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Inspection carried out on 3 March 2021

During an inspection looking at part of the service

Kings Court is a residential home providing accommodation with personal care mainly to older people and people living with a dementia. It can accommodate up to 37 people in one purpose-built building. There were 28 people using the service when we visited.

We found the following examples of good practice.

• Systems were in place to allow safe visiting, including screening and testing visitors to reduce any potential infection risk, before they entered the building.

• Social distancing was encouraged, and changes had been made to communal areas to promote this.

• There was a robust activities programme and people were engaged in a variety of solo and group activities. We saw people had been supported through the use of social media to keep in touch with relatives. On the day of our visit, we saw one person who was “too busy” to speak to their relative on the phone as they were enjoying the activity session!

• Staff wore personal protective equipment (PPE). Training in infection prevention and control measures and the appropriate use of PPE had taken place. The home had a long established infection control champion in place who liaised with other leads within the provider's national group to share learning and developments.

• Systems were in place to admit people safely into the home.

• A regular programme of COVID-19 testing was in place for people and the staff team. The provider had a risk assessment in place for all staff who had refused the vaccination and the registered manager reviewed this with them monthly. There was a good programme of support and counselling available from the provider and the registered manager and deputy manager told us how they tried to support the emotional wellbeing of staff and of each other.

Further information is in the detailed findings below.

Inspection carried out on 20 June 2018

During a routine inspection

Kings Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation for up to 37 older people. On the day of our inspection there were 31 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Kings Court Care Home was last inspected by CQC in November 2015 when the service was rated as Good. At this inspection we found the service remained Good and met all the fundamental standards we inspected against.

People told us they felt safe and there were sufficient staff to meet people's needs. We found there was a consistent staff team who knew people well.

People received safe support with their medicines. We saw the home was clean and we spoke with the head housekeeper who explained their procedures in relation to upholding a clean, infection free environment.

Staff told us they felt well supported in their role; they received induction and training. Staff received supervision and appraisals.

People had choice and control of their lives and staff supported them in the least restrictive way; the policies and systems in the service supported this practice. We saw mental capacity assessments were well completed.

People had risk assessments that described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP and social worker.

Staff were aware of the importance of supporting people with good nutrition and hydration. People told us they enjoyed the food prepared by the kitchen staff at Kings Court.

People had access to healthcare services, in order to promote their physical and mental health. We saw the service worked well with community nursing services and the local G.P.

The premises were homely and suitable for people's needs. People were involved in decisions about the decoration and the provider had taken steps to make the environment more accessible in relation to people with memory issues. The environment and equipment was regularly checked and serviced.

There were detailed, person-centred care plans in place, so that staff had information on how to support people. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes, needs, and choices are taken into account.

End of life care was well managed in partnership with community services and the management team told us they were proud to support people at the end of their life to remain in the Teesdale vicinity.

There were opportunities for people to participate in activities. This included crafts, reminiscing, sing a longs, chats, bingo and activities outside the home.

There was a complaints procedure in place, should anyone wish to raise a complaint. People told us that any issues would be addressed but no one raised any concerns with us.

There was a quality assurance system, which enabled the provider to monitor the quality of the service provided.

We received positive feedback about the registered manager, deputy manager, staff and the service as a whole. Comments from people, relatives, staff and visiting healthcare professionals indicated there was a positive and open culture within the service.

Inspection carried out on 19th November 2015

During a routine inspection

The inspection visit took place on the 19 November 2015 and was unannounced which meant the staff and provider did not know we were visiting.

We last inspected the service on 23 April 2013 and found the service was compliant with regulations at that time.

Kings Court Care Home is registered with the Care Quality Commission (CQC) to provide accommodation for persons who require nursing or personal care for up to 37 people. The home does not provide nursing care. The home is owned and run by Care UK Community Partnerships Limited and is located in the centre of Barnard Castle, County Durham.

There was a registered manager in post who was on a training course at the time of the inspection. 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.

There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). There were two people subject to DoLS authorisations. We raised an issue regarding the appropriateness of the assessments being used by the service to assess someone’s capacity. The deputy manager agreed that some people at the service may lack capacity at times and this was not clearly recorded. During the inspection, the service immediately sought support and training and also sourced a more appropriate capacity assessment that they were going to implement straight away.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

All people told us they felt safe at the service. Staff were aware of procedures to follow if they observed any concerns. The staff team were supportive of the registered manager and each other. Feedback from visiting professionals on the day were very positive about the service at Kings Court.

On the day of our visit the deputy manager was on duty along with three other care staff members for 30 people. The layout of Kings Court is very complex with it being an old building and we observed call bell buzzers were constantly active throughout the morning. We witnessed the administrator supporting people with breakfast and at lunchtime and other staff such as the activity staff member helped out at this time. Feedback from all staff we spoke with was there were not enough staff to ensure the service ran smoothly. The service had recently had to use agency staff to cover sickness although they were actively recruiting. Whilst we did see that care needs were being met and people said they were well cared for, it was apparent that staff were extremely busy. We discussed this with the registered manager after the inspection who agreed to increase the number of care staff to four during the day whilst service user numbers remained at this level.

Appropriate systems were in place for the management of medicines so that people received their medicines safely. Medicines were stored in a safe manner. We witnessed staff administering medicine in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace.

There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. Training records showed that all staff had received an induction and statutory training was running at approximately 95% of staff being up-to-date.

We spoke with kitchen staff who had a good awareness of people’s dietary needs and staff also knew people’s food preferences well. They also told us that they received any equipment and supplies that they requested promptly. People told us they were very happy with the food at Kings Court and we saw where people needed nutritional support or monitoring this was carried out.

We saw people’s care plans were personalised and had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved, when they were able, the person. We saw people being given choices and encouraged to take part in all aspects of day to day life at the service.

The service encouraged people to maintain their independence and the activities co-ordinator ran a full programme of events which included accessing the community with people. We saw people popping in and out of the duty office to chat and spend time with staff and the deputy manager if they were in there and it was evident that staff listened and supported people to be comfortable in any area of the service.

We observed that all staff and the deputy manager were very caring in their interactions with people at the service. People clearly felt very comfortable with all staff members. There was a warm and caring atmosphere in the service and people were very relaxed. We saw people were treated with dignity and respect. Relatives and people told us that staff were kind and professional.

The service undertook regular questionnaires about the safety and quality of the service, not only with people who lived at the home and their family, but also with visiting professionals and staff members. We also saw a regular programme of staff and resident meetings where issues where shared and raised. The service had an accessible complaints procedure and people told us they knew how to raise a complaint if they needed to. We saw that complaints were responded to and lessons learnt from them. This showed the service listened to the views of people.

Any accidents and incidents were monitored by the registered manager to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks.

The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Kings Court. Action plans and lessons learnt were part of their ongoing quality review of the service.

Inspection carried out on 23 April 2013

During a routine inspection

When we visited Kings Court we found 30 people were living there. We spoke with seven of them. Everyone said they were very happy at Kings Court. One person said, "This place is absolutely brilliant; I couldn't be happier." People said the staff understood their needs and were always friendly and willing to help. One person said, "The staff are fantastic; nothing is too much trouble for them."

We found the provider was introducing new computerised care records. We saw this new system was easy to use, and presented information in a clear and logical way. All staff had received training in the new system and were complimentary of it. This meant the risk of people receiving unsafe or inappropriate care, treatment or support was reduced because the provider had an effective means of assessing the needs of people who used the service.

People said they felt safe at Kings Court. Staff were able to describe both safeguarding and whistleblowing procedures. We saw the provider had a safeguarding policy. This meant people were protected from abuse, or the risk of abuse, and their human rights were respected and upheld.

Staff said they felt supported by managers and were confident in their ability to provide good quality care. We saw staff received appropriate training.

We found the provider had a comprehensive range of quality systems and audits in place. In addition the provider sought feedback from the people who used the service, and staff.

Inspection carried out on 27 June 2012

During a routine inspection

People said they were happy at Kings Court Care Home. One person said "I'm as happy as I can be." People said they had been given the opportunity to look around the home before deciding to live there.

People told us they were happy with the care and treatment they were receiving. One person said "The staff will do anything to help" and another said "We are well looked after here, thank you."

People said staff had responded quickly on the occasions they had used their call bells to request assistance. One person who requested help from the staff during the inspection said the staff who attended to them were "Caring and helpful."

People said they were happy with the staff at Kings Court Care Home and the care they provided. One person said "The staff are really nice, they put themselves out, they'll do anything for you." Another person said "All of the staff are helpful."

People said they were aware of the complaints system. One person said "I know how to raise a complaint if I had to. I don't have any complaints though." All of the people we spoke with said they hadn't had any reason to complain.