Archived: Kent House

Updated 24 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 was 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 31 March 2017 and 5 May 2017 and was unannounced. The first day of the inspection was carried out by an inspector, inspection manager, bank inspector and a specialist advisor who was experienced in medicine management. One inspector carried out the second day of the inspection.

Before our inspection, we looked at information the Care Quality Commission (CQC) had received about the service including notifications received from the service. We also looked at safeguarding referrals, complaints and any other information from members of the public. We talked with the local authority quality assurance team to see if they had any concerns or information on the service. The provider completed a provider information return (PIR) prior to the inspection. The PIR 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.

During this inspection we spoke with eight people who used the service, four relatives, the home manager, head of care, the administrator, a covering regional manager, and seven care staff members. We undertook general observations and reviewed relevant records. These included seven people's care records, 11 medicine records and care staff and other relevant information such as policies and procedures.

Updated 24 June 2017

We carried out this inspection on the 31 March and 5 May 2017. The inspection was unannounced.

At our last comprehensive inspection of 25 February 2016 Kent House was rated as requires improvement. At this inspection, although we found considerable improvements had been made there were still areas that required improvement. Improvements were still required in order to meet Regulations 12 and 17.

Kent House is registered to provide accommodation and support with personal care for up to 40 older people, some of whom have dementia. At this inspection there were 23 people using the service. Kent house is part of Gold Care Homes Limited which provides 20 care homes in England.

On the first day of our inspection on 31 March 2017 we found problems with needs assessments, access to GPs and district nurses and a failure to identify these matters and respond to them through the quality auditing process. Following the inspection the provider informed us they were to make a change to their legal entity. In order to check that action had been taken to address our concerns we carried out a second inspection visit before the legal entity had changed to check improvements. On the second day of the inspection we found that action had been taken to address the failings relating to needs assessments.

The service had not had a registered manager since February 2016. An application to register the current home manager had been submitted to the Care Quality Commission for registration along with the provider’s application to change their legal entity. The new legal entity will have a registered manager for the service. 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. It is condition of registration that a registered manager is in place at the home.

Whilst some improvements have been made to the registered provider's governance systems, we found processes for assessing and monitoring the quality of the service were not fully effective. The auditing system had not identified issues we found during this inspection.

We found medicines were not always managed safely. This related in the main for those people who had recently moved to the home.

Following our initial feedback to the home, on the second day of the inspection we saw that the home had started to make improvements.

We saw evidence the home had revised its procedures for admitting new people to the home. The revised procedure aimed to ensure there was a smooth transition when people moved to the home and that care was individually tailored. We saw evidence of this in two admissions that were carried out since our first visit.

The home had made progress in its bid to ensure there were robust local arrangements with members of the multi-disciplinary team, such as the GP, district nurses and pharmacist. This was necessary in order to ensure these services were accessed in a timely manner by people living at Kent House.

We identified improvements care and support of people who had recently moved to the home. Their needs had been fully assessed, planned for and met.

People’s risk assessments reflected their current needs. There were plans in place to mitigate these risks. Staff had clear instructions about the care people required.

Procedures for pressure sore prevention and management had been improved. People were being repositioned according to their tailored schedules.

We saw that the home had improved the practice of seeking consent. They adopted a practice that was in line with the Mental Capacity Act 2005.

The meals provided at the home were good. People were supported to make sure they had enough to eat and drink. Where people had special dietary requirements, this was supported to meet people’s needs.

People were treated with respect and kindness. Staff supported people wherever possible to make decisions and express their wishes and views.

We found two breaches of regulations. You can see what action we asked the provider to take at the back of the full version of this report