Kings Lodge Care Centre

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.

Kings Lodge Care Centre is a care home with nursing for up to 44 older people, including people with physical disabilities, sensory impairments and dementia. There were 40 people living at the home at the time of our inspection.

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

People had not always received safe care in the period prior to our inspection. For example, one person was given a meal which did not comply with guidelines about their food and another person had experienced unexplained bruising. One person had been put at risk of harm by faulty equipment. Medicines were not always managed safely.

Many people’s care plans and assessments were overdue for review and, as a result, did not provide accurate, up to date information for staff. This meant people may not have received the care they needed.

Prior to our inspection, the provider had identified that some areas of the service needed improvement and had developed an action plan, which was reviewed regularly. The provider had also put additional management support in place and begun monthly monitoring visits.

There were enough staff on each shift to provide people’s care. However, people’s experience of care was affected by the home’s reliance on agency staff. The provider had made efforts to recruit permanent staff and had introduced measures which aimed to improve recruitment and retention. The provider had also block-booked agency staff in an attempt to improve the consistency of care people received.

Staff understood their responsibilities in terms of protecting people from abuse and knew how to report any concerns they had. Safeguarding incidents had been reported to the local authority and the provider had contributed to safeguarding enquiries when requested to do so.

People were involved in decisions that affected them and they and their relatives had opportunities to give their views at regular meetings. Staff feedback was also encouraged, and staff told us their views and suggestions were listened to. The home had established links with the local community, which had benefited the people living and working at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The registered provider for the service had changed since the last inspection. The last rating for the service under the previous provider was Good (published 6 May 2017).

Why we inspected

We received information of concern about some aspects of the care people received and the management of medicines. 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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Kings Lodge Care Centre on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice

An appointment system was used to manage visits to the home. Visitors accessed the home through a side entrance and spent time in a designated area. The visitors area had screens to separate visitors from people to prevent the spread of infection. Masks were worn by visitors and the area was deep cleaned between each visit.

An isolation action plan was in place in case of an outbreak of COVID-19. This enabled the home to be sectioned into separate zones to reduce the spread of infection. People had access to lounge areas that had been created within the zones to provide people with space to move around and spend time in.

Staff organised entertainment and this was live streamed onto peoples televisions. This included an orchestral performance and other musical shows. The registered manager maintained community engagement, such as arranging for a local garden centre to give people flowers on Mother's Day.