Kernow House

Updated 19 March 2020

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by four inspectors and an independent specialist nurse advisor who had experience of this type of service.

Service and service type:

Kernow House 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.

The service had a manager registered with the Care Quality Commission. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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 used the information the provider sent us in the provider information return. 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. This information helps support our inspections. We reviewed the last inspection report, information we had received from other agencies and feedback we had received from other interested parties. We used all of this information to plan our inspection.

During the inspection:

We spoke with nine people who used the service, three relatives, 18 staff members, the registered and deputy managers, the maintenance person, three visiting healthcare professionals and a volunteer. We reviewed the care records of seven people who used the service. We reviewed records of accidents, incidents, compliments and complaints, staff recruitment, training and support, medicines records as well as audits and quality assurance reports. Some people were not able to tell us verbally about their experience of living at Kernow House. Therefore, we observed the interactions between people and the staff supporting them. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification of information with the registered manager. We received feedback from one healthcare professional.

Updated 19 March 2020

About the service:

Kernow House is part of the Barchester Healthcare group of homes. It provides personal care and nursing care for up 98 people. There were 71 people using the service at the time of our inspection. The service supports individuals with Huntington's disease, dual diagnosis, acquired brain injury, dementia and mental health issues.

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

Staff understood risks to people and how to help reduce them. Systems were in place to safeguard people. The service raised concerns appropriately.

People received their medicines on time from staff who had received training and competency checks in medicines administration.

Infection control measures were in place to prevent cross infection. People told us the service was kept clean. There were no malodours throughout the service during this inspection.

Staff were recruited safely in sufficient numbers to ensure people’s needs were met. The use of agency staff had dramatically reduced since the last inspection. Staff were supported by a system of induction, training and supervision. Staff told us they felt well supported by senior staff and the registered manager.

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. Any restrictive practices were regularly reviewed to ensure they remained the least restrictive option and were proportionate and necessary.

There were systems and processes in place to monitor the Mental Capacity Act, and associated Deprivation of Liberty Safeguards assessments and records. People were able to make choices about their life and how their care and support were provided. This information was reflected in people’s care plans. Staff understood the importance of respecting people’s wishes and choices.

People, relatives and health and social care staff agreed the staff were kind and caring. Staff respected people’s diverse characteristics and were clear that each person’s individual needs were their priority.

People told us they felt listened to and their privacy and dignity were respected. Comments included, “I love living here, food is lovely, staff are nice, spend time with me” and “It is a lovely here, it is a very caring home.” A relative told us, “I could not be happier with the care here. [Person’s name] even gets her hair done regularly.”

Visiting health and social care staff told us, “I have been coming regularly for some time now. They [Staff] do a good job, I have no concerns at all” and “I have seen improvements in staff morale.”

Everyone had a care plan which was regularly reviewed and updated. These provided staff with guidance and direction to enable them to meet people’s need. People’s preferences were sought and respected.

There were activities provided for people. Two activity co-ordinators supported staff to provide varied activities. Robotic pets and a ‘magic’ table were available for people to use. People were supported to go out in to the local area, with staff, in the service minibuses.

Audits were carried out regularly to monitor the service provided. Actions from these audits were being acted upon to further improve the service. Records were stored appropriately, accessible and up to date.

Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to. The registered manager told us there were no on-going complaints at the time of this inspection.

People and staff told us the service was well led. Staff told us, “This is a good place to work, I have worked in other places and this is one of the best” and “I really enjoy working here.”

People were given various opportunities to provide feedback about the service. The registered manager and senior staff had developed positive relationships with local organisations, which helped ensure people had their needs met promptly. Staff told us they enjoyed working at the service and that the team worked well together.

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:

At the last inspection the service was rated as requires improvement (report published 27 March 2019) and there was a breach of the regulation. At this inspection we found enough improvements had been made and the provider was no longer in breach of the regulation.

Why we inspected:

This was a planning 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.