We carried out a review of the data available to us about Kenilworth Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kenilworth Nursing Home, you can give feedback on this service.
Kenilworth Nursing Home is a residential care home providing personal and nursing care to people with mental health needs. The care home can accommodate up to 30 people. At the time of the inspection 26 people were using the service.
People’s experience of using this service and what we found
The provider had systems and processes in place to help keep people safe including risk assessments and risk management plans. Medicines were managed safely overall. People and relatives told us they thought people were safe. Safe recruitment procedures were followed.
The provider had systems in place to manage infection prevention and control. Staff generally wore personal protective equipment (PPE) appropriately and visiting was managed safely in line with government guidance. COVID-19 testing, care plans and visitor plans were in place.
Incidents, safeguarding concerns and complaints were appropriately investigated so learning took place and relevant agencies such as the local authority and CQC were notified. Audits were undertaken to monitor and to help make improvements to the service.
The provider worked with external professionals to help ensure people’s health and wellbeing needs were met. People, their relatives and staff indicated the managers were approachable and acted on any concerns.
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 good (published 10 September 2020).
Why we inspected
We received a concern in relation to risks about the care provided around people’s health needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 found no evidence during this inspection that people were at risk of harm from this concern.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kenilworth Nursing Home on our website at www.cqc.org.uk.
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 coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service using our monitoring systems which will inform when we next inspect the service.
We found the following examples of good practice.
• Visitors agreed a visiting time in advance, were screened over the phone and agreed to follow the visiting procedures. The provider set up an outside visiting area complete with sink facilities and PPE station.
• The provider worked closely with the local authority and attended all meetings and training on offer from the local authority and PHE. They also kept close links with other care homes in the area and shared ideas.
• The provider was very conscious of their staffs’ needs and invested in them, for example paying for taxis to and from work. They maintained good communication with staff and ensured they had what they needed to do their job effectively and safely, for example risk assessments, PPE and relevant training.
• Once protocols and procedures were in place, the provider was strict about maintaining them.
• The provider was proactive in preparing their service prior to the lockdown and specific government guidance. They began preparing early through their own initiative and completed risk assessments around PPE, food and cleaning products so they were always well stocked. They are continuing to monitor and stock up in these areas as part of their ongoing contingency plan.
Further information is in the detailed findings below.
Kenilworth Nursing Home is a residential care home providing personal and nursing care to people with mental health needs. The care home can accommodate up to 40 people over two floors.
People’s experience of using this service and what we found
The provider had systems in place to safeguard people from the risk of abuse and staff knew how to respond to possible safeguarding concerns. There were also systems in place to identify and manage risks. Safe recruitment procedures were in place and there were enough staff to meet people’s needs. Medicines were managed and administered safely. Staff followed appropriate infection control practices to prevent cross infection.
Supervisions, appraisals and competency testing provided staff with the support they required to undertake their job effectively and safely. People's needs were regularly assessed to ensure these could be met. People were supported to maintain health and access healthcare services appropriately. People were also 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.
Staff were kind and respectful of people’s wishes and preferences and provided support in a respectful manner. People were involved in making decisions about their day to day care. Staff respected dignity and promoted independence for people.
Families were welcomed to the service. People had the opportunity to engage in activities in the home and the community and were supported to follow their interests. There was a complaints procedure in place and the provider responded to complaints appropriately.
The provider had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people. People using the service and staff reported the registered manager was approachable and promoted an open work environment.
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 25 July 2018). 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 was a planned inspection based on the previous rating.
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.
The last comprehensive inspection took place in May 2017. The service was rated requires improvement in the key questions is the service safe and well led? and overall. We found one breach of regulations relating to safe care and treatment for which we served a warning notice on the provider. This was because they did not always administer medicines as prescribed and staff medicines competency assessments were not recorded at the time of the inspection. We asked the provider to make the necessary improvements by 7 July 2017.
On 31 August 2017, we carried out a follow up inspection to check that improvements to meet legal requirements planned by the provider after our May 2017 inspection had been made. We inspected the service against two of the five questions we ask about services: is the service safe and well led? This is because the service was not meeting some legal requirements. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. On 31 August 2017, we found the provider was meeting the regulation relating to safe care and treatment
However, at the inspection on 21 and 2 May 2018, we found the provider was again not fully meeting the regulations relating to safe care and treatment and good governance.
Kenilworth Nursing Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Kenilworth accommodates a maximum of 40 people. At the time of the inspection, 30 people were using the service. The maximum of 40 people is if people are sharing double rooms and the provider was actively moving people to single rooms as they became available.
The service is family run as a partnership and the registered manager is one of the partners. 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.
During the inspection we found medicines management was inconsistent and audits did not always identify discrepancies to help ensure people always received their medicines in a safe way.
The service had systems in place to monitor, manage and improve service delivery and to improve the care and support provided to people. However, these were not always effective. Record keeping was not always complete or contemporaneous, for example when monitoring people’s weight, and medicines audits did not always identify discrepancies.
Incident forms recorded the details of the incident and the resulting actions. Risk assessments were in place but the risk management plans did not always have enough detailed guidance which meant they did not always mitigate risks to people.
There were procedures for reporting and investigating allegations of abuse and whistle blowing. Staff we spoke with knew how to respond to safeguarding concerns. Safe recruitment procedures were followed to ensure staff were suitable to work with people. People told us they thought there was enough staff to meet their needs.
Staff we spoke with understood how to manage infections and wore appropriate protective equipment to reduce the risk of the spread of infection.
People’s needs had been assessed prior to moving to the service and care plans included people’s likes and dislikes. There were also records of end of life wishes and Do Not Attempt Cardio Pulmonary Resuscitation’ (DNACPR) forms where these had been completed.
Care workers had relevant training, supervision and annual appraisals to develop the necessary skills to support people using the service.
People's dietary and health needs had been assessed and recorded so any dietary or nutritional needs could be met.
The principles of the Mental Capacity Act (2005) were followed.
People were treated with dignity and respect and we observed care workers communicated with people with kindness, care and encouragement.
Care plans had information about people’s likes and dislikes and included their cultural and religious needs.
People were involved in planning their care and care plans contained information to give staff guidelines to care for people in their preferred manner.
The provider had a complaints procedure and addressed any complaints appropriately.
People using the service and staff told us the registered manager was available and listened to them and took action where necessary to act on their suggestions or concerns.
The provider received feedback and shared information through monthly team meetings and completed annual surveys.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the safe management of medicines and good governance. You can see what action we told the provider to take at the back of the full version of the report.
After the comprehensive inspection, the provider sent us an action plan and told us they would take action to meet legal requirements in relation to the breach. We undertook a focused inspection on the 31 August 2017 to check that they had followed their plan and to confirm that they now met legal requirements.
This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kenilworth Nursing Home on our website at www.cqc.org.uk.
Kenilworth Nursing Home is a nursing home registered to provide accommodation, personal care and nursing care for up to 40 people, some of whom are living with the experience of dementia, mental health conditions and people that are being cared for under the Mental Health Act 1983. At the time of our inspection there were 33 people living at the service.
There was a registered manager in post who was one of the partners who owned the service. 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 and associated Regulations about how the service is run.
At our focused inspection on, 31 August 2017 we found that the provider had followed their plan of action, and that the legal requirement in relation to safe care and treatment had been met. We are amending our rating for the key question, ‘Is the service safe?’ from ‘Requires improvement’ to ‘Good’. As the provider had strengthened governance arrangements around the management of medicines we have also amended the rating for ‘Is the service Well Led?’ from ‘Requires improvement’ to ‘Good’.
Medicines were administered and managed in a safe way. People’s medicines records were clear and alerted nurses if they were taking dispersible aspirin or PRN (as required) medicines and provided clear guidelines on how to administer these. These had not been managed safely at our last inspection.
Medicines administration records (MAR) charts had body maps attached to them and clear instructions so staff were clean how to administer topical creams. The provider ensured that medicines stock takes and audits were completed weekly.
The provider had implemented a detailed medicines competency test that all nurses had completed to help ensure they were administering medicines in a safe way.
The provider had made progress in auditing the management of medicines and the staff files to ensure there were no gaps in the required documentation.
The last inspection took place on 11,12 and 13 April 2016, when we identified breaches regulations relating to safeguarding service users from abuse and improper treatment, safe care and treatment and the need for consent. Additionally we recommended that the provider continue to make improvements to the environment in line with the National Institute of Care Excellence (NICE) guidance about environments for people with dementia.
The provider sent us an action plan dated 24 June 2016 indicating how they would address the issues raised at the inspection. Improvements had been made, but some areas required further improvement.
Kenilworth Nursing Home is a nursing home registered to provide accommodation, personal and nursing care for up to 40 people, some of whom are living with the experience of dementia, mental health conditions and people that are being cared for under the Mental Health Act 1983. At the time of our inspection there were 33 people living at the service.
There was 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 found that the service did not always administer medicines as prescribed. The provider told us they assessed the competency of staff who administered medicines but this had not been recorded at the time of the observation.
The service had safe recruitment procedures in place and there were a sufficient number of staff to meet people’s needs.
People using the service were protected from harm and abuse. Staff had safeguarding adults training and they knew how to report any safeguarding concerns the might have. Safeguarding information was displayed throughout the service.
The service had risk assessments and management plans in place with guidance on how to minimise risk and promote people’s wellbeing.
Staff were supported through supervisions and appraisals to have the skills they required to provide care and support to people using the service. However, observational spot checks were not formally recorded.
We saw evidence that consent to care and treatment was sought in line with the Mental Capacity Act (2005) guidelines.
People’s nutritional needs were assessed and met.
People’s files contained evidence of timely referrals and access to relevant healthcare professionals.
We observed staff were kind and caring. They treated people with dignity and respect and gave people the opportunity to make choices and have control of decision-making. Staff were aware of people’s individual needs and preferences.
The service had an accessible complaints procedure and people we spoke with knew how to make a complaint.
The service had systems in place to monitor how effectively the service was run to ensure people’s needs were being met.
Relatives and staff said they could speak to the registered manager about concerns.
CQC is currently considering the appropriate regulatory response to the repeated breach of Regulation 12 and we will report on this once this work has been completed.
The inspection took place on 11,12 and 13 April 2016 and was unannounced.
The last inspection took place on 19 and 20 May 2015, when we identified breaches of two regulations relating to safe care and treatment and the need for consent and good governance. Additionally we made two recommendations around the design of the environment and meaningful activities as directed by The National Institute of Care Excellence (NICE) guidance.
The provider sent us an action plan indicating how they would address the issues raised at the inspection. Improvements had been made, but areas such as those indicated by the recommendations required further improvement.
Kenilworth Nursing Home is a nursing home registered to provide accommodation, personal and nursing care for up to 40 people, some of whom are living with the experience of dementia, mental health conditions and people that are being cared for under the Mental Health Act 1983. At the time of our inspection there were 28 people living at the service.
There was 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 found that some practices around the handling of medicines were not safe and this presented a risk.
The provider had not always assessed people’s capacity to consent to care and treatment, specifically around sharing bedrooms and the covert administration of medicines.
The service had improved the environment since the last inspection on 20 May 2015 but needed to continue the programme of redecoration in line with The National Institute of Care Excellence (NICE) guidance about environments for people with dementia.
The provider had daily activities in place but these were not suitable for all the people who used the service. We recommended the service develop the activities programme in line with The National Institute of Clinical Excellence (NICE) Guidance for leisure activities and choice.
We saw the majority of the medicines were administered and dispensed safely.
Staff were supported through regular supervisions and yearly appraisals. Staff were sufficiently deployed and appropriately trained to meet the needs of the people using the service.
The service had a safeguarding policy and procedures in place.
The environment had improved since the previous inspection and was clean and well maintained.
Health needs were being met through assessments, monitoring and support from the relevant professionals.
Staff were kind and caring. They knew the people who used the service well and were able to meet their needs.
People had person-centred care plans and we saw evidence that staff followed them to meet people’s needs.
People who used the service, staff and relatives told us the managers were approachable and they could raise concerns with them.
We found breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
The inspection took place on 19 and 20 May 2015 and was unannounced. The last inspection of the service was on 10 July 2013 and there were no breaches of Regulation identified.
Kenilworth Nursing Home is a nursing home registered to provide accommodation, personal and nursing care for up to 40 people, some of whom are living with the experience of dementia, mental health conditions and people that are being cared for under the Mental Health Act 1983. At the time of our inspection there were 31 people living at the home.
There was 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. People were not protected from the risk of infection because they were not cared for in a clean and hygienic environment.
Risks relating to the use of bedrails, call bells and managing behaviour had not been adequately assessed.
People’s capacity to make decisions about their care and treatment had not always been assessed. The staff did not understand the legal processes required when relatives consented on behalf of people.
The environment was not designed to meet the needs of people who lived with dementia or who were experiencing mental health needs. The environment did not promote people’s emotional well-being.
Although care plans contained information about people’s needs they were not comprehensive, some lacked sufficient detail to enable staff to provide personalised care. The care plans included a monthly review of people’s care although these gave little information on the evaluation of the care that was planned for people and whether their needs were being met adequately.
People had limited opportunities to participate in meaningful activities that were based on good practice guidance.
There were quality monitoring systems in place however, these were not always effective in identifying areas where the quality of the service was not so good or used to make improvements.
There were enough staff to meet people’s needs in the home and community and to keep them safe. Appropriate checks were carried out for new staff.
There were systems in place to ensure that people consistently received their medicines safely, and as prescribed.
Staff were knowledgeable about people’s support needs, and received regular training and support to increase their skills. Staff had a good understanding of safeguarding adults procedures and knew the process to follow to report any concerns.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure that providers only deprive people of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. Where people were deprived of their liberty in their best interests, the provider had followed the appropriate procedures.
People told us that they were happy with the food and drink provided. They were supported by staff to eat and drink sufficient amounts to meet their needs.
Staff worked with other healthcare professionals if there were concerns about a person’s safety or welfare.
People were treated with respect and their privacy and dignity was maintained. People were supported to access advocacy services
People were happy to talk to the manager and to raise any concerns that arose. There was a clear management structure at the service and people, staff and families told us that the management team were approachable, inclusive, and supportive.
We found a number breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We spoke with the manager of the service, the deputy manager and five other members of staff. We also spoke with 15 people who were using the service and one relative who was visiting the home.
People told us that their views were listened to and one person said, "If I had any problems I would tell them and they would listen." We observed positive interactions between staff and the people using the service and people told us that staff always treated them respectfully. One person said, "they're polite to me and I can sit down and joke with them." Someone else said, "they're kind and considerate and if you need something it is there for you."
Care plans took people's individual likes, dislikes and preferences into consideration and promoted choice and independence. All of the care plans had been reviewed at regular intervals and updated to reflect people's changing needs.
People using the service and their relatives told us that the home was kept clean. One person said, "It's always clean, it's all been done this morning" and another person told us, "It's always clean, they hoover lots."
We found that there were systems in place to ensure that checks were completed as required to ensure the home was safe and maintained to a satisfactory standard.
We found that staff received support and were encouraged to undertake training so that they were able to meet people's needs effectively.
The home had quality monitoring systems in place to ensure that any areas for improvement were addressed.
We spoke with the provider, three members of staff and five people who used the service. We found that people had care plans and risk assessments in their care records that had been updated to reflect their changing needs. Health professionals had been contacted and involved in people's care and relatives had been contacted, kept informed and involved in decision making.
One member of staff said, "we have a care plan we follow and we ask the nurse for advice". Another member of staff said, "we have an end of life care plan and we respect people's choices". We observed positive interactions between the staff and people using the service. People we spoke with made positive comments about the staff such as, "the staff are lovely", "they are very good" and "they give me support".
Checks had been undertaken before staff started work at the home and staff were supported to obtain the knowledge and skills to meet people's needs effectively.
The staff we spoke with told us that there were always enough staff on duty to enable them to meet people's needs and the people we spoke with confirmed this. One person said, "there are always enough staff around".
People's care needs had been appropriately assessed and a care plan developed to ensure that staff had the information they needed to care for them effectively. Risks were assessed to support people's safety whilst promoting their independence and people were supported to take part in a range of activities.
The home was well maintained, clean and warm. Health and safety checks were taking place at regular intervals and fire drills were taking place to ensure that people and staff knew what action to take in the event of a fire.
Appropriate recruitment checks were completed to ensure that people were protected from unsuitable staff. There was an effective complaints management system in place and the complaints procedure was clearly displayed throughout the home including in people's bedrooms to ensure that people were aware of how to raise any concerns they had.
People told us they had chosen to live in the home and they were happy. They also said staff were 'kind and caring' and they could give their views about the home to staff. We saw evidence of meetings held for people and their representatives. These provided people with the opportunity to receive up to date information about the home and to share their views. Those people asked said they felt safe living in the home and would talk to staff if they had any concerns.
We saw staff communicating with people in a gentle and respectful manner. They supported people with their care needs whilst encouraging them to maintain as much independence as they could.
People told us there were other people in the home they could talk with and they could go out independently if staff assessed they were safe to do so. One person said they went to church and enjoyed going out and meeting other people.
People said there were some activities available and we saw an activities programme displayed on the lounge wall. During the visit we saw people watching television or drawing and colouring in pictures.
People confirmed staff supported them with their healthcare needs. They saw different healthcare professionals such as GP's, dentists and chiropodists when this was required.