Archived: Kington Court Community Care Centre

Kington Court Community Care Centre is a residential care home which provides personal and nursing care to people either permanently or temporarily. People living at Kington Court Community Care Centre are older people, who may live with physical disabilities, sensory impairment or dementia. There were 30 people living at the home at the time of the inspection. The service can support up to 48 people. The building is purpose built with all the accommodation and communal space located on the first floor.

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

People did not always have risks to their safety managed effectively. Risks within the environment were either not clearly identified or suitable action was not always taken to keep people safe. These risks included window safety, water temperatures, call bells and use of wheelchairs.

Peoples’ medicines were not always managed safely. Staff were not always managing and recording people’s pain relief patches effectively and in line with the manufacturer’s instructions to ensure people fully benefited from these. Clear action was not always taken when potential errors were made by staff members.

People’s care needs were not always met in a timely way by staff members. Observations made were fed back to the management team.

Management systems and audits had not always identified or actioned areas whereby improvement was required in order to keep people safe. Where improvements had been acknowledged these were not always sustained by staff consistently.

Feedback from people’s family members were positive in relation to staff and the care provided.

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 requires improvement (published 08 November 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to the management of medicines, staffing and management follow up. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. In addition, this inspection was based on the previous rating of requires improvement.

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.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kington Court Community 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 breaches in relation to people’s safety, medicines and good governance at this inspection.

Follow up

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.

Kington Court Community Care Centre is a residential care home which provides personal and nursing care to people living at the home either permanently or temporarily. People living at Kington Court Community Care Centre are older people, who may live with physical disabilities, sensory impairment or dementia. There were 34 people living at the home at the time of the inspection. The service can support up to 48 people.

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

The provider checks had not identified where people had not received their medicines as prescribed.

The environment presented a potential risk to people as areas of the flooring required improvement to ensure they were suitable for use.

The registered manager and provider’s representative told us their checks would be revised, to ensure people received the pain relief they had been prescribed, and improvements to the safety of flooring would be made.

People were supported by staff who understood their individual risks and who supported people to stay as safe as possible. There were enough staff to care for people at the time people wanted assistance.

People told us staff used their knowledge and the equipment provided when caring for them, to reduce the risk infections. Staff understood how to raise any concerns for people’s safety and were confident senior staff would take action to support people, should this be required.

People’s needs were assessed before they moved to the home, and staff developed an understanding of people’s preferences as they supported them. People were supported to see other health and social care professionals when they wanted this.

Staff encouraged people to have enough to eat and drink to remain well. People told us the meals provided were improving and gave us examples which showed how their preferences were met. Staff had received the training they needed to develop the skills required to care for people.

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.

People had developed strong bonds with the staff supporting them and told us staff were kind and often went the extra mile to help them and to show people they were valued. Staff encouraged people to make their own decisions about their care and people were supported to maintain their independence, dignity and privacy.

Care plans and risk assessments reflected people’s needs. People’s care was planned in consultation with them, their relatives, and with input from other specialist health and social care professionals, as people chose. People’s care plans were reviewed as their needs changed and considered people communication needs and preferences.

Staff supported people to do things they enjoyed and to remain connected with their faiths and people who were important to them. Systems were in place to manage any complaints. Compliments had been received from relatives regarding the quality of care provided to people at the end of their lives and the warmth of staff. The registered manager planned to identify people’s wishes in the event of people’s sudden death, so their wishes would be respected. Systems were in place to manage any complaints, and to take learning from these.

The registered manger and senior staff had put systems in place to work effectively with other organisations, and to take learning from any incidents. The manager understood their responsibilities and acted to inform CQC of important events at the home.

Staff understood how they were expected to care for people and gave us examples showing how senior staff and the registered manager had listened to their suggestions and driven through improvements in people’s care.

Rating at last inspection

The last rating for this service was Good, (published 30/11/2016).

Why we inspected

This was a planned inspection based on the rating at the last inspection.

Enforcement

We have identified breaches in relation to how people’s medicines and the premises are managed.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme, to ensure all improvements made are embedded. If any concerning information is received, we may inspect sooner.

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

The home provides accommodation for a maximum of 47 people requiring nursing and personal care. There were 45 people living at the home at the time of the inspection. The registered provider also provides treatment for minor injuries to people in the local community with a 'walk in' minor injuries unit.

There was 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.

The home was last inspected in August 2013, during which we did not identify any concerns.

Staff understood how to keep people safe and knew what they should do if they had any concerns. Risks to people's safety were assessed and minimised.

Staff understood people’s health risks and which symptoms were specific to the person and how to keep the person safe.

The provider followed safe recruitment processes to ensure people received care from a staff team who were suitable to support them.

People received their medications safely. People were supported to take their medicines as prescribed.

Staff received regular supervision and training appropriate to their roles.

People made individual choices in their meals and were supported to maintain a healthy diet.

The provider supported people to access a variety of health professionals to ensure they received effective treatment to meet their specific needs.

Staff showed compassion, dignity and respect when supporting people.

People were offered opportunities to pursue their social and spiritual interests.

The provider routinely and actively listened to people to address any concerns or complaints.

People told us the home was well-led and both staff and the management team were very approachable.

Staff also felt supported by the registered manager and felt part of a team.

There were systems in place to gain people’s experiences and to continually monitor the quality of the service provided.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the home had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. They said that the staff were friendly and always acted professionally. One person said, 'The staff are polite and helpful' and another said 'They are very respectful to people'.

People said that they were well looked after. They said that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

Staff provided health and social care support well. Community services were accessed to support people when necessary.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke of their awareness of how to keep people safe from harm. Staff told us about the training that the service had arranged for them to attend so that they would recognise abuse and how to report it.

People told us that staff were always available when they needed help. Relatives told us that staff were available to talk to when they visited. They said that staff were friendly and always acted professionally. One person said that, 'Nothing's too much trouble for them' and another said, 'They're all brilliant'.

People we spoke with said their comments were listened to. One person said, 'They keep you up to date with what's going on'.

You can see our judgements on the front page of this report.