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Reports


Inspection carried out on 4 July 2018

During a routine inspection

This inspection was unannounced and took place on 04 and 06 July 2018. We last inspected Kelvedon House on 20 July 2016, when we rated it as ‘good.’

Kelvedon House is registered to provide accommodation for 52 people who require nursing or personal care. People who live there may have a dementia type illness or a learning disability. At the time of our inspection 49 people were living at the home. The service is delivered across three units; Park View and Jobs Way which are predominantly occupied by people who are living with dementia and the third unit which supports people who have a learning disability.

A registered manager was in place. A 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 cared for by staff who were trained in recognising and understanding how to report potential abuse. Staff knew how to raise any concerns about people’s safety and shared information so that people’s safety needs were met.

People were supported by staff to have their medicines and records were maintained of medicines administered. People and relatives complimented the cleanliness of the home and staff used protective clothing when appropriate.

Staff were available to meet people’s individual needs and demonstrated good knowledge about people living at the home. Staff told us training helped them meet the specific needs of the people they supported.

Staff understood the importance of ensuring people agreed to the care and support they provided and when to involve others to help people make important decisions. The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS) and had submitted the appropriate applications where they had assessed that people were potentially receiving care that restricted their liberty.

People enjoyed a choice of meals and snacks and were supported to access professional healthcare outside of the home, for example, they had regular visits with their GP and any changes to their care needs were recorded and implemented.

People were supported to enjoy a wide range of activities and were involved in their day to day care and chose how to spend their day. We saw further developments including on site reminiscence shops were planned to support people living with dementia. People were encouraged to maintain their independence.

Staff were caring and treated people with respect. We saw people were relaxed around the staff supporting them and we heard and saw positive communication throughout our inspection and saw people smiling and responding positively to staff. Staff showed us that they knew the interests, likes and dislikes of people. We saw that staff ensured that they were respectful of people’s choices and decisions.

People knew how to raise concerns and felt confident they could raise any issues should the need arise and that action would be taken as a result.

The provider had systems in place to check and improve the quality of the service provided. We saw that where areas had been identified as requiring improvement actions had been taken in response.

The registered manager was available to people, relatives and staff and supported staff to carry out their roles and responsibilities effectively, so that people received care and support in-line with their needs and wishes.

Inspection carried out on 20 July 2016

During a routine inspection

Kelvedon House is registered to provide accommodation for 52 people who require nursing or personal care. People who live there may have a dementia type illness or a learning disability. At the time of our inspection 52 people were using the service. The service is delivered across three units; Park View and Jobs Way which are predominantly occupied by people who are experiencing a dementia type illness and the LD Unit which supports people who have a learning disability.

Our inspection was unannounced and took place on the 20 July 2016. At our last inspection in July 2014 the provider was meeting all the regulations but identified that some areas in the key questions of effective and well-led required improvement. We found on this our most recent inspection the provider had made the necessary improvements.

The service had a registered manager. 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 found that overall medicines were administered safely. Staff received training and had their competency assessed in relation to medicines administration. Systems were in place to protect people from abuse and harm. Staff were clear about their role in protecting people from any risks related to care delivery. Staff understood their responsibilities for reporting incidents, accidents or issues of concern. A suitable number of staff were on duty with the skills, experience and training required to meet people’s needs. Recruitment processes operated by the provider were effective.

People were supported effectively by well trained staff. Staff were provided with opportunities for developing their skills and reflecting upon their practice. New staff members were provided with a comprehensive induction. People using the service who were subject to a Deprivation of Liberty Safeguards (DoLS) authorisation were supported by staff in line with this. People’s nutritional needs were well understood and catered for. People’s health and wellbeing was monitored closely by staff and healthcare referrals were made as required to maintain their health and wellbeing.

People and their relatives were involved in planning care and making decisions. People were supported to make choices about all of aspects of daily living. Staff demonstrated kindness and understanding when supporting people. Staff were responsive to people when they were in discomfort or distress and provided them with reassurance and/or distraction. Information was freely available about how people could access advocacy support. People were encouraged by staff to try to do as much for themselves as possible, but staff were there to support them if they needed help. Staff were respectful towards people and provided any support they needed in a dignified manner. Staff had the confidence to challenge each other about dignity issues related to how they supported people.

People were encouraged to express their views and be involved in the planning of their care and support. People were supported to be as active as they wanted based on their personal choices and preferences. Care plans were detailed and demonstrated the level and type of support people required. The service had a dedicated activities coordinator who organised several activity sessions for people to be involved each day. People were supported to maintain and have regular contact with their family and friends. The provider used a variety of methods in order to listen to and learn from feedback from people. The provider acknowledged, investigated and responded to complaints in line with their own policy.

The registered manager had a good knowledge about the people using the service and their needs. Staff were well supported by the

Inspection carried out on 26 & 27 May 2015

During a routine inspection

Kelvedon House is registered to provide accommodation for 52 people who require nursing or personal care. People who live there may have a dementia type illness or a learning disability. At the time of our inspection 48 people were using the service. The service is delivered across three units, Park View, Jobs Way which is predominantly occupied by people who are experiencing a dementia type illness and the LD Unit which supports people who have a learning disability.

Our inspection was unannounced and took place on the 26 and 27 May 2015. At our last inspection in July 2014 the provider was not meeting the regulations which related to supporting workers. Evidence that we gathered during this, our most recent inspection, showed that improvements had been made.

The manager was registered with us as is required by law. 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 and/or their relatives told us they felt confident that the service provided to them was safe and protected them from harm. Staff we spoke with were clear about the how they could access and how to utilise the providers whistle blowing policy. The registered manager was able to demonstrate learning and changes to practice from incidents and accidents that had occurred within the service.

We observed there were a suitable amount of staff on duty with the skills, experience and training in order to meet people’s needs. People told us that were able to raise any concern they had and felt confident they would be acted upon.

People’s ability to make important decisions was considered in line with the requirements of the Mental Capacity Act 2005. However, care plans for people with Deprivations of Liberty Safeguards (DoLS) authorisations did not provide enough guidance as to how the person could be supported without restricting them unnecessarily.

People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration. The lunchtime experience was overall relaxed and positive for most people. People were supported to access a range of health and social care professionals to ensure their health needs were met.

Staff interacted with people in a positive manner and used a variety of communication methods to establish their consent and/or understanding. Staff maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible.

Information regarding how to access local advocacy services was clearly displayed. Staff were aware of how and when to access independent advice and support for people.

People and their relatives were involved in the planning of care and staff delivered care in line with peoples preferences and wishes. Staff supported people to access support for their spiritual or cultural needs.

Information and updates about the service was made available to people and their relatives, in meetings and with the use of a number of notice boards. The complaints procedure was made available in a variety of formats to maximise people’s knowledge and understanding of how to make a complaint.

People, relatives and professionals spoke positively about the approachable nature and leadership skills of the registered manager. Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Systems for updating and reviewing risk assessments and care plans to reflect people’s level of support needs and any potential related risks were not always effective. The registered manager showed us new documentation that was currently being implemented to improve and to develop more consistency in care records.

Quality assurance audits that were undertaken regularly by the provider. The registered manager had identified some of the issues we found during our inspection with records and the environment; but these had not been rectified in a timely or effective manner. The registered manager demonstrated to us that she had reported the environmental issue for several months to the provider. This meant the provider was aware but had not taken action.

Inspection carried out on 1, 2 April 2014

During a routine inspection

At the time of the inspection 40 people lived at Kelvedon House. This unannounced inspection was carried out over two days by two inspectors. We spoke with 11 people who lived there, four relatives, a visiting health professional, nine staff, the registered manager and provider. Some people were not able to tell us their views about the home. However people who we spoke with and their relatives were generally positive about the home.

In March 2014 the provider changed the homes legal entity with CQC. This meant that previous non compliance in respect of this service was not carried over and the home was therefore inspected as a new registration.

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 lead? Below is a summary of what we found. The summary is based on our observations during the inspection, discussion with people who lived at the home, their relatives, the staff supporting them, and by looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

One person told us, " Yes I do feel safe here". A relative told us, "The staff do everything they can to help my relative".

We saw that people were treated with respect and dignity by the staff. Some people were not able to tell us their views but some people who could tell us said that they felt safe living at the home.

Safeguarding procedures were in place and staff had a general understanding of their role in safeguarding people, but would benefit from some further training and support. The registered manager described to us their responsibilities in relation to Mental Capacity and the Deprivation of Liberty Safeguards. This ensured they were aware of what they needed to do to ensure people's well being and safety.

The registered manager had determined staffing levels based on people�s needs and was responsible for setting rotas. We saw from looking at rotas that senior staff were always on duty. This ensured that staff were available with the skills and knowledge needed to support people safely.

Systems were in place to promote learning from events including accident and incidents. This ensured that learning had taken place.

Is the service effective?

Visitors we spoke with confirmed that could visit throughout the day and they could meet with their relative in private. We saw that relatives were involved with people's care and some visitors supported their relatives at meal times and with aspects of their care.

People�s health and care needs were assessed and care plans told staff what people�s care needs were so they could support people consistently. Referrals had been made to external professionals so people got the support they needed to maintain their health and well being.

Staff had received most of the training they needed but some further training was needed to ensure that they had the skills and knowledge needed to care for people effectively. We have therefore asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staff training to ensure the service is effective.

The registered manager told us that they were in the process of setting up care plan review meetings with people and their family to review people's care. They also planned to ask relatives to complete an satisfaction survey to gain their views about the care of their relative.

Is the service caring?

We saw that people were supported by staff that was caring and kind. People were not rushed. Staff spent time sitting and talking to people. A relative told us, "The staff are very good, it is not an easy job that they do".

We found that people's preferences and interests had mostly been reflected in their care plan. Staff that we spoke with knew the needs of the people they supported.

Is the service responsive?

We saw that people completed activities in and outside the service. We were told about a trip for five people to see a premier league football match. On the day we inspected some people went out shopping and for lunch. We saw some people taking part in a group activity and some people enjoying one to one conversations with staff. This meant that people had meaningful activities to take part in.

Relatives told us that they would speak to staff if they were not happy about something.

Meetings had taken place with people and their relatives to enable them to contribute ideas about how to improve the service. Requests had been made to improve the laundry arrangements and the quality of food. This had been listened and responded to.

Is the service well-lead ?

The manager had recently registered with us, CQC.

Staff told us that they felt supported in their role by senior staff and the manager. Staff told us that many improvements had been made at the home since the registered manager had been appointed.

We saw that systems were in place to ensure that the service was continuingly improved. Improvements had been made to the quality of food and the laundry facilities. Staff had received support to carry out their role, more activities were taking place and more specialised resources for people with dementia care needs were to be introduced.