Kings Court Nursing Home

Kings Court Nursing Home is a residential care home providing personal care to 22 people aged 65 and over at the time of the inspection. The service can support up to 29 people in one adapted building.

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

This was a targeted inspection that considered the key question safe. Based on our inspection of safe we found the service did not have a system in place to record the vaccination status of visiting professionals, nor were they asking to see evidence of vaccination. It has been a requirement for registered managers to see evidence that visiting professionals are double vaccinated against COVID-19 since 11 November 2021. Following the inspection, the registered manager acted and implemented an effective process.

All visitors were screened for symptoms of COVID-19 and were required to show a negative Lateral Flow Device (LFD) test result before they entered the home. Visiting took place in a designated area of the home. Unless a person was unable to access the visiting area, in such cases visits took place in the persons bedroom. People and most relatives were happy with these arrangements.

Several areas in the home were in need of maintenance and refurbishment, as a result infection prevention and control (IPC) risks were not always mitigated. Some of these concerns had been picked up when the registered manager and maintenance team completed audits of the home, but not all of the concerns found had been identified prior to the inspection.

Hazards such as chemical and maintenance equipment were not stored safely. The registered manager acted ensuring all hazards were locked away.

People and their relatives told us they felt safe at Kings Court Nursing home. Staff understood their responsibilities to safeguard the people they were caring for and had received safeguarding training. However, not all staff were up to date with their mandatory training, including safeguarding, infection control and moving and handling training.

There were sufficient staff to meet the needs of the people at the home. The registered manager used a dependency tool to ensure they could meet the needs of people before accepting new admissions to the home.

Medicines were administered and stored safely by suitably trained staff.

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 15 September 2021).

Why we inspected

We received concerns about the visiting policy at the home. As a result, we undertook a focused inspection to review the key questions of safe.

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 section of this report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to evidencing vaccination status of visiting professionals and the maintenance of the home.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

Kings Court Nursing Home is a residential care home providing personal and nursing care to 21 people aged 65 and over at the time of the inspection. The service can support up to 29 people in one adapted building.

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

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. However there had been a delay in renewing people’s Deprivation of Liberty Safeguard due to COVID-19.

Some relatives did not find the manager approachable and this meant they had less confidence in raising concerns and complaints.

The provider and registered manager had taken action to rectify all the concerns we found at the last inspection and the provider was no longer in breach of any regulations. There were effective audits in place to monitor the safety of the care provided.

Medicines were safely managed and risks to people were identified and action was taken to keep people safe. People were supported from the risks of infection and the registered manager ensured that staff followed the provider’s guidelines.

People were happy with the food provided and action was taken to ensure they maintained their nutrition and hydration. However, at times relatives felt that the food provided did not support people’s long-term health conditions.

People and their relatives were involved in planning their care and the choices they made regarding their daily lives were respected. Staff were kind and caring and knew the needs of the people they supported.

There were enough staff to meet people’s needs and staff received the training needed to provide safe care to people.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 02 October 2019).

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. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Kings Court Nursing Home is a residential home providing personal and nursing care to 27 people at the time of the inspection. The service can support up to 29 people.

Kings Court Nursing Home accommodates 29 people over two floors. There are three rooms where people share accommodation, with the remainder supported in single rooms. The service does not have private facilities but has access to toilet and bathing facilities on both floors. Lounge and dining areas are also provided on both floors.

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

People were not always protected from risks linked to the environment. Medicines were not administered in line with guidance and records regarding topical medicines were not always up to date. Doors to potentially harmful areas of the home were left unlocked with access to machinery and chemicals. There were enough staff to deliver timely support and care, people felt safe and told us the home was maintained in a clean and tidy manner.

People needs and choices were well supported. Systems were in place to ensure individual’s health and wellbeing were maintained. Staff had a good range of training although supervision and appraisal meetings had not been fully completed. People told us they enjoyed the meals and staff understood the need to provide a balanced diet. Professionals told us staff worked co-operatively to deliver good care.

People were supported to have 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. Some people shared rooms and it was not always documented they had consented to this.

People told us they received good care from dedicated and empathetic staff. Staff had a good understanding of people as individuals. People were able to make choices on a day to day basis, but more could be done to ensure there was active involvement in decisions. We have made a recommendation about this. People’s privacy and dignity were respected and supported.

People’s care records contained good information about their needs and support. Staff were aware of people’s individual communication needs but appropriate processes were not always documented. We have made a recommendation about this. A range of activities and events were provided to help people socialise and engage in meaningful activity. There had been no formal complaints and people told us and concerns were immediately addressed.

A range of checks and audits were in place, although they had not identified or not addressed the issues noted at this inspection. The registered manager had a clear idea of how she wanted to develop and improve the service. Professionals told us the service worked collaboratively.

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

Rating at last inspection (and update)

The last rating for this service was good (published February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective 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. The provider has taken action to mitigate immediate risk and this has been effective.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kings Court Nursing Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from 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.

There was a manager in post who had a pending application to become the registered manager. 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 home is run.

People’s relatives told us that people were safe at the home. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff who were competent to do so. Risk assessments recorded what action staff should take if someone was at risk. Referrals were made to appropriate health care professionals to minimise risks and meet people’s health needs.

There were sufficient staff to keep people safe and meet their needs. The registered manager had followed safe recruitment procedures. Medicines were given to people on time and as prescribed. However we raised concerns with the manager regarding the way medicines were dispensed.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. Staff understood the processes in place for ensuring decisions were made in people’s best interests. Staff and the manager were ensuring these steps were taken for people living at the home. Staff sought people’s consent and recorded this.

Staff were caring, they knew people well, and they supported people in a dignified and respectful way. Staff acknowledged and promoted people’s privacy. People felt that staff were understanding of their needs and they had positive working relationships with them.

People and their relatives were involved in the assessment and reviews of their needs. Staff had knowledge of people’s changing needs and they supported people to make changes to their planned care when people wanted to. Staff were not always consistent in their approach to offering choices. People told us that they had access to activities and hobbies.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the service’s quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.