Kingston Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service had made improvements and no longer in breach of regulations. There were now enough staff to support people and meet their needs. Staff now received relevant and regular training to meet people’s needs. Staff were better supported through supervision to learn, develop and improve their working practices. People were supported to live in a safer environment, which was regularly checked and maintained to ensure risk to people was minimised. Systems were in place to protect people from the risk of abuse or harm. Staff had been trained to safeguard people from abuse and to take appropriate action to protect people when needed. Staff managed identified risks to people to keep them safe from injury or harm. Safety events and incidents were investigated and lessons learnt were used to improve safety at the service. Recruitment checks were undertaken on staff to make sure they were suitable to support people. The premises was clean and hygienic. Staff followed current infection control and hygiene practice to reduce the risk of infections. People received timely support with their medicines and these were administered as prescribed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was an open and transparent culture at the service in which people could confidently raise and report concerns about their safety. People’s safety and wellbeing was prioritised because learning from safety events was used to support staff to continually improve their practice and keep people safe.

Managers encouraged an open and transparent culture at the service so that people and staff could raise concerns without fear. The registered manager told us, “I do walkabouts and speak to people and catch up and see how they are. I try and speak to as many people as I can. I encourage people to come and speak to me as well...and I encourage the staff to come and speak to me at any time and I am always available to them.” Managers and staff told us safety events were investigated and lessons learnt were shared through daily handovers and regular staff supervision and team meetings.

Systems were in place to support staff to report and record safety events when these arose. Clear processes were in place for managers to fully investigate safety events and to use the learning from these to support staff to continually improve their practice and provide safe, high quality care to people. The registered manager told us, “We have a report from the internal quality team monthly and this helps us to identify any themes and trends from all the events reported. For example, falls are looked at to see if there are underlying themes. Me and the deputy manager are constantly using the system and proactive addressing anything that comes up.”

People’s safety was prioritised from the moment they started to use the service. Information was obtained about people’s individual needs and risks to their safety and used to ensure people received safe and appropriate care and support as soon as they moved in.

Managers made sure people, and others involved in their care, were involved in assessments and planning of their care and support, to support a smooth and safe transition when they started to use the service. The registered manager told us, “We complete a pre-admission assessment and I will go out and do the assessment. I will speak to the healthcare professionals involved, the person and their family and get all the information we need about their needs and then when they move in we prepare the staff with the information so they are aware. We prepare the room for the person, for example, if they need bed rails. We let the kitchen know about dietary needs so the person can have meals they like. I make sure each shift on the floor is made aware of new people.”

Partners had positive experiences of working with the service to ensure safe systems of care were established and maintained to meet people’s needs and keep them safe. A healthcare professional told us, “Kingston Care Home has demonstrated their willingness and are keen to work with our service, meeting client’s needs by keeping them safe [and] responding to the suggested person-centred care planning.” Another healthcare professional said the pre-admission assessment process was good and the service would only take people whose needs could be met by staff.

Systems were in place to obtain information about people, their individual needs and risks to their safety to ensure people experienced safe and appropriate care from the moment they started to use the service. People, and others involved in their care, were involved in this process which gave managers a detailed overview of people’s needs and safety risks and how these needed to be managed.

People were supported to live in an environment where they were protected from the risk of abuse, neglect, bullying or harassment. One person told us, “I do feel safe. I like the atmosphere. It’s cheerful.” Another person said, “I’ve been here for three or four years…yes, it’s perfectly safe.” Another person told us, “If I saw any ill treatment I wouldn’t hesitate to say something.”

Staff knew how to safeguard people and received relevant training and support to do so. A staff member told us, “We have to refresh our safeguarding training at least yearly and we know if we ever see anything bad happen to people living here, we must tell the nurse in charge or any of the managers straight away.” Another staff member said, “I would always let the managers know about any safeguarding incidents and I know they have to report it to the local authority safeguarding team and the CQC, which I’m confident they would do.”

People were comfortable and at ease with staff. People did not hesitate to approach staff and ask for their support when they needed this. Staff knew people well and alert to any changes that might indicate people needed reassurance to reduce any anxiety or discomfort they might be experiencing.

Systems were in place to help staff recognise safeguarding concerns and report these to the relevant persons and agencies. Records showed the service worked proactively with the relevant agencies when a concern was raised and managers took appropriate action to safeguard people from further risk, when this was required.

Risks to people were managed well and people were able to do the things that mattered to them. People took part in a wide range of activities and events and staff made sure risks to people were mitigated so that people remained safe doing so.

Staff had been trained to keep people safe and manage risks they might face. A staff member told us, “We receive regular training in falls prevention and how to use mobile hoists and other moving and handling equipment safely. It’s also very clear in people’s individual care plans who might be at risk of falling and what we have to do as staff to stop it happening.” The registered manager said risks to people were regularly monitored and reviewed and changes were made to people’s risk management plans when these were required so that staff had the most up to date information about how to keep people safe.

People moved freely around the service and spent their time as they wished, with no unnecessary restrictions. Staff were present and available in case people required their assistance. Staff followed people’s risk management plans and this enabled people to take reasonable and acceptable risks. For example, we saw 2 staff use appropriate moving and transferring techniques whilst supporting a person to safely transfer from one chair to another.

Systems were in place to ensure risks to people were continually assessed, monitored and reviewed. Improvements had been made to people’s care records which now contained detailed information and guidance for staff on how identified risks should be managed to keep people safe from injury or harm.

The service had made improvements and people were now supported to live in an environment, which was regularly checked, monitored and maintained to ensure risk to people was minimised.

Staff understood the environment and equipment could pose risks to people’s safety and knew how to minimise these risks to keep people safe. Staff told us they had been trained to use equipment to support people and there was enough equipment available to support people with their needs.

The environment was free from unnecessary slip or trip hazards and grab rails were placed at an appropriate height. Staff were confident using equipment when supporting people. Some elements of the environment would have benefited from more consideration of the needs of people living with dementia. For example, some people’s bedroom doors lacked visual clues to help people identify their room. Communal areas such as the lounge, dining area, hallways and bedroom doors had all been painted similar colours, which might make it more difficult for people to orientate around the environment. We discussed this with the registered manager who took on board our feedback and told us about how future plans for the service would ensure a supportive environment was consistently maintained for people living with dementia.

Safety systems and equipment used at the service were maintained and serviced at regular intervals. Managers undertook health and safety checks of the premises at regular intervals. Prompt action was taken to address any safety concerns identified through checks. This helped to ensure the environment, and equipment used, remained in good order and safe for use.

The service had made improvements and people were now supported by a consistent and experienced staff team who knew them well. People told us they didn’t have to wait long for assistance if this was needed. One person said, “I don’t really use the call bell. There is always someone walking by.” Another person told us, “I’m never left unattended. If I press this [call bell] someone is with me in minutes.” A relative felt staff took longer to respond to call bells at night and at weekends. Feedback from people and our checks of the provider’s call bell records did not indicate significant concerns about response times during these periods. However, we discussed this with the registered manager who told us they would look in to this feedback and take appropriate action if this was required.

The service was now better staffed and no longer reliant on temporary agency staff to cover staff shortfalls. A staff member told us, “We used to be so reliant on agency staff here, but not anymore. It’s made such a difference.” The registered manager said, “Because we have continued to actively recruit new staff in recent years we now have our full complement of nursing and care staff and haven’t needed to use any agency staff in the last 12 months.” The registered manager told us they continuously reviewed staffing levels at the service to ensure there were always enough suitably experienced and trained staff on duty to meet people’s needs and keep them safe. Staff said they received relevant and regular training to support them in their roles. A staff member told us, “The training we receive is always relevant and ongoing. Only recently I had to refresh my dementia awareness, moving and handling and oral care training.” Staff felt well supported in their roles. A staff member said, “We have regular individual and group supervision with our line managers and team mates and every 12 months our work is appraised by the manager in charge.”

Staff were visibly present throughout the home and there were enough staff on duty to meet people’s needs. Staff were quick to respond to people’s questions and requests for support. Staff were vigilant when people were moving around the home or undertaking activities to ensure people remained safe.

The service had made improvements and no longer in breach of regulations. Staff were now provided with regular and relevant training to meet people’s needs. They were supported through a regular programme of supervision and appraisal to continually learn and develop in their roles. There were enough staff to meet people’s needs. Staffing rotas were planned based on people’s dependency and needs. Recruitment processes were effective and ensured only suitable staff were recruited to work at the service.

People were supported to live in a clean and hygienic environment. One person told us, “It’s nice and clean. My cleaner came in yesterday. They wear gloves and aprons when they do personal care.” Another person said, “They’re fanatics about the cleaning. You haven’t got to the last bite in your mouth and they are there waiting for the crumbs.” Relatives told us, on occasion, people’s rooms were not as clean as they would like. We discussed this with the registered manager who told us they were already aware of some concerns about this and had taken action to address this already. This included recruitment of new domestic staff and the purchase of new equipment that would support the housekeeping team to maintain cleanliness and hygiene standards more effectively around the home.

Staff received relevant training and knew the processes to follow to minimise the risk and spread of infection. A staff member told us, “We have ample supplies of face masks, aprons and gloves we need, when we’re providing people with personal care, and there’s an expectation we keep our infection control training up to date.”

The environment was clean and hygienic. Personal protective equipment (PPE) was widely available and accessible to staff. Staff wore appropriate PPE when this was required. Handwashing guidance was displayed to prompt good hand hygiene practice. Bathrooms and toilets had hand wash, hand towels and sanitiser readily available to support this practice. Food preparation areas were clean and clear. Food in the fridges, freezers and dry goods cupboard was in date, clearly labelled and stored appropriately.

Arrangements were in place to manage infection risks. Staff received infection prevention and control and basic food hygiene training. There were sufficient supplies of PPE for staff to help them minimise infection risks. Staff maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks. The provider’s infection prevention and control policy was current and reflected national guidance.

People received their medicines safely and as prescribed. One person told us, “The medication is all done well and they’ll give you something if you’re not feeling too good.” Another person said, “[Staff member] does the medication. She is on this morning. You don’t have to wait for it. It’s all done well.”

Staff were clear about their roles and responsibilities in relation to the safe management and administration of medicines and told us they received relevant training. The registered manager said there were regular checks of medicines to make sure these were administered and managed safely by staff

There were regular audits of medicines at the service. This included checks of staff’s practice to ensure they remained competent and safe to administer and manage medicines. Medicines stocks, balances and records showed people consistently received the medicines prescribed to them.