We carried out a review of the data available to us about Kirkwood Court 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 Kirkwood Court, you can give feedback on this service.
Kirkwood Court is a residential care home which accommodates up to 72 older people, in one purpose built building. Care is provided over three floors, including one floor, known as the Grace unit, for people living with dementia related conditions. Nursing care is not provided at the home. At the time of our inspection there were 66 people living at the home.
People’s experience of using this service and what we found
People and relatives were very positive about Kirkwood Court. They spoke highly of the staff team and how well they were cared for. The management team had worked hard since our last inspection to deliver the improvements required. They had strengthened the checks they carried out to monitor the quality of the service.
There were now enough staff to support people. Staffing levels had increased since our last inspection. Safe recruitment procedures were followed. Staff regularly checked the building and equipment to make sure it was safe. Medicines processes had improved.
Staff had the skills and experience to meet people's needs. People told us they were well supported. They had access to a range of health professionals, when required. People told us there was lots of food on offer, and that it was usually good quality. People’s nutritional needs were known and met.
Care was provided in a person-centred way. Staff knew people well. People and relatives told us staff were kind and treated them well. Families were welcomed into the home. Staff supported people to be as independent as they could be.
Staff knew people’s needs and their preferences for how they would like to receive their care. These were usually well documented although at times records had not been updated where needs had changed. There were a range of activities and events on offer for people to take part in.
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.
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 31 July 2018). At that inspection we found two breaches of regulation. 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.
This unannounced comprehensive inspection took place on 28 and 29 March 2018 and 4 April 2018. This meant that neither the provider nor the staff knew we would be visiting the home on the first day of our visit. Following these visits we requested further information from the provider and contacted relatives and staff by telephone. We concluded these inspection activities on 13 April 2018.
We last inspected this service in October 2015. At that time we found the service was meeting all legal requirements and rated the service as 'Good'. However, during this inspection we found some shortfalls in the delivery of care, and therefore rated the service as 'Requires Improvement'.
A registered manager was not in place at the time of the inspection. The previous registered manager had de-registered shortly before our inspection. The provider had employed a new manager who was in the process of applying to CQC to become 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 service is run.
Whilst processes and procedures were in place for the safe management of medicines, these were not always being followed.
Staffing levels were not consistent. On the days we visited we saw people’s needs were well met, however staff, people and relatives we told us there were not always enough staff on duty. Rotas showed staffing levels were regularly below the number we observed during the inspection. The regional manager told us any staff shortage was dealt with by the manager or domestic staff providing care. However feedback from people, relatives and staff was that there were not always enough staff available.
Robust recruitment procedures were in place, and the provider had recently strengthened their agency staff protocol after an incident where someone had mistakenly been assigned to work in the home.
The home continued to monitor accidents and incidents, manage risks and follow infection control processes.
People's needs had been assessed. However, as care plans varied in quality and detail, in some instances information about how to meet identified needs was missing.
Staff were up to date with training the provider considered mandatory for their roles. They received regular opportunities to discuss their roles and care they provided.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People told us they enjoyed the food at the home and that it was plentiful. Mealtimes were well organised and an enjoyable experience. Where needed, prompt referrals were made to health and social care professionals, such as speech and language teams, dietitians, specialist nurses and GPs.
People and relatives told us staff were caring. They gave us examples of when they had been touched by the way staff had gone out of their way for people. We saw that staff knew people well and had good relationships.
People were encouraged to be independent, and their right to privacy was respected. Staff supported people to maintain links with people and organisations which were important to them. Relatives told us they were welcome to visit any time, and some people were supported by staff to attend church services.
Information was available to people about the service. People were included in the planning of their care. Relatives told us their input had been valued when plans of care were being written. Most care records included information about people's choices and preferences.
Processes were in place to enable people to be cared for with compassion at the end of their lives. A relative spoke highly of the support both their family member and they received at this important time.
There were a range of activities on offer in the home, and regular trips were planned to places of interest. Staff had worked with people to help them to think of 'Three Wishes', which were personalised activities that they would like to achieve.
The provider followed their complaints policy. Some relatives told us they had complained and received a response.
The quality assurance system included a range of audits carried out regularly by the manager, regional manager and the provider's quality assurance team. However, whilst we saw audits highlighted issues with the standard of record keeping, remedial actions identified had not always been carried out. Medicines audits had not identified issues with 'as required' medicines.
Staff described low morale. However, people, relatives and staff were positive about the change in management structure, and proposed changes which the new manager had committed to make.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to Regulation 17: Good Governance and Regulation 18: Staffing 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 21 and 22 October 2015 and was unannounced. This means the provider did not know we were coming. We last inspected Kirkwood Court in October 2013. At that inspection we found the service was meeting the legal requirements in force at the time.
Kirkwood Court provides personal care for up to 72 older people, including people with dementia- related conditions. Nursing care is not provided at the home. At the time of our inspection there were 63 people living at the home.
The service had a 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 service is run. The provider informed us that the registered manager was leaving and a new manager had been appointed who would be applying for registration.
People told us they felt safe at the home and with the staff who supported them. Care was provided in a clean, safe and comfortable environment. Staff were trained in safeguarding and understood how to protect people from abuse.
New staff were thoroughly vetted to make sure they were suitable to be employed. Staffing levels were determined according to the numbers and dependency of people living at the home.
People were given support to maintain their health and well-being, access health care professionals, and to take their prescribed medicines safely. A varied and balanced diet was provided to ensure people had good nutrition. Where necessary, dietetic advice was obtained and staff supported people with their eating and drinking needs.
Staff were provided with training that enabled them to care for people effectively. All staff received regular supervision to support their personal development and an annual appraisal of their work performance.
People directed the ways they wished to be supported and gave consent to their care and treatment. Formal processes were followed to uphold people’s rights under mental capacity law when they were unable to make important care decisions.
Staff were caring and respectful in their approach and promoted people’s privacy and dignity. They had a good understanding of people’s preferences and encouraged them to make choices about their care.
People’s needs and any risks were assessed and documented in individual care plans. Care was routinely reviewed and adapted when people’s needs changed. A range of activities and events were provided to help people meet their social needs.
There was an open culture and people and their families were consulted about the running of the home. A complaints procedure was in place and any concerns were promptly responded to and investigated.
Appropriate management arrangements had been made to support the service and provide leadership until the new manager took up post. Standards at the home were subject to continuous monitoring to assure the quality of the service and the care that people received.
We spoke to the staff at the home and during our visit we were assisted by the regional manager.
We found there were enough staff on duty to meet people's needs.
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.
We saw people were cared for effectively and care was planned for the individual.
We saw people were safe and protected from abuse.
We saw there was sufficient staff to provide care and support.
The provider had an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.
The representatives or advocates of people who used the service were positive about the care and support provided. Comments included 'I am very happy here, the care is very good' and 'You get everything you need. They (the staff) treat me very well'.
People told us they were happy with the care and support they received. For example, one person remarked; 'It's very pleasant; we're very lucky to be here.' Another person said; 'There's a pull cord here and in my bathroom ' they're very patient.'
People also made positive comments about the staff, and the comments we heard included: 'The staff are very good.' Another person told us; 'The foods good, the staff are good.'
People said they received enough to eat and drink and relatives said they were happy that people who needed assistance to eat received it. They said 'the food is really nice' 'I have put on weight' 'I really enjoy the food, breakfast is my favourite' 'you have lots of choice'.
People confirmed that they could receive medical and specialist attention when they needed it and were helped to fulfil their social needs within the home and community. People we spoke with said 'there is lots to do' 'the cinema is a bit small' 'I can join in or relax in my room' 'we are always thinking and planning outings and we are involved in where we go'.
People told us that their home was clean, comfortable and warm and commented 'come and look at my beautiful room' 'look at my views of the garden' 'the place is spotless I feel proud when my family and friends visit'.
They said staff were kind and caring and seemed to be well trained. People confirmed that they were given the opportunity to comment on the service, change routine or raise complaints. They said that their visitors were made to feel welcome and information exchange was good.