Background to this inspection
Updated
7 July 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. This service was previously inspected in May 2017. At that time, we found there were areas that required improvement.
This inspection was conducted over two days by one adult social care inspector. We were accompanied by an expert by experience on the first day of our inspection visit. An expert by experience is a person who has used this type of service in the past.
Prior to the inspection, we looked at information we had about the service. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law.
Before the inspection, we had asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they planned to make. We reviewed the information included in the PIR and used it to assist in our planning of the inspection.
During our visits we spoke with 15 people individually and six relatives. In addition, we observed people in communal areas. We spent time with the register manager, the deputy, eight care staff, a domestic assistant and maintenance operative. The regional manager and support team also attended the second day of our inspection to support the registered manager, introduce themselves to us and answer any questions we had. We observed lunch and staff interaction with people. We looked at ten people’s care records, together with other records relating to their care and the running of the service. This included staff employment records, policies and procedures, audits and quality assurance reports.
Updated
7 July 2018
This inspection took place on 25 and 26 April 2018 and was unannounced. Kingswood Court Nursing Home is registered to provide care for up to 66 people. At the time of our visit there were 54 people were living at the service. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.
There was a registered manager who had been in post for a year. 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.
At the inspection of May 2017, we rated the service overall as Requires Improvement. At that inspection, we found breaches of Regulations 9 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed safely and people were not receiving meaningful activities that met their personal preferences.
Following the inspection, we told the provider to send us an action plan detailing how they would ensure they met the requirements of those regulations. At this inspection, we saw the provider had taken action as identified in their action plan. In addition, they had sustained previous good practice. As a result of this inspection, the service has an overall rating of Good.
Why the service is rated Good
The appointment of the registered manager had significantly helped rectify previous poor management of the service. It was evident they were confident and committed to embrace new challenges and to continue to improve the service. An increase in the provider’s oversight meant that a number of improvements had been made to help ensure that people were safe and received quality care.
Improvements had been made to help ensure people were protected from the risk of poor management of medicines. The registered manager and staff followed procedures, which reduced the risk of people being harmed. Staff understood what constituted abuse and what action they should take if they suspected this had occurred. Staff had considered actual and potential risks to people, plans were in place about how to manage, monitor and review these. People were supported by the service’s recruitment policy and practices to help ensure that staff were suitable.
Staff had the knowledge and skills they needed to carry out their roles effectively. They felt supported by the registered manager and deputy at all times. They had a good understanding of the Mental Capacity Act 2005 (MCA). The care staff understood its principles and the importance of supporting people to make decisions and protect their rights. People enjoyed a healthy balanced diet based on personal preferences.
People and their relatives felt staff were caring and kind. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.
People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The registered manager had implemented a programme of ‘planned growth’ that had been well managed and they were committed to continuous improvement. The provider and registered manager understood the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.