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Archived: Kingsthorpe View Care Home Good

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Reports


Inspection carried out on 28 April 2015

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

Kingsthorpe View Care Home is registered to provide accommodation, nursing care and personal care for up to 50 older people. The home is on two floors with various communal areas for people to sit and meet with relatives. There were 39 people living at the home at the time of our inspection.

This unannounced inspection took place on 28 April 2015. At our previous inspection on 10 & 11 July 2014 we found the provider was not meeting all the regulations that we looked at. We found concerns in relation to infection control, care and welfare of people, quality assurance and safeguarding. A warning notice was served regarding quality assurance. The provider sent us an action plan detailing when the improvements would be made by. During this inspection we found that the necessary improvements had been made.

At the time of this inspection the home did not have a registered manager. 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 and associated Regulations about how the service is run.

Staff treated people in a way that people preferred and there were sufficient numbers of staff to safely meet people’s needs. People received care which had maintained their health and well-being. Relatives were very happy with the care provided

Medicines were stored correctly and records showed that people had received their medication as prescribed. Staff had received appropriate training for their role in medicine administration and management.

Staff supported each person according to their needs. This included people at risk of malnutrition or dehydration who were being supported to receive sufficient quantities to eat and drink.

Staff respected people’s privacy and dignity. The majority of staff knocked on people’s bedroom doors and waited for a response before entering. People told us that staff ensured doors were shut when they were assisting them with their personal care.

People’s needs were not always clearly recorded in their plans of care so that staff had the information they needed to provide care in a consistent way.

People confirmed they were offered a variety of hobbies and interests to take part in and people were able to change their minds if they did not wish to take part in these

Effective quality assurance systems were in place to monitor the service and people’s views were sought and used to improve it.>

Inspection carried out on 10 and 11 July 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an unannounced inspection.

In October 2013, our inspection found that the care home provider had breached regulations relating to consent to care and treatment, care and welfare of people who use services, cleanliness and infection control, how the quality of the service was monitored and records. Following the inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we looked to see if these improvements had been made. We saw that improvements had been made in the areas of cleanliness and infection control and records. Issues remained regarding consent to care and treatment, the care and welfare of people who use services and how the quality of the service was monitored.

Kingsthorpe View Care Home is a care home providing accommodation and nursing care for up to 50 adults. There were 39 people living there when we visited. The care home provides a service for people with physical nursing needs and for people living with dementia. A registered manager was in post at the time of our visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm, however, we saw some examples of people being put at risk of avoidable harm. Suitable arrangements for staff to respond appropriately to people with behaviours which might challenge the service were not always in place or being followed. The Mental Capacity Act 2005 was not being adhered to. However, staff were recruited through safe recruitment practices and infection control procedures were being followed.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The DoLS are a code of practice to supplement the main Mental Capacity Act 2005 Code of Practice.

We looked at whether the service was applying the DoLS appropriately. These safeguards protect the rights of adults using services by ensuring that if there are restrictions on their freedom and liberty these are assessed by professionals who are trained to assess whether the restriction is needed.

The registered manager told us there was no one currently living in the home who was being deprived of their liberty. They explained that they had contacted the local authority for advice following recent legal judgments regarding DoLS and had been advised to complete documentation for all people living in the home. They were in the process of completing the documentation. We saw no evidence to suggest that anyone living in the home was being deprived of their liberty. We found the location to be meeting the requirements of the DoLS.

Not all staff were receiving supervision, appraisal and appropriate training as required. Records and observations showed that people who used the service were not always protected from the risks of inadequate nutrition and dehydration. We saw that limited adaptations had been made to the design of the home to support people with dementia. However, the home did involve outside professionals in people’s care as appropriate and people told us that staff knew what they were doing.

We observed interactions between staff and people living in the home and staff were kind and respectful to people when they supported them.

The service did not always respond appropriately to people’s needs and we asked the registered manager to make a safeguarding referral regarding the care being provided to one person. People told us they were not happy with the level of activities offered in the home. However, people who used the service told us they had no complaints and knew who to complain to if they needed to.

There were systems in place to monitor and improve the quality of the service provided, however, these were not always effective and people who used the service and their relatives were not regularly involved to drive improvement. However, staff told us they would be confident raising any concerns with the management and that the registered manager would take action. People told us that the registered manager was approachable and had taken action to improve the service.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 21 November 2013

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

We carried out this inspection to follow up on a warning notice we issued to the provider in respect of the safeguarding people who use services from abuse. We had told the provider and manager that the service must be compliant with the notice by 20th October 2013.

We spoke with two people living in the service who both told us that they felt safe in the home. One person said, “It’s all right here, the staff are alright.”

During our visit we found people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider was fully compliant with the warning notice.

Inspection carried out on 1, 2 October 2013

During an inspection in response to concerns

We found the previous registered manager had left employment. A new manager was now in post and working towards making the required improvements.

We found there had been improvements in respect of staff respecting people’s privacy and dignity. People using the service told us that staff were respectful at all times and their privacy and dignity were maintained.

We saw that people were able to make their own choices and decisions wherever able throughout our visit. One person said, “I am happy here, I can do what I want to do when I want to do it.” However further improvements were needed in respect of implementing the Mental Capacity Act 2005.

During our observations we saw there had been an improvement in respect of staff interactions with people and the way in which they responded to people’s needs. We saw that staff were available to give assistance to people where needed. Staff were responsive to individual needs.

We spoke with four people about the care they received from staff. They all told us they were happy with the care and support they received. One person said, “It’s wonderful care.” Another person said, “The staff are very nice, they look after me well. I am happy here.”

We found due to a lack of care planning and risk assessments that people were not fully protected from the risk of abuse.

We found there had been improvements in respect of the cleanliness and maintenance of the home.

We spoke with four people using the service and they told us they felt there were enough staff available to support them. We also spoke with a relative of a person using the service and they told us they felt there were enough staff to meet the needs of people.

Four people we spoke with told us they liked the staff and felt they supported them as they should. One person said, “They are nice and they know what they are doing.” Another person said, “The staff are very kind, they know how to look after me.”

We found there had been some improvement in respect of the quality assurance and record keeping.

Inspection carried out on 5 June 2013

During a routine inspection

We spoke to two relatives of people using the service during our visit to Kingsthorpe View Care Home. One person said, “I have found the manager very open to speak with. My [relative] has had some personal belongings go missing in the home.” Another person said, “My relative is content here."

We observed staff talking to other staff whilst supporting people and we also saw some staff carrying out tasks without communicating with the person.

We examined the communal areas, people’s individual rooms, cleaning and food preparation areas. The home had not acted upon the risks identified from a recent infection control audit and this meant people were at risk of infection. During our inspection we identified a number of areas within the home in need of redecoration or updating.

The staff we spoke to raised concerns about staffing levels within the home. We also observed medication not being administered on schedule due to the insufficient number of nurses available.

The provider had not notified the Care Quality Commission of all incidents which had occurred within the home as required by the Care Quality Commission (Registration) Regulations 2009. We prompted the manager to provide this information prior to our inspection and on the day of our visit.

We found risk assessments had not consistently been reviewed and we also found some gaps in some of the daily records.

Inspection carried out on 5 December 2012

During a routine inspection

We spoke with people who were using the service and relatives during our visit to Kingsthorpe View Care Home. To help us understand the experiences of people living in the home we also used our SOFI (Short Observational Framework for Inspection) tool during the visit. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

The people we spoke with told us that they had been involved in the development of their care plans. One person said, “The staff always ask me what I need.” Another person using the service said, “I love the staff here.”

We spoke to relatives of people who use the service and one person said, “I am always made to feel welcome and there is a nice atmosphere here.”

People using the service and relatives told us they felt safe with the support they were being provided. One person said, "I feel safe and I can talk to staff." People told us that they liked the staff and staff were able to meet their needs. They also told us they felt they could speak to the manager or staff and they would be listened to.

We found that staff were supported to provide care that met people's needs. We also found that the provider took steps to assess the quality of the service being provided.