Archived: Kingsmead House Care Home

Updated 30 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17 May 2017 and was unannounced. It was conducted by two inspectors, one experts by experience (Ex by Ex) and a nurse specialist (SPA). An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed all the information we held about the provider. This included information sent to us by the provider in the form of notifications and safeguarding adult referrals made to the local authority. A notification is information about important events which the provider is required to tell us about by law. We contacted the local authority quality assurance and safeguarding team to ask them for their views on the service and if they had any concerns, no concerns were raised.

On this occasion we did not ask the manager to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

As part of the inspection we spoke with twelve people, four staff members, the manager and five relatives. We also spoke with the chef, the maintenance person, the activity co-ordinator and one health care professional. We spoke to the regional manager and the provider before and after the inspection.

We spent time observing care and support provided throughout the day of inspection, at lunch time and in the communal areas. We reviewed a variety of documents which included four people’s care plans, risk assessments, and people’s medicine administration records (MAR). We also reviewed four weeks of duty rotas, four staff recruitment files, health and safety records and quality assurance records. We also looked at a range of the provider’s policy documents. We asked the manager to send us some additional information following our visit, which they did.

We last inspected the service as a focused inspection in the domain of Well Led on 27 January 2017. There was a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The previous fully comprehensive inspection occurred on 17 September 2016. There were four breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and enforcement action was taken against the provider in Regulation 17.

Updated 30 June 2017

Kingsmead Care Home House Care Home is a nursing home for up to 40 people, with a range of support needs including personal care, nursing needs and for people who require end of life care. On the day of our inspection there were 19 people living in the home.

There was a manager in post; however they were not yet registered with CQC. An interview date was pending. 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 told us that they felt safe, however, the provider had been issued with an Enforcement Notice from the Fire Service. The provider told us that the works would be completed by the end of June 2017.

There were sufficient staff to keep people safe. There were recruitment practices in place to ensure that staff were safe to work with people.

People were protected from avoidable harm. Staff received training in safeguarding adults and were able to demonstrate that they knew the procedures to follow should they have any concerns.

People’s medicines were administered, stored and disposed of safely. Staff were trained in the safe administration of medicines and kept relevant and accurate records. For people who had ‘as required’ medicine, there were guidelines in place to tell staff when and how to administer them.

Staff had written information about risks to people and how to manage these. Risk assessments were in place for a variety of tasks such as falls and moving and handling. The manager ensured that actions had been taken after incidents and accidents occurred to reduce the likely hood of them happening again.

There were mixed views about activities. Improvements had been made since the last inspection. There was an activity programme in place. The manager recognised that further work needed to be done in this area.

Improvements had been made in the home, however further work was needed with record keeping, ensuring that care records were fully completed and were personalised.

People’s human rights were protected as the registered manager ensured that the requirements of the Mental Capacity Act 2005 were followed. Where people lacked capacity to make some decisions, mental capacity assessment and best interest meetings had been undertaken, however they lacked details. Staff were heard to ask people’s consent before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had sufficient to eat and drink. People were offered a choice of what they would like to eat and drink. People’s weights were monitored on a regular basis to ensure that people remained healthy.

People were supported to maintain their health and well-being. People had regular access to health and social care professionals.

Staff were trained and had sufficient skills and knowledge to support people effectively. Staff received regular supervision and an annual appraisal.

People were well cared for and positive relationships had been established between people and staff. Staff interacted with people in a kind and caring manner.

People’s choices and views were respected by staff. Staff and the management knew people’s choices and preferences. People’s privacy and dignity was respected.

People received a personalised service. Care plans contained information for staff to support people effectively. However, it was not always evidence that people and their relatives had been involved in care planning. We have made a recommendation.

The home listened to staff and people. Some relatives told us that this was inconsistent. There was a complaints procedure in place. Complaints had been responded to in line with the provider’s complaints procedure.

The management promoted an open and person centred culture. Staff told us they felt supported by the management and that they were approachable. Relatives and people told us that they had seen improvements in the care provided however there were still some inconsistencies. Improvements could be made with some care records. We have made a recommendation.

There were procedures in place to monitor and improve the quality of care provided. The management understood the requirements of CQC and sent in appropriate notifications.