7 May 2020
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 Care Act 2014.
This inspection was undertaken by an inspector manager, an inspector, an assistant 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.
Service and service type
Kentford Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted the Local Authority and Healthwatch for information they had about the service to help us plan the inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who lived at the service and eight relatives about their experience of the service provided. We spoke with the registered manager, the deputy manager, head of care, head of administration, one qualified nurse, one senior carer, two care assistants, two activities staff, one maintenance staff and one housekeeper. 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.
We reviewed a range of records. This included five people’s care records and multiple medication records. We saw records relating to the management of the service. These included minutes of meetings with staff and checks undertaken by the registered manager and senior staff on the safety and quality of care, such as audits and surveys relating to the quality of care. We also saw accidents and incidents reports and systems used to manage complaints. In addition, we reviewed the compliments which had been received by staff
After the inspection
We sought clarification from the provider to validate evidence found which was supplied the day after the inspection. We looked at training data and quality assurance records.
7 May 2020
About the service
Gracewell of Kentford is a care home providing personal and nursing care to up to 88 older people who may also live with dementia, physical or mental health needs. Accommodation is across three separate floors. At the time of the inspection there were 81 people living at the home.
People’s experience of using this service and what we found
People received planned care which improved their wellbeing from staff who considered and used their knowledge of what mattered to people, to provide person-centred individualised care. People knew they were important and well cared for because the staff took time to understand and get to know them, their histories and celebrated their unique life experiences. We saw positive rapports and strong bonds had developed between the people living at Kentford Manor and the staff supporting them. People using the service told us staff were kind and understanding and relatives told us staff’s kindness also extended to them.
Staff showed commitment to supporting people and spoke with a high degree of warmth about the people they cared for. People were empowered to make their own decisions about the care they wanted, and their relatives were consulted appropriately. Where people needed extra support to make decisions, this was provided by staff who knew people and their preferences well. People were treated with respect and staff were proactive in supporting people’s right to independence and privacy.
Each person had a personalised care plan which had been written from a detailed assessment of their needs and also their choices and views of how they wished to be cared for. People had a wide range of opportunities to do things they enjoyed, based on their preferences. People's communication needs were identified, and assistance was provided to enable people to express themselves in their preferred way. Systems were in place to take learning from any concerns or complaints and people and relatives were confident staff would address these. Staff were supported to provide good care at the end of people’s lives.
Each person had a recorded risk assessment to inform staff how to lessen the risk and care for the person. There were enough staff available to meet people’s needs throughout the day and night. Medicines were managed safely by staff who had received appropriate training. The service was clean and well maintained.
Staff had been provided with training and developed skills which clearly linked to the needs of the people supported at Kentford Manor. People enjoyed their mealtime experiences, which reflected their choices, and people were provided the assistance they required so they would have enough to eat and drink to remain well. Appointments with health and social care professionals were planned and also could be arranged promptly when required. 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.
People and relatives told us the service was well managed because of the experience and caring nature of the senior team and staff. There registered manager met with the senior staff each day and there was a service governance system which included carrying out quality checks to assure care was being carried out safely and to take any action to improve the service as identified.
Rating at last inspection
The last rating for this service was Good, (published 1 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk