Kings Lodge Care Centre

Updated 8 December 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

Three inspectors, a specialist nursing advisor and an Expert by Experience carried out the inspection. 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

Kings Lodge Care Centre 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. Kings Lodge Care Centre 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 place. The manager had begun the process of registering with CQC.

Notice of inspection

The inspection was unannounced.

Before the inspection

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 6 people who lived at the home, 2 visiting professionals and 9 relatives about the care their family members received. We spoke with the manager, the clinical lead, the provider’s regional manager, and 6 staff, including a nurse, 2 care staff, the chef, the wellbeing co-ordinator and a housekeeper.

We looked at care records for 6 people, including their assessments, care plans and risk assessments. We checked 5 staff recruitment files, medicines management, records of complaints and accidents and incidents and the home’s business contingency plan. We reviewed policies, procedures, meeting minutes, surveys, and quality monitoring reports.

Updated 8 December 2022

Kings Lodge Care Centre is a care home with nursing for a maximum of 44 older people, including people living with dementia, physical disability or sensory impairment. There were 39 people living at the home at the time of our inspection.

The home is purpose-built and accommodation and facilities are arranged over two floors.

People’s experience of using this service:

People felt safe at the home and when staff provided their care. Risks were assessed and managed effectively. Accidents and incidents were recorded and reviewed to identify learning. Medicines were managed safely. Staff attended safeguarding training and understood their role in protecting people from the risk of abuse.

Staff were recruited safely and there were enough staff on each shift to keep people safe. A number of permanent staff had recently been recruited and the use of agency staff had reduced as a result. This had improved the consistency of care people received but people said some staff’s limited English made communication difficult. The provider had identified this issue and had put measures in place to support staff to improve their English.

Staff had access to the training they needed to carry out their roles. Some staff had not been receiving regular supervision. The manager had identified this and told us staff supervision would take place regularly moving forward.

People enjoyed the food at the home. They said they had a good choice of meals and had been asked for their views about the menu. People who needed texture-modified meals received these in line with recommendations made by healthcare professionals.

People’s needs were assessed before they moved into the home to ensure staff had the necessary skills to provide their care. People were supported to maintain good health and told us they were able to see healthcare professionals when they needed to. The design and layout of the building met the needs of people with mobility issues and people living with dementia.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Mental capacity assessments had been carried out to establish whether people were able to make informed decisions about their care. The manager had identified that some assessments needed revision to ensure they related to specific decisions and had begun reviewing all mental capacity assessments.

People had positive relationships with the staff who supported them and relatives said staff showed kindness in their approach to care. Staff treated people with respect and maintained their dignity when providing care. People told us they enjoyed the activities at the home. The management team had recognised that there were limited opportunities for activities for people who chose to stay in their rooms and had put plans in place to address this.

The manager had taken up their post in September 2022 and the clinical lead had been appointed in October 2022. People who lived at the home and their relatives told us the manager had overseen improvements to the service. Relatives said the manager had improved communication with them, and had encouraged them to be more involved in the life of the home and in planning their family members’ care. The management team had been working to improve the culture within the staff team, and relatives said they had noticed an improvement in staff morale, which had benefited their family members.

People told us their feedback was listened to and acted upon. People felt comfortable making complaints and told us any concerns they raised had been taken seriously and responded to. Staff had opportunities to raise any issues they had at team meetings and were encouraged to give feedback about the support they received.

The management team had developed a service improvement plan, which recorded areas where improvements were needed. The manager and the clinical team had begun reviewing and updating people’s care plans to ensure they were person-centred and reflected people’s needs and life histories, including for people admitted to the home under the ‘discharge to assess’ scheme.

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 requires improvement (published 17 November 2021) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

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

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.

Follow up:

We will continue to monitor information we receive about the service, which will help inform when we next inspect.