We inspected this home on 13 November 2017. At our last inspection in February 2016, we found the previous provider was meeting the regulations and we rated the home as good. However, our key question ‘is the service safe’ was rated as ‘requires improvement.’ We asked the provider to take action to make improvements in relation to reporting safeguarding’s and staffing levels, and this action has been completed. However we found improvements were needed in relation to the deployment of staffing and how the staff team worked together to ensure they were always responsive to people’s needs.
Kings Bromley is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care home is registered to accommodate 47 people in one adapted building; on the day of our inspection, 36 people were using the service. The home is situated at the end of a private lane and has open views. All the outdoor spaces were secure and access was available. The property had an open reception which was also the location for the manager’s office and a visitor toilet. The home was then accessed key pad entry. The home had of a large ground floor which flowed in a circle, so that people could walk around the home. Upstairs there were six bedrooms which had been refurbished. There were two lounge areas and an open dining area.
The service had a registered manager in post. 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.
There were sufficient staff to support people’s needs, however they did not always worked together to ensure people’s needs had been met. The care plans provided details on the care to be provided, however in respect of people’s end of life care this was not always completed in a timely way.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
Any staff who had been employed had received a range of checks to ensure they were suitable to work in the home. We found staff had established positive relationships with people and they showed respect for people’s choices.
People were able to choose the meals they wish to eat and alternatives were provided. People’s weights had been monitored and advice sought to maintain people’s nutritional needs. We saw that medicines were managed safely and administered in line with people’s prescriptions. Referrals had been made to health care professionals and any guidance provided had been followed. Relationships that were important to people had been supported and when groups of family and friends visited they were provided with the opportunity to have a private space.
Care plans covered aspects of peoples care needs, including their history and previous pastimes.
People were encouraged and supported with activities they wished to engage in and further work was being developed to support people who did not wish to engage in group activities. Any complaints had been addressed and resolved in a timely manner.
Staff felt supported by the registered manager and there was a clear process in place to cascade information about the service and the needs of people. Staff had received training and the provider was looking to invest in further training to expand the staff knowledge.
The registered manager and provider had established a range of audits to support the improvements within the home. People had the opportunity to feedback on the care and support they received and any concerns raised had been addressed.
We saw that the previous rating was displayed in the reception of the home and on the provider’s website as required. The registered manager understood their responsibility of registration with us and notified us of important events that occurred at the service; this meant we could check appropriate action had been taken.