Kingfisher Court Care Centre

Kingfisher Court Care Centre is a residential care home providing accommodation and personal care for up to 40 people aged 65 and over, including people living with dementia, in one adapted building. At the time of the inspection 25 people were living at the service.

People’s experience of using this service and what we found

People were protected from the risks of abuse by staff who understood their responsibilities in relation to protecting vulnerable people.

Best practice guidance in the management of medicines was followed to ensure people received their medicines in a safe way.

People were supported by a knowledgeable team of caring staff who were recruited safely. Staff knew people well and understood how best to communicate with them in a way they could understand.

The service was clean and there were robust infection prevention and control measures in place. Staff wore appropriate personal protective equipment, adhering to the current Government guidance.

The nominated individual and manager had implemented effective checks and audits on the quality and safety of the service. When shortfalls were identified, action was taken to address these.

The service worked well in partnership with advocacy organisations and other health and social care organisations. This helped to improve the outcomes for people using the service.

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.

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 (published 5 February 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 13 January 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the breaches found in relation to staff deployment, assessing and managing risks and governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kingfisher Court Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kingfisher Court Care Centre is a residential care home providing accommodation and personal care for up to 40 people aged 65 and over, including people living with dementia in one adapted building. At the time of the inspection 25 were living at the service and one person was in hospital.

People’s experience of using this service and what we found

Staff deployment had not been consistent to ensure safe staffing levels were maintained. The provider took immediate action to address this.

Weight monitoring had not been fully effective. Repositioning charts showed some gaps in the expected frequency people required to be repositioned to maintain their skin integrity. Best practice guidance in the management of medicines was not consistently followed.

The provider’s internal governance, systems and processes had not fully identified the shortfalls in the expected care standards identified during this inspection.

Safe staff recruitment checks were completed before staff commenced their employment. Staff were knowledgeable about people’s individual needs. Relatives were complimentary about staff’s approach and considered them to be competent, experienced and skilled.

Staff had received safeguarding training and any concerns were reported and action taken to protect people from avoidable harm.

The prevention and control of infections were minimised due to infection control best practice being followed. Health and safety checks were completed regularly on the premises, environment and care equipment. Incidents were reviewed for themes and patterns and action was taken to reduce further risks.

Staff were positive about their role and shared the registered manager’s values in providing person centred, open and transparent care. Staff were clear about their role and responsibilities and received ongoing training and opportunities to discuss their work. Staff were positive and complimentary about the registered managers support and leadership style.

People, relatives and staff received opportunities to give feedback and this was used to develop the service. The provider and registered manager had met their registration regulatory requirements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 12 October 2017).

Why we inspected

We received concerns in relation to the management of falls and how people were protected from avoidable harm. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

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 coronavirus and other infection outbreaks effectively.

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. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

The provider took action to mitigate the risks and staffing levels were reviewed to ensure staff deployment was consistent in meeting people’s individual needs and safety.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kingfisher Court Care Centre on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified three breaches in relation to staff deployment, assessing and managing risks and governance of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Kingfisher Court Care Centre is registered to provide accommodation and personal care for up to 40 older people and people with dementia and physical disabilities. On the day of our inspection there were 39 people using the service.

At the last Care Quality Commission (CQC) inspection on 26 February 2015, the service was rated Good in all domains.

At this inspection we found the service remained Good.

There were enough staff to meet people’s needs, however at times staff were rushed and their interactions with people were task focused.

People could be assured that they would receive their medicines as prescribed by their doctor. People’s health needs were met and where necessary they had access to health professionals.

Staff understood their responsibilities to keep people safe. Risks were assessed and measures put in place to prevent avoidable harm. Staff understood how to raise concerns about people’s safety if they needed to. The provider followed safe recruitment practices.

People were supported by staff who had received training and support to meet their needs. Staff felt supported and their competency in their role was checked.

Our observation of the lunch time service was that it was chaotic at times and that people sat for a long time in the dining room before their meal was served. Records did not reflect that drinks or snacks were served over a 24 hour period. Where people had dietary requirements, these were met and staff understood how to provide these.

People had consented to the care they received. The service supported people in line with the requirements of the Mental Capacity Act. People’s mental capacity to consent to their care had been assessed where there was a reasonable belief that they may not be able to make a specific decision.

Staff at all levels treated people with kindness and compassion. People were supported to maintain their independence. However at times people’s dignity was not protected.

The care needs of people had been assessed and were regularly reviewed to ensure they continued to be met. Staff had a clear understanding of their role and how to support people who used the service.

People had access to activities so that they could follow their interests and remain active if they wanted to.

The provider had sought feedback from people and their relatives and staff about the service. People and staff felt that the deputy manager was approachable and action would be taken to address any concerns they may have.

Systems were in place to monitor the quality of the service being provided and to drive improvement. These had not always been effective in identifying when records relating to people’s fluid intake had not been accurately maintained. Where systems had identified areas of concern, action had been taken to address these in a timely manner.

The provider was aware of their responsibility to report events that occurred within the service to CQC and external agencies. There was not a registered manager in post at the time of our inspection. It is a requirement of the provider’s registration that there is registered manager in post.

We saw care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. We found people were not always receiving appropriate support with maintaining their skin integrity.

We spoke with four people using the service about the cleanliness of the home. They all told us that they thought the home was clean and tidy. One person said, 'It is very nice, staff clean my room and do my laundry.' Another person said, it's a lovely environment, it's kept clean and tidy.'

During our tour of the home we found it was clean and tidy and people's rooms were personalised. We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

We saw staff were being offered training and supervision to develop their knowledge and skills in relation to the job role they were to perform.

People using the service offered many positive comments about the care and support they received.

The complaints procedure outlined the steps that would be taken if someone raised an issue of concern to ensure this was dealt with to the person's satisfaction.

We saw there was an area called 'Memory Lane' in the service which lent itself to providing a stimulating and orientating environment to older people. The corridor was set out in the theme of a street which had a sweet shop window displaying sweets from years gone by, a telephone box (which contained a telephone for people to use) and a bakery displaying a range of breads and cakes. There was also a 'market stall' full of fresh fruit and we saw people helping themselves to the fruit to eat.

We spoke with four people using the service and they all told us they felt safe in the home. They all told us staff were always kind to them and they had not seen anything happen in the home which had caused them concern. One person said, 'I feel very safe here' and another said, 'I feel much safer here than I did at home.'

We observed positive interactions between staff and people using the service. There was a relaxed atmosphere and we saw that people using the service looked comfortable talking to staff.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.