We carried out a review of the data available to us about Kingswood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kingswood House, you can give feedback on this service.
older people, including people living with dementia. At the time of the inspection 18 people were using the service.
We found the following examples of good practice.
¿ Clear processes were in place for facilitating family and professional visits safely. Window visits could take place throughout the pandemic period as all bedrooms were on the ground floor. Consideration was given to the shortest routes to a person’s bedroom if they received a professional heath visitor such as a district nurse.
¿ The service participated in regular Covid-19 testing of staff and people living in the service. This meant swift action could be taken to prevent the spread of infection in the event any test results were positive.
¿ Staff had access to sufficient supplies of personal protective equipment (PPE) including hand sanitiser, masks, gloves and aprons. Staff were seen to be wearing masks during the inspection visit. Staff had received additional training in infection prevention and control, and how to put on and take off PPE safely.
¿ Cleaning of all areas of the service took place regularly and domestic staff were on shift seven days per week to support this. Disinfection of communal areas, high touch areas such as handrails and door handles, and equipment such as walking frames occurred throughout the day and night.
¿ The staff team took on extra shifts to cover gaps in the rota as far as possible. This meant the service had minimal use of agency staff. If agency staff were used, the same worker attended and they undertook Covid-19 testing. None of the permanent staff team worked in any other care service. These staff practices reduced the risk of cross infection.
¿ Furniture had been moved around in the lounge and dining areas to support social distancing. This meant people could still spend time in communal areas which supported their wellbeing and reduced the risk of isolation.
Further information is in the detailed findings below.
Kingswood House is a residential care home registered to provide personal and nursing care for up to 26 older people, including people living with dementia. At the time of the inspection 18 people were using the service.
People’s experience of using this service and what we found
Since the last inspection changes in management had caused some disruption in the systems to manage oversight on quality at the service. At the time of this inspection a new manager had taken up post and an application to register with the Care Quality Commission (CQC) was in progress. The manager had previously worked at a senior level at the service and understood the needs of the service. The provider visited the service on a regular basis, they were very receptive and pro-active in response to the findings of this inspection.
Staff recorded accidents and incidents, but a system to reflect and analyse the reports for any trends or themes was not in place. Following the inspection, the provider implemented a monthly accident and incident audit system.
Information was contained in people’s care plans about meeting their oral care needs. But further work was needed to increase staff knowledge in this area. Following the inspection, the provider arranged for specific oral care training, and put in place oral care assessments and monthly audits. They had also met with a dentist to arrange for domiciliary dental visits to take place at the service.
The provider had an open-door policy, they said family members and people who use the service chose not to go through the formal complaint channels. However, they did not have an effective system in place to demonstrate the actions they had taken to address any concerns or complaints. Following the inspection, the provider placed literature on the complaints policy on display and implemented systems to record all concerns and complaints brought to their attention and their actions taken in response.
Having the above systems embedded into practice will enable the provider to identify where quality and/or safety may be compromised; to respond appropriately and without delay.
A range of individual risk assessments were in place that identified areas where people needed support to manage their safety. For example, risks of falls or skin tissue damage due to poor mobility and frailty. The assessments detailed the controls and equipment in place to reduce and manage the risks to an acceptable level.
Staff knew their roles and responsibilities in relation to keeping people safe. The provider co-operated with the local safeguarding authority in response to safeguarding concerns and investigations had taken place.
The staffing numbers were appropriate to meet the needs of people using the service. The provider closely monitored staffing levels to ensure they were suitable to meet people’s needs. Appropriate recruitment checks were completed, which included checks for any criminal convictions, and satisfactory employment references were obtained before staff started working at the service.
People received their medicines in line with the medicines policy and procedures. Staff received appropriate training and their competency to administer medicines was assessed. Regular medicines audits took place and any issues were dealt with in a timely way. Medicines reviews were carried out with the GP to ensure prescribed medicines were appropriate to people’s needs.
Staff received infection control training and understood the importance of using protective personal equipment (PPN) such as, gloves and aprons. Information was on display to remind people of the importance of good hand washing techniques.
Staff training records demonstrated mandatory health and safety training was provided to all staff and training to meet the specific needs of people using the service. Staff received regular supervision to discuss their work and learning and development needs.
People were supported to maintain a healthy balanced diet. People at risk of not eating and drinking enough were referred to the relevant healthcare professionals. People at risk of dehydration had fluid monitoring charts in place. However, the systems to check people received the recommended daily amount of fluids needed improving. The provider took immediate action by introducing a system to ensure people’s food and fluid monitoring charts were checked daily. This meant timely action could be taken to encourage people to increase their diet and hydration or when to seek medical advice.
People's needs were assessed, and people and their relatives were involved in the care reviews. People had regular access to healthcare professionals and staff sought support from health professionals in response to any deterioration in their health. Records showed that prompt referrals were made, for example to the GP and speech and language therapist and the staff followed the advice from healthcare professionals.
Routine health and safety audits and fire systems checks took place. Each person had a personal evacuation plan (PEEP) in place. Equipment used to support people to move, such as hoists were regularly maintained. A programme of redecoration, repairs and refurbishments was in place.
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.
All the people spoken with said they were pleased with the care they received. People's individuality was promoted and respected. People were encouraged to express their views and to make choices. People had formed positive relationships with staff and their privacy and confidentiality was maintained.
People’s care plans contained sufficient detail to guide staff on the care and support people required. They were reviewed regularly, and any changes were communicated to the staff team to keep them fully appraised of people's current needs. The provider was aware of the requirement to provide people with accessible information, we saw that information was provided in large print. Staff were aware of people with sensory, sight and hearing loss, and how they communicated.
A range of activities were provided for people. People were supported to maintain relationships with friends and family and there were no restrictions on visiting times. Staff received training on end of life care to ensure people were provided with the right support to have a comfortable, dignified and pain-free death.
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 23 June 2017).
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.
Kingswood House provides accommodation for older people requiring support with their personal care. The service can accommodate up to 24 people. At the time of our inspection there were 20 people living at the home.
At the last inspection, in April 2015, the service was rated Good. At this inspection we found that the service remained overall Good but that the provider needed to ensure that there was always sufficient enough staff to safely meet people’s changing needs.
Staff were appropriately recruited and people were protected from the risk of harm and received their prescribed medicines safely.
The care that people received continued to be effective. Staff had access to the support, supervision, training and ongoing professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.
People developed positive relationships with the staff who were caring and treated people with respect, kindness and courtesy. People had detailed personalised care plans in place which enabled staff to provide consistent care and support in line with people’s personal preferences.
People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.
The service had a positive ethos and an open culture. The provider and registered manager were visible, actively looking at ways to improve the service. There were effective quality assurance systems and audits in place; action was taken to address any shortfalls.
We carried out an unannounced comprehensive inspection of this service on 16 April 2015. A breach of legal requirements was found.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements and ensure people’s liberty was not deprived without proper authorisation.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met the legal requirements.
This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kingswood House on our website at www.cqc.org.uk.
During this inspection on 11 August 2015, we found that improvements had been made. Appropriate arrangements were now in place to identify potential areas where someone’s liberty might be at risk of being deprived. Applications had also been made, as is legally required; to seek authorisation to restrict some people’s liberty in order to protect them and keep them safe.
This inspection took place on 16 April 2015 and was unannounced.
Kingswood House provides a service for up to 24 people, who may have a range of care needs including dementia and physical disabilities. There were 17 people living in the home on the day of the inspection.
There was a registered manager in post. 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.
At the last inspection of Kingswood House on 25 September 2013, we asked the provider to make improvements to ensure that the temperature of medication storage was monitored to ensure it was kept within the recommended range. We also asked that the balance of medication stored in the home be better accounted for. We found during this inspection that the provider had taken positive action to address both these areas. Systems were in place to ensure people’s medicines were managed in a safe way and that they got their medication when they needed it.
We found that the service worked to the Mental Capacity Act 2005 key principles, which state that a person's capacity should always be assumed, and assessments of capacity must be undertaken where it is believed that a person cannot make decisions about their care and support. However, we found some people’s liberty had been deprived without proper authorisation.
Staff had been trained to recognise signs of potential abuse and keep people safe. People felt safe living at the service.
Processes were in place to manage identifiable risks within the service and ensure people did not have their freedom unnecessarily restricted.
There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs.
The provider carried out proper recruitment checks on new staff to make sure they were suitable to work at the service.
Staff had received training to carry out their roles, including support to achieve national health and social care qualifications.
People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.
The service had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.
Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.
We saw that people were given regular opportunities to express their views on the service they received and to be actively involved in making decisions about their care and support.
People’s social needs were provided for. We saw people preparing for activities that had been arranged on the day of the inspection.
A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to.
Systems were also in place to monitor the quality of the service provided and drive continuous improvement.
We spoke with three members of staff. All had a good knowledge of people's needs and preferences. One staff member explained that there were very few changes to the staff team explaining that people 'know who is helping them get up each morning.'
We saw that medicines were stored securely but the temperatures of the medication storage were not being monitored to ensure medication was stored within the recommended range.
We saw that new staff had induction programme followed by on on-going training to ensure that they had the skills and knowledge to support and care people living in the home.