Archived: Kings Lodge Care Centre

Updated 6 May 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 31 March 2017 and was unannounced. The inspection was carried out by three inspectors and a specialist nursing advisor.

Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. The provider had returned a Provider Information Return (PIR) on 10 March 2017. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR before our inspection to ensure we addressed any areas of concern.

During the inspection we spoke with nine people who lived at the home and two relatives. 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 tell us about their experience directly. We spoke with nine staff, including the manager, deputy manager, nursing, care and catering staff.

We looked at the care records of four people, including their assessments, care plans and risk assessments. We looked at how medicines were managed and the records relating to this. We looked at five staff recruitment files and other records relating to staff support and training. We also checked records used to monitor the quality of the service, such as the provider’s own audits of different aspects of the service.

After the inspection, we received feedback from one relative and one social care professional via email.

Updated 6 May 2017

Kings Lodge Care Centre is a care home with nursing for a maximum of 42 older people, some of whom are living with dementia and/or sensory impairment. There were 35 people living at the home at the time of our inspection.

The inspection took place on 31 March 2017 and was unannounced.

There was no registered manager at the time of our inspection but the home manager had applied for registration with the Care Quality Commission (CQC) and their application was being assessed. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

At our last inspection in 22 January 2016, we found the provider was breaching legal requirements in relation to infection control and treating people with respect. Some areas of the home were not adequately clean and staff did not always follow good infection control practice, which presented a risk of infection. Some staff did not respect people's privacy or treat them in a way that maintained their dignity. The provider sent us an action plan setting out the action they planned to take to improve standards in these areas.

At this inspection we found the provider had taken action to meet these legal requirements. There was a cleaning schedule in place, which ensured the home was clean and hygienic. People were protected from the risk of infection because staff maintained safe infection control practice. Staff demonstrated compassion in their approach and treated people with dignity and respect. People had developed positive relationships with the staff who cared for them and relatives told us staff were kind and caring.

People felt safe at the service and when staff provided their care. There were enough staff on each shift to meet people’s needs but staff were not deployed effectively at all times during our inspection. The manager responded promptly to address this issue, allocating an additional member of staff in one part of the home and introducing a checklist to evidence that appropriate checks were carried out.

Risks to people had been assessed and staff implemented measures to reduce these risks. Staff understood safeguarding procedures and were aware of their responsibilities should they suspect abuse was taking place. People were protected by the provider’s recruitment procedures. There were plans in place to ensure people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly to keep the premises and equipment safe for use. People’s medicines were managed safely.

People were supported by staff that had the skills and experience they needed to provide effective care. Relatives said staff knew their family members’ needs well and provided consistent care. Staff had an induction when they started work and access to ongoing training, supervision and support.

During our inspection we found some inconsistencies in the recording of mental capacity assessments. After the inspection, the manager provided evidence that appropriate procedures had been followed when decisions that affected people were made. Where people did not have the capacity to make decisions, relevant people had been involved in making the decision in the person’s best interests. Applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe

People were supported to have a balanced diet and enjoyed the food at the service. People’s nutritional needs had been assessed and were kept under review. The service had access to healthcare professionals if people developed nutritional needs that required specialist input. People’s healthcare needs were monitored effectively and they were supported to obtain treatment if they needed it.

The service was responsive to people’s individual needs. Care plans were person-centred and reviewed with the input of the person receiving care and their friends and families. Staff understood the importance of treating each person as an individual and ensuring that the care they received reflected their preferences. People had access to a range of activities and events. The service employed activities co-ordinators, who provided activities and opportunities for engagement based on people’s needs and interests.

The provider had a written complaints procedure, which detailed how complaints would be managed. None of the people we spoke with had made a complaint but all told us they would feel comfortable raising concerns if they were dissatisfied. The complaints record showed that complaints were investigated and responded to appropriately.

Since taking up their post, the manager had encouraged people, relatives and staff to contribute their views about how the service could be improved. Relatives told us this had had benefits for their family members in how their care was provided. Staff said the manager had improved the support they received and communication amongst the staff team. People told us the manager knew everyone living at the home well and spoke with them regularly to hear their views.

The provider monitored the service to ensure appropriate standards were maintained. Senior staff conducted audits to ensure key areas of the service were being managed safely and effectively. There was an action plan for the service, which was reviewed regularly to ensure any areas identified for improvement were addressed. The provider used surveys to seek feedback from people, relatives and professionals who had a regular involvement in people’s care. Where people had made suggestions for improvements, we saw that these were acted upon by the provider.