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Kingsway Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 13 June 2019

During a routine inspection

About the service

Kingsway Care Home provides personal care (without nursing) for up to 11 people with a learning disability or autism. The home is adapted from a domestic residential property and does not present externally as a care home.

The service had not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance as it initially opened before this guidance became available. Registering the Right Support ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. Ten people were using the service at the time of our inspection. This is larger than current best practice guidance, but the size of the service having a negative impact on people was mitigated by the home fitting into the residential area where it was sited. There were no identifying signs, with only the industrial bin indicative this was other than a family property. Staff did not wear anything that suggested they were care staff when coming and going with people, with use of domestic, family style cars for transport.

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

People were usually supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; although application of policies and systems in the service could better support this practice.

The service didn’t always apply the principles and values of Registering the Right Support (RRS) and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people did not fully reflect the principles and values of RRS for the following reasons; Some people’s perception was they did not always have a choice as to daily routine and their involvement in care planning could be improved. We saw the staff had sought people's views and preferences however and there were best interest decisions in place for use of any restrictions to keep people safe. There were many areas where we saw people had choice though.

People and relatives told us they had a positive experience in respect of the care and support they received. They told us they received support from staff in a timely way and were not kept waiting for assistance. We saw people looked comfortable in the presence of staff and people told us they felt safe at the home. Staff were knowledgeable about potential risks to people and were able to tell us how these would be minimised.

People were supported by staff who were kind and caring and staff were seen to respect people and promote their privacy, dignity and independence. People and staff had a warm, friendly relationship.

People were supported by care staff who had a range of skills and knowledge to meet their needs, although would benefit from further training in core areas of knowledge, which the provider had planned. Staff understood their role, felt confident and well supported. Staff received supervision and felt supported by the provider. People's health was supported as staff worked with other health care providers to ensure their health needs were met.

Staff were knowledgeable about people’s needs and preferences. People’s records needed improvement to reflect people’s involvement and how the care we saw was planned. The provider was working to develop more accessible care records, but we heard from people they ha

Inspection carried out on 22 February 2019

During a routine inspection

About the service:

Kingsway Care Home provides accommodation for up to eleven people who need help with their personal care. The home supports people who live with a learning disability and other complex support needs. At the time of the inspection eleven people lived in the home. The home has a combined communal lounge and dining area, a second quiet lounge for people to share and a back garden for people to enjoy.

People’s experience of using this service:

The overall rating for this service is ‘inadequate’ so therefore the service is in special measures. This was because the service was found to be in breach of Regulations 9, 11, 12, 17 and 18 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There was no adequate or effective systems and processes in place to monitor the quality and safety of the service. This resulted in people being exposed to ongoing risks with regards to their care.

The provider’s fire safety arrangements were unsafe. There was no evidence that any staff had practiced how to evacuate people from the home in an emergency for over two years. People who lived in the home also did not have personal emergency evacuation plans in place. This meant should an emergency arise, emergency personnel would not have important information about people’s needs and support requirements in an emergency situation.

People’s needs and risks were not properly assessed or managed. Where people had health conditions, their care plans did not always contain sufficient information about these conditions and the support they required.

Records showed that the support some people received was inconsistent and unreliable. People’s care was not personalised to their needs as staff lacked adequate information on what these were in order for them to do so.

People’s support was not always appropriate. CCTV was used to monitor people’s movements in communal areas without their consent and the language used in some care records was not very respectful.

Where people’s capacity to consent to decisions about their care was in question, the provider had not always followed the Mental Capacity Act 2005 to ensure that any decisions made on people’s behalf were legally consented to and in the people’s best interests.

The management of medication was not safe and the manager failed to demonstrate that they understood safe medication practices within the home.

The provider’s complaints procedure did not meet the Accessible information standard and did not provide relevant information to people on how to complain to in the most suitable way for them to understand.

There was little evidence that information about the service such as accident and incident information, safeguarding and resident meetings were used to learn from and improve the service.

Information in respect of people’s eating and drink needs was limited and the preparation of one person’s special diet did not follow recommended advice. People told us they were happy at the home and said they got enough to eat and drink. During our inspection, we saw that staff members treated people kindly and with respect.

People had the support of other health and social care professionals. For example, dentists, opticians, GP’s as well as specialist medication teams for any medical conditions.

Staff told us they felt supported by the manager and records showed staff received supervision in their job role. Staff received training and training was up to date.

Regular meetings took place with people who lived at the home and their views and opinions on the activities they would like to become involved in sought. We saw that people enjoyed a range of social and recreational activities. For example, knitting, horse riding, barbecues and college.

The atmosphere at the home was warm and homely.

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

Rating at last inspection and wh