Kitnocks House

Updated 4 August 2022

The inspection

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.

Inspection team

The inspection was carried out by one inspector, a medicines inspector and an 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. The Expert by Experience supported the inspection by making telephone calls remotely to get feedback about the service.

Service and service type

Kitnocks House 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. Kitnocks House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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. There was a manager who was new to the service who was in the process of applying to become the registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used information gathered as part of monitoring activity that took place on 21 March 2022 to help plan the inspection and inform our judgements. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 14 relatives about their experience of the care provided. We spoke with 18 members of staff including, the nominated individual, manager, clinical lead, a registered nurse, senior health care assistants, health care assistants, maintenance team members, quality assurance officer and regional manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included seven people’s care records, multiple medicine records, six staff files in relation to recruitment and records relating to the management of the service. Following the inspection, we continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 4 August 2022

About the service

Kitnocks House is a nursing home providing personal and nursing care to 63 people. People living at the home had high complex support needs in relation to their diagnosis of dementia, mental health conditions, learning disabilities and physical disabilities. At the time of the inspection there were 63 people using the service.

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

People were given their medicines in a way that met their individual needs. The provider had implemented a new electronic medicines administration and management system during the inspection. They were monitoring and updating the system as required promptly to fully embed the new system. The service had systems and processes in place for the safe storage, administration and use of medicines. However, these processes were not always followed, to ensure medicines were stored in line with recommendations. We have made a recommendation about the storage for some medicines.

We received mixed feedback from relatives about the staffing levels within the home. We observed safe staffing levels throughout the inspection and staff appeared unhurried and responsive to people. The provider was open about the challenges they had faced recruiting staff. They had created a recruitment team and implemented different initiatives to encourage recruitment and retention of staff. Safe recruitment processes were in place. Staff files contained the information required to aid safe recruitment decisions.

The provider had arrangements in place to assess and monitor risk. Risks to people were recorded in their care plans. 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. There were appropriate policies and systems in place to protect people from abuse. The manager understood their responsibilities to safeguard people from abuse.

Accidents and incidents were monitored, reviewed and analysed for trends and patterns. The provider carried out monthly and quarterly analysis of all accidents and incidents which had resulted in positive outcomes for people.

People were supported to maintain contact with their family members and friends throughout the pandemic. The provider facilitated visits for people living in the home in accordance with government guidance.

The manager promoted an inclusive, value based and positive culture. The management team had implemented changes to make the home more robust to weather challenges. Staff were deployed flexibly across the home to ensure people’s needs were met. They were confident in the changes being implemented and had a clear rationale for the changes. Most staff told us they felt supported, valued and listened to. However, some staff felt communication could be improved.

There were systems and processes in place for monitoring the quality of care and used to plan improvements. Where the quality assurance audits identified issues, remedial action was taken.

Most relatives were overall positive about the home. However, some felt communication could be improved on. Relatives mostly confirmed they were involved in people’s care and were able to contribute to care planning.

The management and staff team worked in partnership with a variety of healthcare professionals and had developed good working relationships which supported positive outcomes for people.

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 17 February 2021).

Why we inspected

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

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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