Kingsley Rest Home

Kingsley Rest Home is a residential care home providing personal care to up to 21 people. The service provides support to older adults, some of whom were living with dementia. At the time of our inspection there were 20 people using the service.

People’s experience of the service and what we found:

People were safeguarded from abuse and avoidable harm and the provider assessed risks to ensure people were safe. There were sufficient numbers of staff and the provider operated safe recruitment processes. People were supported to receive their medicines safely. Staff followed safe infection prevention and control practices. The provider learned lessons when things had gone wrong.

There was a positive and open culture at the service and the provider understood their responsibilities under the duty of candour. The provider had a clear management structure that monitored the quality of care to drive improvements in service delivery. People and staff were involved in the running of the service and fully understood and took into account people’s protected characteristics. The provider had created a learning culture at the service which improved the care people received and the provider worked in partnership with others.

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.

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 9 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Kingsley Rest Home on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kingsley Rest Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kingsley Rest Home accommodates up to 14 people in one adapted building and provides support for people who predominately have a physical disability and/or a mental health condition such as dementia. At the time of the inspection there were 13 people living in the home.

There was a registered manager at 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.

Improvements were needed to ensure effective systems in all areas of care provision were in place to assess and monitor the quality of the service people received.

People received safe care and we found there were enough staff to provide support to people that met their needs. We found that people were protected from the risk of harm and received their medicines safely. The provider had safe recruitment procedures in place to ensure that staff were of a good character and suitable to support people who used the service. Infection control measures were in place to protect people from the risks of cross infection.

People were supported to make decisions about their care and staff sought people’s consent before they carried out support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Improvements had been made to ensure the environment was safe. People’s health and wellbeing was maintained and staff sought advice if people were unwell. People enjoyed the food and were supported with their nutritional needs. Staff received training to enable them to support people’s needs effectively. There were good communication links within the service and with external agencies.

People were treated with dignity and staff were caring and kind. People’s privacy was respected an upheld. Staff understood people’s individual communication needs and people were given choices which ensured their individual preferences were met.

People were supported with interests and hobbies that were important to them. People and their relatives were involved in the planning and review of their care. Staff knew people well, which meant people were supported in line with their preferences. There was a complaints policy in place and people understood how to complain if they needed to. People’s end of life wishes were gained.

People were involved in the service and encouraged to provide feedback about the way the service was run. The registered manager was approachable to both people and staff and staff felt supported in their role.

The service had a registered manager. 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 and associated Regulations about how the service is run. A deputy manager was also working at the service on the day of our inspection. The registered manager was managing two services under the provider's registration and told us that they split their time between the two. On the day of our inspection the deputy manager called the registered manager in from the other service where they were based at the time we arrived.

We found that work was being carried out on the building and as a result some people's bedrooms were very cold and were unsuitable for them to use. We had received information prior to our inspection about the premises being cold and found this to be the case in certain areas when we inspected the home.

We found that some of the care plans and risk assessments we looked at contained out of date information and that one person had not had their medication for several days. This put this person at risk of harm.

We found some instances where the service was not delivering care which met people's individual needs and some of the documentation in place referred to care being delivered in a regimented way. Some people were not clear about whether they were able to get up when they wanted or whether they could choose where they spent their time.

We found that staff understood how to protect vulnerable people from abuse and that staff had received training in safeguarding vulnerable adults. Complaints had been logged and responded to and incidents were recorded and reviewed.

Staff were safely recruited and we found that there were enough staff to meet people's needs. Staff reported to be well supported by the management and we found that checks were in place to monitor staff performance.

The principles of the Mental Capacity Act (MCA) were being following and Deprivation of Liberty Safeguards had been applied for where appropriate.

People were given sufficient quantities of nutritious food and were supported as needed to eat and drink.

The service had a clear management structure in place and staff were positive about how the service was managed. However, the provider and the registered manager had failed to pick up on some of the issues that were identified during our inspection, including the routines and directions for staff which indicated a lack of person-centred care and raised concerns about people being woken up early in the morning.