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Inspection Summary


Overall summary & rating

Good

Updated 26 January 2018

This unannounced comprehensive inspection took place on 2 January 2018. The last inspection took place on 31 December 2015 when the service was meeting the legal requirements. The service was rated as Good that time. The service continues to be rated as Good.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Kimberley Court is a care home which offers care and support for up to 36 predominantly older people. At the time of the inspection there were 36 people living at the service. Some of these people were living with dementia. The service uses a detached building over three floors with a passenger lift for people to access all levels.

The current registered manager had been in post since April 2017 and had made many changes to the service provided. Staff were positive about the support they received from the registered manager. Healthcare professionals were positive about the service provided by Kimberley Court.

There were systems in place for the management and administration of medicines. People received their medicines as prescribed. The service had reported five medicine errors to CQC since January 2017. There were some gaps in the medicine administration records (MAR) where staff had not signed to show they had given a medicine. Regular medicine audits were being carried out but were not always identifying when staff had not signed MAR sheets. We were assured this would be addressed immediately.

The service held personal money for some people. This was easily accessed by people when they needed to purchase things such as hairdressing, newspapers or toiletries. Accounts were kept for each person. We checked the money held in cash which did not tally with the records, there was excess cash held. It was identified that money paid by staff and visitors for meals over the Christmas period had been added, in error, to the cash box and not recorded. This was resolved during the inspection.

Staff recorded some people’s food and fluids to ensure they had sufficient intake. However, some of these records were not clearly and consistently documented. Information in some people’s care plans was not clearly directing staff when and what to record. Action was taken by the registered manager immediately following this inspection to review, assess and stop the recording of two people’s intake as it was no longer required.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly. People had their capacity assessed and best interest meetings were held and documented as required. People were asked, where possible, to sign their own consent forms. However, the service did not have an accurate record of all appointed attorneys and what powers those people held to make decisions on behalf of people living at the service. An accurate record was compiled by the registered manager the day after the inspection visit.

Equipment and services used at Kimberley Court were regularly checked by competent people to ensure they were safe to use. The premises were regularly checked and maintained by the maintenance person. There had been problems with the heating system leading to the system having extensive work carried out before Christmas. However, two people’s bedrooms were found to be cold with radiators that did not work and one which was leaking. The registered manager took immediate action to address this concern with portable heaters provided and an urgent request to the heating engineers to return to the service to address the issue.

We walked around the service which was comfortable and appeared clean with no odours. People’s self-contained flats were personalised to reflect their individual tastes. Each flat door had identifying pictures and designs to help support people who needed additional orientation to their immediate surroundings. Each lockable door had a letterbox and doorbell. People were able to have keys to their own rooms if wished. People were treated with kindness, compassion and respect.

Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.

Staff were supported by a system of induction training, supervision and appraisals. Staff meetings took place to support each team of staff as well as whole service staff meetings.

Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm. People were supported by staff who knew how to recognise abuse and how to respond to concerns.

The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The registered manager had a record which provided them with an overview of staff training needs.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had no staff vacancies at the time of this inspection. However, we identified that some people waited a while before staff responded to their call bells. Staff who were present in the lounge were not able to hear call bells which rang in the corridor outside. The registered manager addressed this immediately and sent us evidence of a call bell point having been ordered for installation and pagers provided to staff.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Staff were available to support people with their meals. Staff sat with people and ate together to help make the meal a sociable occasion.

Care plans were well organised and contained clear information. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff.

The environment had been enhanced with a dementia friendly ‘street’ and interactive retro train carriage, taking people on a journey on the Bluebell line complete with station stops. This had been set up in the lower floor of the service accessible to people via the lift. Reminiscence activities were supported with an old style kitchen, sweet shop, games room, photographs of film stars, old newspapers and leaflets, baby dolls and prams and a number of activities and chats supported by the staff. An activity co-ordinator was not in post but specific care staff had been provided with support to provide a range of activities on a planned basis. During the inspection people were enjoying and paying attention to a range of entertainment that took place in the lounge.

People were supported to go out supported by staff for walks or to visit local attractions. People who enjoyed gardening had been supported to grow food which had been used to compliment the menu options available at the service.

The manager was supported by a deputy manager, team leaders and a team of motivated care staff. The district manager and dementia support advisor, who also attended this inspection, supported the registered manager. There were regular audits of many aspects of the service delivery in place and the provider monitored the progress of the service against desired objectives.

Inspection areas

Safe

Good

Updated 26 January 2018

The service remained Good.

Effective

Requires improvement

Updated 26 January 2018

The service was not entirely effective. The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. However, the records regarding who could consent on behalf of others were not completely accurate. We have issued a recommendation in this section of the report.

Records relating to the monitoring of people�s food and drink intake were not always clear.

Two flats did not have effective heating working. This had not been identified and reported prior to this inspection.

Staff were well trained and supported with regular supervision and appraisals.

People had access to a varied and nutritious diet.

Caring

Good

Updated 26 January 2018

The service remained Good.

Responsive

Good

Updated 26 January 2018

The service remained Good.

Well-led

Good

Updated 26 January 2018

the service remained Good.