Archived: The Kensington

The Kensington is a residential care home providing personal care for 21 older people at the time of our inspection, some of whom may be living with dementia. The service can support up to 35 people. The accommodation is a combination of old and new single storey buildings. The home is situated in the centre of Immingham close to local amenities.

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

A range of audits and checks were carried out to monitor the quality and safety of the service. However, these checks had not identified that the provider was failing to meeting the legal requirement to display their Care Quality Commission (CQC) rating in the service, and on their website.

People were supported by staff who kept them safe from harm. One person said, “I am well looked after here. I feel very safe.” A visitor told us, “My relative is so much better since coming here, has a much better quality of life.”

Staff understood how to safeguard people at risk and how to report any concerns they may have. Care plans had been developed to assist staff to meet people's needs.

People were supported by appropriately recruited and trained staff. Medication was managed by staff who had received training to do so.

The registered manager demonstrated a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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.

People told us they enjoyed the food, and that they had choice. Referrals to other health professionals were made when required. The environment was well maintained and suitable for the needs of the people who lived there.

People were supported to take part in social activities. The registered manager and provider responded to complaints received in a timely manner.

Staff had a good understanding of people's preferences of care and worked to promote people's independence. People were supported by kind and caring staff, who enjoyed their jobs and treated people with dignity and respect. End of life care was managed with compassion, taking into consideration people's views.

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 27 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection we recognised that the provider had failed to display their last inspection ratings. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

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.

This inspection took place on 8 December 2016 and was unannounced. The service was last inspected December 2015 and was found to be compliant with the regulations inspected at that time. However, it was rated as requires improvement because there were some practise issues and some recommendations made.

At the time of the inspection 23 people were living at the service.

Currently there is no registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Due to this the service can only be rated as requires improvement in the well-led domain.

People were cared for by staff who understood the importance of protecting them from abuse. Staff had also received training in how to recognise abuse and how to report this to the proper authorities. Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service. Procedures were in place which ensured people were not exposed to the risk of cross infection and the service was clean and tidy. People’s medicines were administered safely and staff had received training in this area. The medicine training was updated regularly. Systems were in pace to enable people to administer their own medicines with staff support if this was appropriate.

People were provided with a wholesome and nutritionally balanced diet. People’s choices were taken into account when devising menus and the cook asked people about their preferences for meals. Those people who had a poor appetite were provided with a fortified diet to ensure they received the right amount of nutritional intake. People were provided with snacks and hot and cold drinks. Staff monitored people’s dietary needs and health care professionals were contacted if anyone was experiencing any difficulties, for example, difficulty with swallowing or a poor diet. Staff had received training which equipped them to effectively meet the needs of the people used the service. This training was updated regularly and staff were supported to gain further qualifications and experience. New staff underwent a thorough induction which assessed their competency in stages; this ensured people were cared for by staff who had the right skills and experience to meet their needs. Systems were in place to ensure anyone who used the service that needed support with making informed decisions were protected by legislation, and any decisions made on their behalf was least restrictive and were made in their best interest.

People were cared for by staff who understood their needs, respected their privacy and upheld their dignity. People had good relationships with the staff and there was a lot of friendly banter and laughter around the service. People or their representatives were involved with the formulation of care plans. This ensured people received care which was of their choosing. Staff made sure people were involved in their care and took the time to explain to them what they were doing when providing support in personal care tasks. They also ensured people were safe and were not distressed by any actions undertaken, for example, when using lifting equipment.

Information was available to staff which described the person and their preferences, this helped staff to provide care which was person centred and of the person’s choosing. Care plans described how the staff were to support people and keep them safe, this included mobility needs, nutritional needs and tissue viability. People who used the serviced had access to a range of activities which they could participate in on a daily basis; however, more could be done to engage those people who were living with dementia in more meaningful activities. This was discussed with the acting manager on the day of the inspection and she was to undertake further research with the activities coordinator. The registered provider had an accessible complaints procedure in place and all complaints had been investigated wherever possible to the complainants’ satisfaction. Information was available which sign-posted people to outside agencies if they were not satisfied with the way the investigation had been undertaken.

The way the service was run was open and transparent. People who used the service, their relatives and others who had an interest in their welfare were consulted about the running of the service. This was achieved through meetings and surveys. Action plans were put in place to address any issues raised, these were time limited. Audits were undertaken to assess the effectiveness of the service and if it was meeting the needs of the people who used it. Again action plans were put in place to address any shortfalls identified. The management team were accessible to both staff and the people who used the service and saw suggestions as a way of moving the service forward and developing. Staff meetings were held so staff could have an input into how the service was run. All equipment used to assist people was regularly serviced and repaired when required, as was the fire detecting equipment.