Background to this inspection
Updated
7 August 2021
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 Care Act 2014.
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
This inspection was carried out by one inspector.
Service and service type
Kington Court Community Care Centre is a ‘care home’. 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.
The service had a manager registered with the Care Quality Commission. This means that they 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 on the first day. We announced our return so as to ensure a member of the management was able to be present at the location.
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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who used the service and one relative about their experience of the care provided. We spoke with fourteen members of staff including the registered manager, the operations manager, the clinical lead, an agency nurse, two residential coordinators, five care staff, one activities coordinator, one receptionist and one maintenance person. We carried out an observation during a mealtime to help us understand people’s experience.
We reviewed a range of records. This included three people’s care plans plus a small number of others which were viewed for specific information and multiple medicine records. We looked at two staff files in relation to recruitment. In addition, we looked at records relating to the management of the service. We viewed the environment where people were living.
After the inspection
We continued to seek clarification from the operations manager and registered manager including a meeting using electronic technology. We sought and reviewed additional information. We also spoke with three relatives of people for their experience of the service provided.
Updated
7 August 2021
About the service
Kington Court Community Care Centre is a residential care home which provides personal and nursing care to people either permanently or temporarily. People living at Kington Court Community Care Centre are older people, who may live with physical disabilities, sensory impairment or dementia. There were 30 people living at the home at the time of the inspection. The service can support up to 48 people. The building is purpose built with all the accommodation and communal space located on the first floor.
People’s experience of using this service and what we found
People did not always have risks to their safety managed effectively. Risks within the environment were either not clearly identified or suitable action was not always taken to keep people safe. These risks included window safety, water temperatures, call bells and use of wheelchairs.
Peoples’ medicines were not always managed safely. Staff were not always managing and recording people’s pain relief patches effectively and in line with the manufacturer’s instructions to ensure people fully benefited from these. Clear action was not always taken when potential errors were made by staff members.
People’s care needs were not always met in a timely way by staff members. Observations made were fed back to the management team.
Management systems and audits had not always identified or actioned areas whereby improvement was required in order to keep people safe. Where improvements had been acknowledged these were not always sustained by staff consistently.
Feedback from people’s family members were positive in relation to staff and the care provided.
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 requires improvement (published 08 November 2019).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We received concerns in relation to the management of medicines, staffing and management follow up. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. In addition, this inspection was based on the previous rating of requires improvement.
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 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 COVID-19 and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kington Court Community Care Centre on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to people’s safety, medicines and good governance at this inspection.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.