Updated 10 December 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of three adult social care inspectors, a nurse specialist and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care home. Visits to the service took place on 11 and 18 November, and telephone calls were made to relatives and friends on 18 November.
Service and service type:
Kun Mor and George Kiss is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
This inspection was unannounced.
What we did:
Before the inspection, we reviewed information we held about the service, including previous reports and notifications sent to us at the Care Quality Commission. A notification is information about important events which the service is required to send us by law.
The provider did not complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.
During the inspection:
We spoke with the registered manager, the deputy manager and the provider’s head of care. We also talked with five care staff including a team leader, the provider’s practice and clinical lead, housing and health and safety lead, housekeeping and kitchen management lead, and end of life and training leads.
On the first day of the inspection we spoke with eight people and the second day, three people who used the service. We made calls to thirteen relatives following the inspection visits. We also spoke with a visiting GP.
We looked at 10 people’s care records; records of accidents, incidents and complaints, audits and quality assurance reports and records of residents’ meetings and staff supervision records. We reviewed recruitment records for six staff.
We reviewed medicine administration records (MAR) and medicines management, as well as staff medicine competency assessments.