Archived: Kents Hill Care Home

We asked the provider to submit an action plan to tell us how they would meet these regulations in the future; they stated that they would be meeting them by 31 May 2016. During this inspection we returned to see if the service had made the improvements they stated in their action plan. We found that the provider was now meeting these regulations.

We undertook this focused inspection on 15 June 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kents Hill Care Home on our website at www.cqc.org.uk.

Kents Hill Care Home is based in a residential area of Milton Keynes and provides nursing and personal care for older people, who may be living with dementia. The service is registered to provide care for up to 75 people, on the day of our inspection there were 60 people living there.

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.

Improvements had been made to the systems for medication management and documentation. The registered manager had made sure that people's medication records had photographs and information to guide staff. In addition, they had implemented checks and audits to monitor the administration of medication and identify areas for improvement.

The provider had also made improvements regarding response times to people's call-bells. There had been changes made to staff deployment within the service and the system for when staff took their breaks to help ensure busy times were covered by staff. Audits were carried out to review staff responses to call-bells, to ensure people's needs were met in a timely manner.

Kents Hill Care Home is based in a residential area of Milton Keynes and provides nursing and personal care for older people, who may be living with dementia. The service is registered to provide care for up to 77 people, on the day of our inspection there were 57 people living there.

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.

Medication was not always recorded and managed appropriately, to ensure it was administered safely, in addition, staffing levels at the service were not always sufficient to meet people’s needs. People were protected from harm or abuse, and staff were aware of their reporting and recording responsibilities in this area. Risks to people, their visitors and staff members had been assessed, and control measures had been put in place to mitigate those risks. Staff members had been recruited safely, following robust procedures.

There were induction and training courses in place for members of staff, as well as regular supervision and appraisal sessions, to ensure they had the skills, knowledge and support they needed to perform their roles. The service had processes to comply with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards, however records did not always show that specific decisions were considered for each person. People had a choice of food and drink, and were happy with the food that was available. People were supported to see healthcare professionals as and when they needed to.

People’s needs were not always met, as call bells were not responded to quickly, often leaving people waiting for support to arrive. People and their family members were not always involved in planning their care. Family members also told us that they did not always feel that they received, or had access to all the information that they required. There were positive relationships between people and members of staff. Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

Care plans were in place for people and were based upon their individual specific needs and wishes. They were reviewed and updated regularly, to ensure they reflected the most recent and up-to-date information regarding people’s care. There were activities at the service which were regularly put on, to keep people occupied and stimulated. The service also had a complaints procedure in place, to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.

There were quality assurance systems in place at the service, however they were not always effective in identifying areas of concern, therefore improvement action was not always taken. There was a positive and open culture at the service. People were comfortable living there and members of staff were motivated to provide quality care which met their needs. The registered manager was well known to people and they were aware of their regulatory responsibilities.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive to people's needs?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

All of the people we spoke with told us they felt safe living at Kents Hill Care Home. One person said, 'We are really well looked after.' We observed that plans of care included risk assessments to promote people's safety such as assessments for malnutrition, the risk of falls and moving and handling assessments. We also observed staff used safe movement and handling techniques.

We saw that the premises were well maintained with no risks to people's safety. Most of the people who used the service had access to the outside, although for those people living on the second floor of the home this had to be with the support of care staff to ensure their safety.

We found that staff had been safely recruited and there were enough staff on duty to support people's safely and to meet their needs appropriately.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DOLs). We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. They had sought appropriate advice from the local authority following the recent changes in guidelines.

Is the service effective?

Steps were taken to involve people in making decisions about their care and support by involving them in their care planning. It was clear that people had stated their preferences, particularly in relation to their food likes and dislikes and people were routinely asked their opinions on how the home was run.

Staff we spoke with had a good understanding of people's needs and knew how they preferred to be supported. This meant people were supported appropriately in relation to their needs

Is the service caring?

Staff spent time interacting with the people who used the service as they were going about their chores. A relative told us they were always made to feel welcome and felt confident that the care their loved one received was of a high standard.

We saw evidence that staff from Kents Hill Care Home sought the support of care professionals, for example a G.P. correctly.

Is the service responsive?

The staff team underwent regular updates of their training to ensure they had the experience and qualifications to meet people's needs. There were sufficient staff on duty at anytime and the manager confirmed that staffing levels were kept under review.

During our inspection we observed that call bells were answered in a timely fashion and any requests from people were responded to. Activities were planned to help stimulate people and people told us these were varied and catered for all interests

Is the service well- led?

At the time of our inspection the service was led by a manager who was registered with the Care Quality Commission. The registered manager held regular meetings with the staff and the relatives. Staff told us they felt able to speak with the manager and were confident the manager would address any issues they raised.

Individual plans of care reflected people's health care needs and personal preferences. Risk assessments were in place to reduce and manage the impact of identified risk factors.

The people we spoke with all said they were comfortable and liked their surroundings. We saw that each person we spoke with in their own bedroom had arranged their private space the way that suited them.

People said that they enjoyed their meals and had plenty to eat and drink throughout the day.

One person said, "There is always something going on I can join in with if I want to." We saw that there was a range of activities planned for the week ahead, including an organised dog 'show' when we visited.

Another person said they received the care and support they needed and felt safe at 'Kents Hill' because they could rely on the staff to do "a good job".

We spoke with five members of staff who all had a good knowledge of people's care needs and spoke positively about the support people received at 'Kents Hill'.

Overall, we saw that people living at the home were happy and well supported by the staff team.

We saw that people in the communal lounges appeared relaxed and happy in the presence of staff. The home was warm, clean, and free from odours. We saw evidence that people's rooms were personalised with their belongings.

We saw staff go about their duties in an unhurried yet purposeful manner. They took time to converse with people and they were friendly and helpful to visitors.