alternative was offered.
Is the service responsive?
We found from our previous inspection that the provider had taken some action to rectify concerns identified. During this inspection we identified a number of issues about which the provider took immediate action to rectify or improve the situation and to ensure people's care and support needs were being met.
At our last inspection we had identified that Improvement was needed to the systems in place to seek people's feedback about the service. At this inspection we found that meetings had taken place with people to seek their views. We found that a survey had been sent to the relatives of people who lived at the home. People were informed of the outcome of the survey and the actions taken in response in a newsletter. One person told us, 'We have had a residents' meeting, I've been to it, it was quite useful'.
We saw that there was a copy of the home's complaints procedure available to the people who lived in the home and those who may represent them. This contained the information necessary if they wanted to raise an issue.
The provider took account of complaints and comments to improve the service. One person who lived at the home told us, 'Because of my chest, I complained about smokers in the garden and they split the chairs and put the smokers further away.' A relative told us, 'The management and staff act on any concerns raised, they respond very quickly.'
Is the service well-led?
The service was led by a registered manager, who was supported by a district manager. Both were present during our visits to the home. Staff, relatives and people living in the home told us that the managers were accessible and took account of their comments.
The district manager told us that to improve the supervision and day to day running of the home the care manager had recently moved from an upstairs office to downstairs. The district manager also told us that it was intended to complete an overall service improvement plan for the home to enable improved tracking of actions taken to address any issues identified as needing improvement.
The findings of our visit identified that a number of improvements regarding record keeping were needed. This had also been identified by the provider's own audits and work was underway to achieve this.
The provider may wish to note that whilst improvements have been made, sporadic incidents where the home has not performed as well as it should and the home's history of not meeting regulation mean that the service needs to demonstrate that the quality of the service continues to be improved and sustained
We visited the home on two separate days and spoke with ten people who lived at Kerria Court. Some people were not able to share their views of the service so we used a number of different methods to help us understand the experience of people using the service.
We spoke with the registered manager, care manager, district manager, eight members of staff, and two health care professionals. We also spoke with the relatives of three people living at the home.
People we spoke with were complimentary about the home and told us that they were happy with the care they received.
Some action was needed to improve the meal time experiences of people to protect them from the risks of inadequate nutrition and dehydration.
Previously we found that improvements were needed to help protect people from the risk of abuse. This inspection found that improvements had been made.
There were not enough staff at all times to meet people's needs. Quality assurance systems had not been fully implemented and were not effective in identifying all areas that had needed improvement.
During our visit we spoke with ten people who lived at Kerria Court. Not all of the people were able to tell us in detail about their views of the home. We spoke with the registered manager, district manager, six members of staff, and a student on placement at the home. We also spoke with two relatives of a person living at the home.
The support we observed was delivered with kindness and respect. One person told us, 'It's very nice here, I would not want to go anywhere else.'' However, we found that some people did receive the support they needed to meet some aspects of their care. There were omissions and their care plans did not explain the care and support each person needed as fully as they should.
People were protected from the risks of inadequate nutrition and dehydration and usually received their medication in a safe way.
People who used the service may not be protected against the risk of unlawful or excessive control or restraint because suitable arrangements were not in place.
There were not always enough staff to meet people's needs.
The provider did not have an effective system to regularly assess and monitor the quality of service that people received.
People we spoke with were happy with the care they receive. People told us ' There are lots of activities here'. 'If you are unwell they look after you, they get you sorted straight away'. 'Staff support me to transfer in the way I need'. 'I'm happy here'.
Summary of our findings for the essential standards of quality and safety Page 3 of 44 The majority of people we spoke to were happy with the meals provided. People told us ' You can choose to have lunch in your room if you want to'. 'Food is very good here, very varied'.
People told us they were referred to health professionals when they needed to be. One visitor told us 'If people are not well they will get the GP out straight away'.
People told us 'Staff come and check on me to make sure I am okay, they look after you well'. 'They come quickly if I use the call bell'.
Visitors to the home told us 'I think there are enough staff'. 'Staff are always available if we need them'. 'There are always plenty of staff about at meal times'.
People spoken with were confident about whom they could raise concerns with and that their concerns would be addressed. One person told us 'I would tell a team leader if I had a complaint'.
Visitors to the home told us 'I have not made any complaints. If I had a complaint I would feel confident in raising it', 'We had information on making a complaint. They listen, they are welcoming of any concerns', 'We did not make any complaints but would have felt able to if needed. Staff here put themselves out for you'.