Kilkee Lodge Residential Home

Updated 21 June 2023

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

The inspection was undertaken by 2 inspectors and an Expert by Experience. 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

Kilkee Lodge 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. Kilkee Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did 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 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 8 people who used the service and 4 relatives during the site visit. We received emails from 8 relatives about their experience of the care provided. We spoke with 12 members of staff including the registered manager, deputy manager, supervisors, seniors and health care assistants, housekeeping, and catering staff.

We observed staff and the way they cared and supported people. We viewed a range of records. This included 3 people's care plans and medicine administration records. We looked at 2 staff member's personnel files in relation to the service's recruitment practices. A variety of records including quality assurance and management documentation were viewed.

Updated 21 June 2023

About the service

Kilkee Lodge Residential Home is a care home which provides accommodation with personal care for up to 80 people. At the time of the inspection the service was supporting 76 people accommodated in 1 adapted building on 2 floors.

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

Audits on quality and safety had improved since the last inspection, However, further improvements were needed to ensure oversight of hygiene, refresher training, risk assessments and complaints process.

Assessments were completed and risks to people’s health and wellbeing had improved. However, there was no oversight that these had been completed correctly. Comments and concerns raised by people and family members were not always recorded appropriately so that lessons could be learnt, and improvements made.

Kilkee Lodge was providing a rehabilitation service where people used the service to gain independence skills to return home. However, there was no clear protocol or guidance for how this was provided. The provider's statement of purpose needed to be updated.

Infection prevention and control measures were in place; however, some improvements were needed to areas of the service to ensure they were odour free. Some facilities such as 2 of the bathrooms were not able to be used by people as they needed attention.

Medicines were managed in line with professional guidance and people received their medicines as prescribed. Systems were in place to manage safeguarding concerns and staff were clear about the actions they should take, where they had a concern.

The deployment of staff and rota arrangements had been improved and met the needs of people using the service. There were enough staff on duty to provide appropriate care and support to people living at Kilkee Lodge. Staff were safely recruited to work at the service and were inducted and trained to provide good care.

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.

Staff were responsive to people’s needs. People were able to participate in social and leisure activities provided by the service. People were given appropriate care and support at the end of their lives.

The management team were accessible and clear about their roles and responsibilities. They supported staff who were consistent, kind and caring. The management and staff team had developed positive working relationships with external stakeholders and other healthcare professionals. Lessons had been learnt when things had gone wrong.

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 17 May 2021) and there were 2 breaches of the regulations. The provider completed an action plan after the last inspection in April 2021 to show what they would do and by when to improve. At this inspection there was not enough improvement, and the provider was still in breach of the regulations.

At our last inspection we recommended the provider review the deployment of staff to ensure staff were available to respond to requests for assistance. At this inspection we found the provider had acted on the recommendations and improvements had been made.

Why we inspected

We undertook this unannounced focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions of Safe, Responsive and Well led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

We have found evidence the provider needs to make improvements. Please see the well led section of this full report.

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

Enforcement and Recommendations

We have identified a breach in relation to good governance at this inspection.

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

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