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Archived: Kingfisher Court Good

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Reports


Inspection carried out on 27 April 2016

During a routine inspection

This unannounced comprehensive inspection took place on 27 April 2016. The last inspection took place on 19 June 2014. The service was meeting the requirements of the regulations at this time.

Kingfisher Court is a care home which offers nursing care and support for up to 13 people. The service is purpose built to provide specialist accommodation and rehabilitation facilities for those with acquired brain injury and associated neurological conditions. At the time of the inspection there were 12 people living at the service.

The service had a registered manager in post. 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.

We walked around the service which was spacious, airy and comfortable. Each person’s room was ensuite and personalised to reflect their individual tastes. People received very personalised care and were treated with kindness, compassion and respect.

We looked at how medicines were managed and administered. We found it was possible to establish if people had received their medicine as prescribed. Regular medicines audits were consistently identifying if any errors occurred.

The service had identified the numbers of staff required to meet people’s needs and these were being met. Some people required one to one support from staff throughout the day and we saw this was provided.

Staff were supported by a system of induction training, supervision and appraisals. Staff knew how to recognise and report the signs of abuse. Staff received training relevant for their roles and there were good opportunities for on-going training and support and development. More specialised training specific to the needs of people using the service was provided. For example, epilepsy care, continence and stoma care and care of people with acquired brain injury.

Staff meetings were held regularly. These allowed staff to air any concerns or suggestions they had regarding the running of the service and share information related to people living at the service.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy. One person who had specific dietary needs had requested and was being provided with the necessary equipment in their room to enable them to prepare some of their own meals.

The registered manager, deputy manager and all staff had a good understanding of the Mental Capacity Act 2005. Applications had been made for authorisations for potentially restrictive care plans. Authorisations had been granted for people to be deprived of their liberty so that they could be cared for safely. The service had robust processes and procedures in place to monitor when reviews of these authorisations were due.

Care plans were well organised, detailed and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs recorded. People were involved in the planning of their own care and where appropriate, relatives were included.

Activities were provided on a one to one basis by staff according to each person’s needs and interests. People were supported to have good access to the local community and were able to take part in varied activities that they enjoyed.

The registered manager was supported by the provider through regular telephone conversations and meetings. At the service support was provided by the deputy manager and a motivated team of nurses and senior care staff. Some staff had worked at the service for some time and all staff told us they enjoyed their work and felt they were a good team.

Inspection carried out on 23, 25 June 2014

During a routine inspection

At the time of our inspection, Kingfisher Court was providing accommodation, care and support to nine people with Acquired Brain Injury and associated neurological conditions. Some of the people using the service had complex needs which meant they were not all able to tell us their experiences. We observed the care and support being given and how staff interacted with people. We spoke with the registered manager, deputy manager, three support workers and one person who used the service. Following our inspection we spoke with two relatives of people who use the service in telephone conversations. We also looked at care and support records.

At the time of our inspection Kingfisher Court had two registered managers for this location. In this report the registered manager refers to Alexandra Downes.

This is a summary of what we found �

Is the service safe?

The service was safe. We saw guidance for staff about maintaining people�s dignity whilst care was provided. One relative we spoke with said: �I�m really happy with the care and support my relative receives. They have only been at Kingfisher Court a short while but they have come on in leaps and bounds�.

Specialist engineers visited annually to service and carry out maintenance works on equipment. Records demonstrated the passenger lift had undergone routine maintenance in March 2014. The five overhead hoists and one mobile hoist had been serviced in May 2014 in accordance with Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). A fire risk assessment had been carried out 26 May 2014. This had highlighted three defects within the home which were addressed by the provider on 6 June 2014.

Support staff we spoke with told us that they felt the staffing levels were adequate to meet the needs of the people living at the service and they were managing their workload effectively. One person using the service said: �There is always plenty of staff around to help us�.

People's personal records including medical records were accurate and fit for purpose. All records we looked at provided up to date information and guidance on how best to meet people's care needs. We saw that medical appointments were recorded and that care plans had been updated to reflect changes in care that resulted from medical appointments.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Relevant staff had been trained to understand when an application should be made, and how to submit one. The registered manager was aware of recent changes to the legislation and was awaiting further guidance from the managing authority.

Is the service effective?

The service was effective. The four care plans that we examined had been reviewed within the previous 28 days. We saw that each person�s care had been reviewed by the registered manager with support workers healthcare professionals and the person receiving care.

Is the service caring?

The service was caring. We saw evidence that specific risk assessments had been completed for people based on individual needs that identified and the type and degree of support they required.

Is the service responsive?

The service was responsive. One person had been identified as at risk from developing pressure areas. We saw a plan had been put in place to reposition the person every two hours. We reviewed the care notes for this person for the previous two months prior to our inspection. Records demonstrated that the person was repositioned every two hours which included night time.

Is the service well led?

The service was well led. Support workers told us that before people came to live at Kingfisher Court the registered manager assessed their needs to ensure that the home and support workers could meet those needs. One support worker said: �As a team we focus our efforts on managing the adjustment that is sometimes necessary when people come into the home�.

The registered manager told us: �We communicate with people�s families regularly and if there are any problems we deal with them straight away. The annual satisfaction survey is an important means for us to check whether we are getting things right as far as relatives are concerned� This meant that there were processes in place to regularly seek people�s views on the care and support provided.

Inspection carried out on 24 July 2013

During a routine inspection

We spoke with three people who lived at Kingfisher Court and two relatives of people who used the service. They all spoke positively about the care and support that people who used the service received. We also spoke with the manager, deputy manager and three care workers.

We looked at the care records of four people who used the service. Each person had an assessment of their needs and a care plan, including risk assessments. The records contained comprehensive and up to date information about people's health and social care needs with entries showing how the care and support was delivered.

Care workers we spoke with told us that they had received safeguarding training and we saw the provider's policy that highlighted the importance of regular safeguarding training. We also saw the local authority's safeguarding policy.

We looked at the medicine administration records for three people living at the home. These had been fully completed. All medicines were kept securely within the medicine trolley. Records were kept when medicine was refused by people or not required, for example, when people said they didn't need pain relief.

Effective recruitment and induction processes were in place. Interviews were conducted by the manager and head of personnel and a standard set of questions were used. This was followed by a three day induction process consisting of one day at the providers head office and a further two days at Kingfisher Court working alongside the manager. The probationary period consisted of a review after the first week and was conducted by the manager. This process was followed by further reviews at three months and six months.

Kingfisher Court had systems to monitor the quality and assurance and this was conducted by the provider. We saw the most recent quality assurance audit that had been undertaken in early July 2013. This covered for example, health and safety, staffing, medication policies and complaints.