We inspected Kirkley Lodge on 21 July 2015. The inspection was unannounced which meant that the staff and registered provider did not know that we would be visiting.
Kirkley Lodge is a two-storey purpose built care service that is registered to provide care to a maximum number of 47 older people across three units. Primrose and Roseberry units are on the ground floor. Primrose has 11 beds for people who have been identified as having ‘extra care needs’ whilst Roseberry has 12 beds for those people living with a dementia. Peacehaven is on the first floor and is a 24 bedded unit for people receiving personal care.
The home had a registered manager in place. 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 our last inspection of the service on 9 and 17 July 2014 we found that care records were not always accurate or fit for purpose. The registered provider sent us an action plan telling us they would be compliant by 30 June 2015. We checked care records at this inspection and found that improvements had been made.
There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Staff we spoke with were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. However we did notice that some water temperatures of showers were too cool. This was pointed out to the registered manager at the time of the inspection who told us they would take action to rectify the temperatures.
The care plans we looked at incorporated a series of risk assessments. They included areas such as the risks around moving and handling; going out; falls; skin integrity. nutrition and hydration. This helped to ensure people were supported to take responsible risks as part of their daily lifestyle with the minimum necessary restriction.
We saw that staff had received supervision on a regular basis and an annual appraisal.
Staff had been trained and had the skills and knowledge to provide support to the people they cared for. From the people and relatives we spoke with we received an even split as to whether people thought there was enough staff on duty to meet people’s need. We asked the registered manager to review their dependency levels of people who used the service to determine if there are sufficient staff on duty.
The registered manager understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) which meant they were working within the law to support people who may lack capacity to make their own decisions. However some staff had limited knowledge of MCA (2005) and DoLS.
We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
Appropriate systems were in place for the management of medicines so that people received their medicines safely. However, we saw that the temperature of some rooms in which medicines were stored in were on occasions too high. If medicines are not stored at the correct temperature they may not work in the way they were intended, and so pose a potential risk to the health and wellbeing of the person receiving the medicine.
There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, respectful, patient and interacted well with people. People told us that they were happy and felt very well cared for.
We saw that people were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met. Menus were varied and had been looked at to ensure that they were nutritious.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.
We saw people had been assessed and had plans of care in place. Some of the care plans we looked at would benefit from more detail to ensure that records detailed clearly how to meet the care and support needs of people.
At the time of the inspection the registered manager was looking to recruit an activity co-ordinator to plan and deliver activities to people who used the service. The previous activity co-ordinator had left two weeks before the inspection and in the interim care staff were delivering activities for people. We received mixed responses in terms of activities, some people preferred to spend time on their own and chose not to join in activities. Some people were happy with the level of activities but some felt that more activities could be taking place.
The registered provider had a system in place for responding to people’s concerns and complaints. People were asked for their views. People said that they would talk to the registered manager or staff if they were unhappy or had any concerns.
There were systems in place to monitor and improve the quality of the service provided. We saw there were a range of audits carried out both by the registered manager and senior staff within the organisation. We saw where issues had been identified; action plans with agreed timescales were followed to address them promptly.