2 July 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection team was made up of one inspector, one bank inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Kingfisher Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Kingfisher Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was not a registered manager in post.
The service had recently undergone a change in management, with the previous applicant withdrawing their application to register with the Care Quality Commission (CQC). At the time of our inspection, a general manager was in day to day charge of the service, and a job advert for the post of registered manager had been published.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 12 people, five relatives, two visiting professionals and eight members of staff including the general manager, cook, senior care staff and care staff. We reviewed various records in relation to the running of the service, including three recruitment files, maintenance checks and various audits. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. After the inspection we continued to clarify information with the general manager and spoke with one relative.
2 July 2022
About the service
Kingfisher Lodge is a residential care home providing regulated activities personal and nursing care to up to 60 people. The service provides support to people with dementia, older and younger adults, and people with a learning and/or physical disability. At the time of our inspection there were 52 people using the service.
Kingfisher Lodge is laid out over two floors, with en-suite bedrooms, communal dining and lounging areas, to each floor. Both floors are accessible by lift and stairs. People have level access to a large, well-stocked garden from the ground-floor. The manager’s office is located adjacent to the reception area on the ground-floor.
People’s experience of using this service and what we found
The manager raised potential safeguarding concerns with the local authority safeguarding team. Staff spoke confidently about how they would identify abuse and what they would do if abuse was witnessed or suspected. Risk assessments were in place where required, for example for people at risk of falls. The manager had identified medicines related recording was not always robust and was working to improve this at the time of our inspection. The provider used a staffing dependency tool based on peoples’ needs, we received mixed comments about staffing levels.
The provider submitted notifications as required and used checks and audits to identify shortfalls, errors and omissions. Staff knew people well and had recently worked with a dementia specialist to provide people with more person-centred care. At the time of our inspection, the service did not have a registered manager in place, a recent application for registration had been withdrawn and a general manager was in post for the interim. The manager and regional director had identified areas for development, plans were in place to support this.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of safe and well-led, the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support: People were supported to have maximum control of their lives and make their own choices. The service shared relevant information with external professionals to support these choices.
Right care: Staff had not received learning disabilities training, however this had not impacted people and the manager planned to rectify this. Staff knew people well.
Right Culture; The service worked with peoples’ families to ensure people experienced good outcomes.
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 good (published 20 November 2020)
Why we inspected
We received concerns in relation to the management of medicines and safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.