You are here

The provider of this service changed - see old profile

Reports


Inspection carried out on 8 August 2017

During a routine inspection

The inspection took place on 8 and 9 August 2017 and was unannounced.

Kings Court is a care home for up to 38 people. It provides care and support to people over the age of 65 years living with dementia. At the time of our visit there were 24 people at the home. The home has a range of communal areas and well maintained accessible gardens.

The home had a registered manager in place. 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.

People were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence.

People said they felt safe at the service and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.

People were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way.

People’s medicines were managed safely. People had enough to eat and drink throughout the day and night. The mealtime was an inclusive experience.

There was an open and friendly culture combined with a dedication to providing the best possible care to people. Staff were approachable, knowledgeable, professional and keen to talk about their work. The atmosphere in the home was happy and calm. People were engaged and occupied; they interacted and chatted with each other. Every person we spoke to was complimentary about the caring nature of the staff.

Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.

There were enough staff on duty to support people with their assessed needs. The registered manager considered people’s support needs when completing the staffing rota and staffing levels were calculated appropriately. The registered manager followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People benefited from receiving a service from staff who worked well together as a team. The registered manager and the staff team took pride in their work and were looking for ways to improve the service. Staff were confident they could take any concerns to the management and these would be taken seriously. People were aware of how to raise a concern and were confident appropriate action would be taken.

The premises and gardens were well maintained. All maintenance and servicing checks were carried out, keeping people safe. People were able to contribute to improve the service. People had opportunities to feedback their views about the home and quality of the care they received.

Inspection carried out on 18 June 2015

During a routine inspection

This inspection took place on 18 June 2015 and was unannounced.

Kings Court is a care home for up to 38 people. It provides care and support to people over the age of 65 years living with dementia. At the time of our inspection there were 19 people living at the service. The service is purpose built, arranged over three floors accessed by a passenger lift, and situated in Horsham. Five of the bedrooms had adjoining en suite facilities. Long term care and respite care was provided.

There was 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.

At the last inspection in September 2014, the provider was in breach of Regulation 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This was because there were not sufficient numbers of suitably qualified, skilled and experienced staff employed to ensure the health, safety and welfare of people living in the service. The provider provided the Care Quality Commission with an action plan as to how they would address these issues. We looked at the improvements made as part of this inspection and judged that they were now meeting this requirement.

Since the last inspection there have been a number of changes to the service. The name of the service has been changed as this service was previously called Hazelhurst. The regulated activities being run from this service has also changed from a care home providing nursing care, to a care home providing residential care only for people living with dementia. The service has been subject to a significant refurbishment programme to improve the environment that people lived in. Advice and support has been taken to ensure the changes to the environment considered the needs of people living with dementia. Staff spoke of a significant period of change that they were still working through. The service was only at half occupancy at the time of our inspection. There had been a high turnover of staff which had led to a high use of agency staff to help cover the staff rota. The changeover of staff had affected the continuity and number of staff attending specialist training (such as dementia care) provided to enhance staff skills.

Senior staff and representatives of the provider carried out a range of internal audits, including care planning, checks that people were receiving the care they needed, for example for the completion of care plan and risk assessments, medication, and health and safety. However, they were not able to show us in all instances that following the audits any areas identified for improvement had been collated in to an action plan and how and when these had been addressed. There was no evidence of learning from any complaints or incidents and accidents in the service. This was to ensure the continuous improvement and development of the care provided.

The provider had detailed policies and procedures in place to direct staff and for staff to reference. However, these had not been regularly reviewed to ensure that current guidance had been considered. This was to ensure that staff had up-to-date guidance of the practices to follow.

People and their representatives had limited opportunities to give formal feedback on the care provided though meetings and the use of questionnaires. The provider had not actively sought the views of a wide range of stakeholders to analyse and use the information to improve the service.

The registered manager monitored peoples dependency in relation to the level of staffing needed to ensure people’s care and support needs were met. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

People were cared for by staff who had been recruited through safe procedures. Recruitment checks such as a criminal records check and two written references had been received prior to new staff working in the service.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. Staff had policies and procedures to follow and demonstrated an awareness of where to get support and guidance when making a DoLS application. A number of applications had been made we found that people could freely move around the service when they wished to.

Medicines were stored correctly and there were systems to manage medicine safely regular audits and stock checks were completed to ensure people received their medicines as prescribed.

There was a maintenance programme in place which ensured repairs were carried out in a timely way.

People's individual care and support needs were assessed before they moved into the service. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments were detailed and reviewed regularly giving clear guidance for care staff to follow. Peoples healthcare needs were monitored and they had access to health care professionals when they needed to.

People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner.

Visitors told us they felt people were safe. They knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to.

People said the food was good. Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences.

Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the manager, who they described as very approachable.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we have asked the provider to take at the back of this report.

Inspection carried out on 11 September 2014

During an inspection to make sure that the improvements required had been made

We carried out a follow up inspection to check action had been taken in areas where the service was not meeting minimum standards at our last inspection in April 2014. We gathered evidence against the outcomes we inspected to help answer two key

questions about the concerns we raised then: “Is the service safe?” and “Is the service effective?”

At the time of this inspection 22 people were living at the home. We spoke with two of them and relatives of another three in order to understand the service from their point of view. We observed care and support provided in the shared areas of the home. We looked at records and files. The registered manager was on leave when we visited the service. We spoke with the provider’s project manager who was providing cover and four members of staff.

This is a summary of what people told us and what we found.

Is the service safe?

People’s relatives said they were satisfied their family members were safe while using the service. However, two of the three relatives we spoke with raised concerns about the number of staff on duty. Records showed the service had failed to provide the number of care workers they had assessed as being necessary to meet people’s needs.

Although the provider had made improvements, and planned to continue making improvements, we found there were still not enough trained, experienced staff to ensure people were supported in a way that met all their needs. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staffing.

Is the service effective?

People who used the service received care and support based on detailed care plans and assessments. Where people required treatment for, or had been identified as being at risk of, a specific condition, appropriate risk assessments and care plans were in place. Processes were in place to ensure people received effective care according to their plans.

Inspection carried out on 9 April 2014

During an inspection to make sure that the improvements required had been made

We carried out a follow up inspection to check action had been taken in areas where the service was not meeting minimum standards at our last inspection in November 2013. We also used this inspection to answer our five questions. Is the service safe, is it effective, is it caring, is it responsive and is it well led? At the time of our inspection there were 26 people using the service. We spoke with two of them and relatives of another two in order to understand the service from their point of view. We observed care and support provided in the shared areas of the home. We looked at records and files. We spoke with the home’s manager and six members of staff.

At the time of our inspection the provider did not have a registered manager in post, but the manager had recently submitted their registration application.

This is a summary of what people told us and what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People’s relatives said they were satisfied their family members were safe while using the service. One person who used the service told us, “I am very happy here.” Staff treated people with dignity and respect. People were cared for in a clean, hygienic environment, and systems were in place to reduce the risk of the spread of infection. Arrangements were in place to deal with foreseeable emergencies.

However, we found there were not enough trained, experienced staff to ensure people were supported in a safe manner. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staffing.

Is the service effective?

People who used the service told us that they were satisfied with the care and support they received. One said, “I am happy here. I like it all.” People’s care plans contained assessments of people’s needs and instructions for staff about how to meet their needs. We observed staff supporting people effectively.

However, we found people’s needs for social interaction and stimulation were not consistently met. Where people were at risk of acquiring a pressure injury, we could not be certain their care plan was followed at all times. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the care and welfare of people who use services.

Is the service caring?

Relatives of people who used the service told us support was provided in a caring way. We saw staff were patient and encouraging when supporting people. They made sure people were happy with the outcome of care and support interventions before moving on.

Staff we spoke with were motivated to provide high quality care. They were aware of people’s needs and how they preferred to have their care delivered.

Is the service responsive?

People’s care plans took into account information about people’s needs and preferences. Where people were not able to communicate, information from family members or others was used. Care plans were reviewed regularly and the service responded to changes in people’s needs or circumstances. Visiting relatives told us they found the service listened to suggestions and comments about people’s care and support.

We found the service had systems in place to ensure the care and treatment provided was appropriate to people’s changing needs.

Is the service well-led?

Systems were in place to regularly assess and monitor the quality of the service provided. Risks were assessed and appropriate action plans were in place. There were processes in place to review and learn from incidents, accidents and complaints.

Inspection carried out on 19 November 2013

During an inspection in response to concerns

During our visit we met and spoke with six people living at the home and five relatives of people living at the home. We also spoke with seven members of staff. As the home looked after people with dementia, we found that some of the people that we spoke with were unable to provide us with meaningful verbal accounts of their experiences in the home. Therefore we gathered evidence by spending time watching how people spent their time, the support they got from staff and whether or not they had positive experiences.

We saw that staff addressed people by their preferred names. Personal care was carried out in private and staff were discreet when asking about care needs. We saw that people felt comfortable in approaching staff and asking for assistance.

Most of the relatives we spoke with told us that they were happy with the care that their loved ones had received at the home and that they felt that the home was meeting with their relatives care needs. One person said, “The staff are very good with him, and they are always friendly”. Another relative said, “We can visit at any time, and the staff couldn’t be nicer, we have only ever seen them being kind to the residents”.

However, one relative told us that they had concerns that their relative's dignity had been compromised by staff. Another relative told us that they felt that the laundry service at the home was not meeting with their relative's requirements.

We found that care records were not being updated correctly when people's care needs had altered. We found that the home was not meeting with appropriate infection control standards of cleanliness.

We also found that records were not always stored in a way that protected people's private information. We also found that records did not always contain accurate information and had not always been completed correctly by staff. We found that the home's quality systems were insufficient as they had not uncovered areas poor record keeping or infection control issues.

Inspection carried out on 10 April 2013

During a routine inspection

We spoke with five people and two relatives of people using the service during our visit. People told us that they were happy living at the home. One person said, "I like it here they are kind to me". Another person said, "I get what I need, I only have to ask".

One relative of a person with challenging behaviour told us, "They do a good job here, my relative has never settled anywhere before here but I feel that they are managing them well. The staff are always on hand and keeping an eye on them and I think they are well cared for." The relative went on to say, "I visit most days and my relative is always clean and well groomed. I watch the staff caring for other residents too and they are always polite and kind".

We spoke with five staff members during our visit. All of the staff that we spoke with felt that they were able to care for residents. They told us that communication was good at the home, and that they had the necessary skills and resources to meet people's needs effectively. One staff member said, "We do a good job here, I love working with the people here they are what gets me out of bed in the morning and coming in to work".

We found that people were cared for by staff that understood their needs as staff had received training and support to perform their roles effectively. We also saw that the organisation had systems in place to effectively monitor the quality of care that they were providing to people.

Inspection carried out on 4 December 2012

During an inspection to make sure that the improvements required had been made

We spoke with six people and one relative during our visit. People told us that they were treated with dignity and respect.

One person said. “ I have no problems here, I’m looked after and watch the telly I’m not unhappy about anything”.

Another person said. “I used to have hobbies but not here, I just have to potter about when I can. There’s just nothing much to do but I’m well looked after so can’t complain”.

A relative we spoke with said that due to their family member's dementia and associated limitations; “You can’t really give her choices and she doesn’t do anything here, but that’s because of her lack of ability, it's not to do with the home. She’s cared for very well here, nicely dressed, relaxed and in robust health. There are no outward physical signs of concern. She’s chair bound and just sits there due to her limitations. The staff are a good crowd, approachable and a caring lot and it’s a happy atmosphere here”.

We found that the home had a peaceful and calm atmosphere and that staff treated people in a polite and respectful manner. We had some concerns about the condition of care records; And felt that people in the home were under stimulated with a lack of activities and meaningful interactions with staff. We also had concerns around how the provider was monitoring the quality of its service provision.

Inspection carried out on 5 September 2012

During a routine inspection

We spoke with the relatives of three people, four people who use the service, and five members of staff during our visit to Hazlehurst.

People told us that the staff at Hazlehurst were respectful and kind.

One person said, “I am very happy with the care here”.

Two people that we spoke with felt that there were not enough staff on duty in the home, one person said, “sometimes they don’t appear to have enough staff and they do seem to use a lot of bank and agency staff”.

One person said, “my main criticism is that there is nothing for him to do here, no stimulation, no activities, he just sits in the chair all day”