Kings Lodge

Kings Lodge is a residential care home providing personal and nursing care to 62 people aged 65 and over at the time of the inspection. The service can support up to 64 people. The care home accommodates people in one adapted building across four separate wings, each of which has separate adapted facilities. One of the wings specialises in nursing care and another specialises in providing care to people living with dementia.

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

People felt safe living at Kings Lodge and were supported by staff who had been trained in safeguarding and how to identify different types of abuse. People received their medicines in a safe way by staff that were trained in this area and subject to regular competency checks.

Risks to people were identified, assessed, monitored and managed. Risk assessments set clear guidance for staff to follow to ensure risks were mitigated as much as possible. Accidents and incidents were analysed and acted upon to reduce future reoccurrence.

People were kept safe from the risk of spread of infection wherever possible and additional cleaning schedules and audits had been introduced to reduce infection risk around Covid-19.

Staff and people told us that the management team included them in decisions regarding the running of the home. The registered manager and assistant manager worked well together to ensure staff felt valued and respected.

Regular staff meetings continued through the pandemic and regular feedback was requested from people living in the home. The home worked well with other health and social care professionals.

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 14 January 2020).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 coronavirus and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

The overall rating for the service has remained the same. This is based on the findings at this inspection.

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

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 Lodge is a residential care home providing personal care to 24 people aged 65 and over at the time of the inspection. The service can support up to 64 people. The home is one adapted building separated in to four different units. One of the units specialises in providing care for people living with dementia.

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

In the previous inspection a breach was identified of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 in relation to consent. People had not been correctly assessed and relatives were consenting to restrictions on people without the appropriate legal authority paperwork being reviewed. This had now been addressed, and enough improvement had been made for the service to no longer be in breach of regulation 11.

Recommendations made following the previous inspection had been acted upon and addressed.

People told us that the staff made them feel safe and they treated them with kindness and respect. People were safeguarded from harm by suitably trained staff who were confident about their knowledge of safeguarding, knew how to identify different types of abuse, and how to report any incidents accordingly.

Any risks posed to people were assessed, monitored and minimised in a suitable way. Staff were trained and the registered manager followed safe recruitment processes. There were enough staff to meet people’s needs.

People received their medicines when they needed them in a safe way. Medicines were managed in line with best guidance and competent staff knew their responsibilities in relation to their receipt, storage and management of all medicines. People also had access to healthcare professionals when required and referrals were made in a timely way.

People were supported to eat and drink enough to meet their needs and nutritional value. People were encouraged to enjoy food and options were given to people where possible. People took part in meaningful activities.

Care plans were person-centred and detailed how people liked to receive their care. This was also supported by interactions seen between staff and people. Staff were kind, considerate and treated people with respect and dignity and people were treated as equals.

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.

Staff took part in regular supervisions and appraisals so any issues could be addressed quickly. Staff were also asked for feedback during regular staff meetings. People also had the opportunity to provide feedback through survey questionnaires and resident meetings held within the home.

The registered manager understood their legal responsibilities and had shared information with us and other key professionals when required to do so.

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 28 November 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of any regulations.

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 Lodge is a new home providing residential care for older people including those living with dementia. The care home has been opened just over a year. The building is designed to accommodate and care for up to 64 people in four different units. At the time of the inspection there were 19 people living there, 13 of whom were living with dementia.

People in residential care homes receive accommodation and 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.

There was no registered manager in post 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.

The registered manager had resigned recently and the provider was taking the necessary steps to recruit to the role. The registered provider was present for the inspection. They had a dual role as they also managed another care home but were spending two days a week at Kings Lodge. There were other staff who were currently taking on addition management tasks who were also present on the day of inspection.

There had been some upheaval recently with the loss of senior staff at the home. The provider was aware of the need to support the workforce, and give clear leadership. Whilst aspects of the care were good, there was a recognition that improvements were still needed and staff needed support to make the necessary changes.

There was some inconsistency in the way that people’s consent for care was agreed which was not meeting the legal requirements of the Mental Capacity Act.

Whilst there was sufficient staff on the day we visited, there was some evidence that staffing levels had been stretched in the past. We have made a recommendation about the need for the provider to continually review staffing, based on the needs of the people as the service grows.

Some improvements were needed to ensure the facilities and furniture were always suitable to meet the physical and specialist needs of the people who lived there. Some people were kept waiting to have their lunch served. We have made recommendations to the provider.

People’s wishes for the end of their lives were not always documented or clear. Some care plans were not signed off as agreed with the person. Daytime activities for people, and opportunities to access the community was being improved by the provider. The involvement of people, relatives and staff in the service was still being developed and further engagement was needed.

People were kept safe from harm. The risks to people’s safety were assessed and staff knew of the actions they should take. People were protected from the spread of infections through the safe practices of staff.

The environment people lived in was kept very clean. People received their medicines on time and from staff who were trained and understood the medicines administration. Staff were aware of their responsibilities to protect people from abuse.

Accidents and incidents, including any falls that people experienced, were recorded and monitored including trends. Lessons had been learnt from a recent safeguarding incident and processes were updated.

People’s physical, psychological and social needs had been assessed before they moved into the service. People had enough to eat and drink throughout the day. Choices were provided and their nutritional needs were being met.

People’s health was maintained and they had access to specialist services when needed.

People were treated with kindness, respect, and compassion. They felt they were listened to and their emotional needs were being met. People made day to day decisions about their care. Privacy was always maintained. Staff made sure they spent one to one time with people and engaged with them personally.

There was a complaints process in place, though people said they had no reason to use this.

The service had developed partnerships with other agencies and had an ambition to do more.

The service had experienced a time of uncertainty and the provider was supporting staff during a period of change. There was evidence that the provider was already acting to improve and create a good basis for growth.

During this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made three recommendations to the registered provider.

You can see what action we told the provider to take at the back of the full version of this report.