Hallmark Kew House Luxury Care Home

Kew House is a residential care home that can provide nursing and personal care for up to 81 people in one adapted building. At the time of our inspection 69 older people were living at the care home, including people with residential and nursing care needs, and people living with dementia.

People’s experience of using this service

People living in the care home and relatives were positive about the standard of care provided at Kew House.

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 were kept safe, and were confident any concerns they raised would be listened to. Staff understood how to safeguard people. People were cared for and supported by staff who knew how to manage risks people might face. The premises were kept hygienically clean, and staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. Medicines systems were well-organised, and people received their prescribed medicines as and when they should. The service was adequately staffed by people whose suitability and fitness to work at the care home had been thoroughly assessed.

People living at the care home, their relatives and staff working there were all complimentary about the way the service was managed, and how approachable the staff in-charge all were. The provider promoted an open and inclusive culture which sought the views of people living at the care home, their relatives, community health and social care professionals and staff working there. The provider worked in close partnership with various community health and social care professionals and agencies to plan and deliver people's packages of care and support.

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

Rating at last inspection and update

The last rating for this service was outstanding (published 18 December 2019).

Why we inspected

We undertook this inspection to check whether the service was continuing to provide an outstanding rated service to people.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains outstanding. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kew House at www.cqc.org.uk.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. If we receive any concerning information, we may inspect sooner.

Hallmark Care Homes (SW19) Limited (also known, and referred to throughout this report, as Kew House) is a care home providing personal and nursing care for 81 people at the time of the inspection in one adapted building. The service can support up to 81 people.

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

The provider had a comprehensive, evidence-based dementia strategy in place that governed all aspects of service design and delivery, as well as the work of staff at all levels. This strategy highlighted the importance of social engagement, communication, relationships and a sense of ‘personhood’ that resulted in positive outcomes for people and an enhanced quality of life.

The service ensured people, relatives and associated professionals were at the heart of assessment, care planning and care delivery. People received good, effective care and support from a highly skilled staff team. 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.

Staff, relatives and people told us about their experience of living and working in Kew House, and the strong relationships built between people, staff and relatives. People were treated with dignity and respect.

People had access to a wide range of activities which enabled them to live fulfilled and active lives. There were numerous examples of staff’s endeavour to provide meaningful experiences and lasting happy memories. There were examples where staff had gone the extra mile to ensure people were able to fulfil their wishes. The provider had invested in technology to support people and this had proved beneficial both in terms of well-being outcomes and engagement during family visits.

The registered manager was proactive in ensuring they had a visible presence within the home and operated an open-door policy ensuring that any low-level concerns were dealt with promptly, preventing escalation. Staff were praised and encouraged to develop their skills and qualifications and flourished under a transparent and enabling culture.

The service was well-led by a management team whose determination and drive was to deliver an outstanding service, leading by example, fully committed to quality and placing people at the heart of everything they did. The whole home approach was evident and enabled staff to develop skills transferrable to other roles/duties within the service and a clear sense of teamwork. The provider had systems in place to monitor and improve the quality of the service including high quality communications sharing good practice and achievement across the organisation.

People received a service that was safe, were protected from abuse and avoidable harm. Staff received training and were confident about raising concerns if needed. Accidents and incidents were recorded with managerial oversight to identify any emerging patterns to prevent recurrence. People were supported by a sufficient, dedicated and consistent staff team who knew them well. Medicines were managed and administered safely. Measures were in place to prevent and control the spread of infection.

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 25 August 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Hallmark Care Homes (SW19) Limited, also known as Kew House, provides accommodation and personal and nursing care for up to 81 older people. The service operates over three communities. Each community occupies a floor of the home. Oak community on the ground floor provides personal care and support. Cedar community on the first floor provides support to people living with dementia, and Maple community on the second floor provides nursing care. At the time of our inspection 70 people were using the service.

A registered manager was in post. They had been at the service since December 2015 and were registered when the service was re-registered in July 2016. 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.

On the whole there were sufficient staff on duty to meet people’s needs. Staff were aware of the support people required and provided them with this promptly. Staff were aware of their responsibilities to care for people, including to safeguard them from harm and to work in accordance with the Mental Capacity Act 2005. Staff received the training they required to undertake their role. Staff reported that they felt well supported by their management team, however, we found that staff had not received supervision at the frequency stipulated in the provider’s policy.

People’s care and support needs were assessed, and on the whole detailed care plans were produced informing staff how to meet these needs. We saw that this considered a range of support needs including in relation to people’s physical health, psychological health and social needs. The majority of people had care plans in place outlining their wishes in regards to end of life care. However, we identified that this was not in place for all people and did not always take into account pain management. People were able to access healthcare professionals when needed, and staff liaised with specialists for advice when needed.

Staff were aware of the risks to people’s safety, and management plans were in place to minimise and manage those risks. The risks were reviewed regularly to identify if they had changed and if people needed additional support. We saw that appropriate action had been taken to reduce the risks of people falling and developing pressure ulcers at the service. Staff also monitored people’s food and fluid intake for those at risk of becoming malnourished or dehydrated.

There were positive and caring interactions between staff and people using the service. Many of the people at the service considered the staff as “friends”. We observed staff engaging people in conversations and a number of different activities. There was a comprehensive lifestyle (activities) programme in place and people were able to choose what activities they participated in and how they spent their time. The staff had organised for people to interact with the local community through links with local schools and via the ‘pre med’ project. This involved students prior to starting their medical degrees undertaking work experience at the service.

People’s privacy and dignity was maintained. Staff were aware of people’s individual preferences and supported them with any cultural or religious needs they had.

The provider obtained feedback from people and their relatives to inform service provision, and to identify where improvements may be required. We saw that a process was in place to monitor and respond to any complaints received. Staff were also asked for their opinions and encouraged to express their views. The staff were working with the provider’s regional dementia lead to implement the provider’s dementia strategy. This included supporting people and their relatives to further understand what dementia is and how this may impact on the people living on the dementia community. The registered manager had also started a “good care” workshop to further obtain information from relatives about what good care means to them, so that it could be used to improve service provision.

The registered manager and the senior management team regularly reviewed the quality of service provision through a programme of audits and review of key performance data. A thorough action plan was in place outlining what steps were planned to address all areas identified as requiring improvement.