Archived: Kings Park Nursing Home

Kings Park Nursing Home is a care home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection. The service is currently registered to support up to 40 people. Accommodation is provided over two floors and all the bedrooms are single occupancy. There are communal lounges and dining areas, bathrooms and an accessible garden.

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

People looked well cared for. Relatives spoke positively about the service and staff and felt their family members were well cared for. Risks were assessed and reviewed and checks and maintenance of equipment was being completed. Safer recruitment processes were being followed and generally there were enough staff to meet the needs of people. Medicines were being safely stored and managed. The home was clean and tidy, and a programme for redecoration 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.

Systems for oversight were in place and the registered manager and management team completed a wide variety of checks and audits to ensure the home was safe and drive improvements. Staff and relatives felt able to raise concerns and were confident that any issues would be addressed. Meetings were held to ensure staff and relatives were kept up to date on changes in the home. Staff and relatives told us communication worked well.

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 requires improvement (published 20 August 2019).

Why we inspected

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

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.

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 has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kings Park Nursing 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.

We found the following examples of good practice.

¿ National guidance was followed on the use of personal protective equipment (PPE) and regular Covid 19 testing was taking place. There were supplies of PPE readily available to staff and visitors. There was clear signage on the correct use of PPE and handwashing techniques throughout the home.

¿ Staff had received training in social distancing, handwashing, donning and doffing and infection prevention and control.

¿ There were detailed risk assessments, guidance and information available to staff and managers regarding Covid19.

¿ Arrangements were in place for ensuring safe visits, this included health screening and use of PPE. A 'visiting pod' was being built to allow safe visiting. Local restrictions on visiting were in place at the time of the inspection and alternative measures such as video calls were being used.

¿ The environment was very clean and clutter free. Clear and detailed cleaning processes and procedures were in place. Furniture had been arranged in a way that encouraged social distancing.

¿ There was a separate unit, within the home, available to allow safe admission into the home for new residents.

¿ Staff were very positive about the work they were doing and felt supported by managers and senior managers.

We were assured that this service met good infection prevention and control guidelines.

Further information is in the detailed findings below.

Kings Park Nursing Home is a care home providing personal and nursing care to 38 people aged 65 and over at the time of the inspection. The service can support up to 40 people. All the rooms are single occupancy. Accommodation is provided over two floors serviced by a lift. There are communal lounges and dining areas, and an accessible garden.

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

Relatives and staff told us there was sometimes insufficient numbers of care staff. This impacted on the amount of time people waited for assistance and support. The provider was in the process of recruiting extra staff and was utilising agency staff, and staff from other homes. The layout of the laundry area could be improved for effective infection control.

We have made a recommendation about laundry management.

Staff told us they wanted extra training to support people with complex needs. People told us they enjoyed the food at the service and specialist diets were provided where required. 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.

People were supported by staff who were kind and caring. Staff promoted independence and ensured people spent time with and enjoyed time with people who were important to them. People felt comfortable with staff and formed positive relationships. Staff were aware of people's privacy and dignity and made sure this was respected. People were listened to and had their choices responded to.

People were supported to take part in a variety of activities that they enjoyed and were meaningful. Complaints were responded to effectively. People's communication needs were assessed and responded to. Staff told us they had not been trained in end of life care.

We have made a recommendation about end of life care.

A new registered manager joined the home in May 2019 and had established an open and honest culture where staff and people felt able to share their views, and where incidents, safeguarding concerns and complaints were dealt with proactively. The registered manager had already recognised some areas we identified during the inspection as requiring improvement. The registered manager had a plan in place and was working to improve the service over time. Staff told us they felt valued in their roles under the new management.

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 (published16 January 2017).

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.

Kings Park Nursing Home is a purpose built care home and is registered to provide accommodation for up to 40 people who require nursing and personal care. At the time of our inspection there were 38 people living at the home.

There was a registered manager in post. 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.

People told us they were happy with the service and felt the staff did a good job. We heard how people felt the home was well-run and that the registered manager was extremely effective.

We found that a range of stimulating and engaging activities were provided at the home. There were enough staff to support people to undertake activities in the home and community. We saw people went on trips to museums and local pubs as well as the airport. On the day of our visit people were making baubles for the Christmas trees.

People’s care plans were tailored for them as individuals and created with them and their family involvement. People were cared for by staff that knew them really well and understood how to support them. We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful. We saw that they were aware of how to respect people’s privacy and dignity. Staff also sensitively supported people to deal with their personal care needs.

Staff were supported and had the benefit of a programme of training that enabled them to ensure they could provide the best possible care and support. Staff were all clear that they worked as a team and for the benefit of the people living at Kings Park Nursing Home. Their comments and feedback fed into the continuous improvement of the service.

The registered manager understood the complaints process and detailed how they would investigate any concerns. They actively sought people’s views and acted upon suggestions. They had also promoted a reflective learning culture in the home, which allowed staff to look at even the smallest of incident to determine what lessons could be learnt.

The registered manager and staff had a clear understanding of safeguarding. The registered manager acted as a champion for people and would raise complaints and safeguarding matters when this was needed.

We found that there were enough staff on duty to meet people’s needs. The registered manager had closely considered people’s needs and ensured there were sufficient numbers of staff. For the 38 people using the service there were two nurses, a senior carer and six care staff on duty during the day and then a nurse and six care staff overnight.

The registered provider had provided care staff with access to a development programme that allowed them to become competent in providing clinical care such as wound and catheter care. They also became trained to take blood and monitor people’s health. This programme was near completion for some staff and the registered manager told us the intention was that the staff would be employed within the home as a clinical support.

Where people had difficulty making decisions we saw that staff worked with them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations.

We reviewed the systems for the management of medicines and found that people received their medicines safely. Medicines were closely managed and this ensured people received their medication exactly as prescribed.

People told us they were offered plenty to eat and we observed staff to assist individuals to have sufficient healthy food and drinks to ensure that their nutritional needs were met. The cook provided a home cooked healthy diet and also provided a range of fortified meals for people who needed extra calories to ensure they maintained their weight. People were supported to manage their weight and nutritional needs.

People were supported to maintain good health. The staff had formed good links with the Consultants, GPs, dieticians, speech and language therapists, tissue viability nurses, community nurses and the falls team.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people. The staff team was stable and a number of the staff had worked at the home for over four years.

The service had a strong leadership presence with a registered manager who had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. Thorough and frequent quality assurance processes and audits ensured that all care and support was delivered in the safest and most effective way possible.

"The staff always keep me up to date with the condition of my relative. I have always noticed that there are enough staff around to help the people living here. A friend recommended this home because of the good staff and the good care they provide and now I have seen it myself."

"They do a lot of activities downstairs, but I would like to see them to do more upstairs."

"The staff are caring and know the people living here very well."

"I feel confident that the staff have the right skills to care for people properly."

"People here need a lot of help, I hope they make sure there are enough staff on duty at all times".

People told us they were satisfied with the care and support provided by staff and that they felt confident in raising concerns with the manager or the staff team.

During this visit we found that improvements had been made since the last inspection visit and this showed the management approach was positive and focused on improving people's experience of care and support.