Kingsway Nursing Home

We found the following examples of good practice.

The provider had procedures in place to support visits and prevent visitors from catching and spreading infection. Relatives could book visits in the home’s visiting pod or conservatory, both of which could be accessed without entering the main building. All visitors were robustly screened for COVID-19.

The provider considered people’s emotional wellbeing. People were encouraged to have regular telephone and video contact with friends and family. The provider organised activities such as afternoon tea and themed nights to support morale.

Adequate supplies of PPE were in place and had been throughout the pandemic. There were fully stocked PPE stations located throughout the home. Some users of the service chose to wear a mask and these were readily available for them in the home.

All staff were observed to be wearing PPE and were bare below the elbow. Staff had completed training in how to safely put on, take off and dispose of PPE. The registered manager carried out practical assessments and hand washing competencies to ensure staff complied with good practice.

The home was clean and tidy throughout. The provider had increased cleaning during the pandemic. Disinfectant wipes were located at all workstations so equipment could be cleaned after each use.

The provider had up to date infection prevention and control (IPC) policies and procedures in place. The provider carried out regular IPC audits.

The registered manager spoke positively about the support from the staff team, the provider and healthcare professionals.

Kingsway Nursing Home provides nursing and personal care for up to 42 people in a two storey, purpose built building. Care and support is provided to older people, including some people living with dementia and adults with mental health needs. At the time of inspection 39 people were using the service.

People’s experience of using this service and what we found

People told us they felt safe and happy living at Kingsway Nursing Home. Safeguarding procedures protected people from the risk of abuse. Risks to people were assessed and actions were taken by staff to reduce any risks identified. The providers recruitment processes reduced the risk of unsuitable staff being employed. Lessons were learnt from adverse incidents.

Staff had a good skills mix and were trained to carry out their roles safely. They were supported with regular supervision meetings and appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice.

People told us they enjoyed the food on offer. People and relatives said staff were caring. Staff knew the people they were supporting very well. People received person-centred care based on their choices and preferences. A range of activities were available to people and people were able to follow their interests and hobbies. Feedback was sought from people and acted upon.

Complaints were managed appropriately. Audits and checks were carried out by the management team and provider. The service worked in partnership with other agencies to fully meet people’s needs.

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 good (published 28 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Kingsway Nursing Home is a care home which provides personal and nursing care for up to 42 people. Care is provided to older people living with a dementia, younger people with alcohol related brain damage and people with mental health needs. At the time of the inspection there were 41 people using the service.

The service accommodated people across two floors. There is an enclosed garden for people to use.

People’s experience of using this service and what we found

People spoke positively about the care and support they received. Risks to people’s health, safety and wellbeing were well managed. We found no evidence of unwarranted restrictive practices, although we did find equipment a person might use to prompt them to move around the service was not kept within their view. One person in their last placement had been going out independently, but this had not happened since moving to the service. We pointed this out to the registered manager who took immediate action to address this.

The fire alarm was tested to ensure it would activate in the event of fire, but staff were not simulating the practice of evacuating people from the building. We pointed this out to the registered manager who confirmed after the inspection this fire practice would take place as a matter of priority and over a short timescale. We also shared this information with the fire authority.

There were enough staff employed and on duty to meet the needs of people. The provider had an effective recruitment and selection procedure. People told us they felt safe with the staff who supported them.

There were arrangements in place to ensure people received medicines in a safe way, although some people were refusing their medicines, but their care plan documentation suggested they lacked capacity to make such a decision. We pointed this out to the registered manager who confirmed they would take immediate action to correct this.

People were protected from the risk of infection and staff had received training in infection prevention and control.

Accidents and incidents were monitored and analysed enabling any safety concerns to be acted upon and lessons learnt.

Effective quality assurance systems were in place, although some improvements were needed as it did not identify some areas of improvement that we identified during this inspection.

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 the service was good (published June 17)

Why we inspected

We received concerns in relation to the safety of people. As a result, we undertook a focused inspection to review the Key Questions of safe and Well-led only. We received concerns about the restriction and safety of people who used the service. We were informed that some people had chosen to have their bedroom door locked by staff when they were in their bedroom. We were also made aware that those people were unable to get out of bed and open their door. A decision was made for us to inspect and examine those risks.

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 found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kingsway Nursing Home on our website at www.cqc.org.uk.

Kingsway Nursing Home provides nursing and residential care for up to 42 older people with dementia, younger people with alcohol related brain damage and people with mental health needs. On the day of our inspection there were 41 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

We last inspected the service in March 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service, meeting the needs of those people with a dementia type illness. Appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Staff told us they were fully supported in their role. Staff were suitably trained and received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.

Without exception people, visitors, and health and social care professionals said staff were extremely caring. For example, the care was, “Exemplary” and “Person centred to the highest degree”. The service had a holistic approach to the care they provided and had carried out extensive research into the benefits of using animal assisted therapy and aromatherapy in a care setting.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. A member of the staff had won an award for dignity in care at the Great British Care Awards in 2016. People who used the service, visitors and staff had been involved in creating a dignity tree to describe what dignity meant to them.

People who used the service were placed at the heart of the service and were encouraged to be involved in the running of the home and were made to feel valued.

Staff were trained in providing end of life care and care plans were in place to ensure people’s end of life plans and wishes were recorded.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The registered provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

Staff felt supported by the management team and were comfortable raising any concerns. People who used the service, family members, staff and visiting professionals were regularly consulted about the quality of the service and provided positive feedback on how the service was run.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service were cared for by staff that had carried out appropriate training. People were aware of how concerns could be raised and were protected from potential harm because the provider had a robust recruitment process.

All the people who used the service had personal evacuation plans in place so that they could be assisted from the building in the case of an emergency.

Is the service caring?

People who used the service were treated as individuals and were encouraged to be as independent as possible.

Care plans and risk assessments for people who used the service were person centred and included enough information to ensure staff had the appropriate knowledge to care for them.

Is the service responsive?

We saw people who used the service had regular reviews of their care. We saw changes to people's care were made as soon as the need was identified.

The provider had a business continuity plan in place to ensure people continued to be cared for in the event of an emergency.

People who lived at the home were helped to access dentists, opticians, and chiropodists to help ensure their wider health needs were being met.

Is the service well led?

We spoke with three members of staff who worked at the home. Staff told us they were happy working there and felt they were fully supported in their roles. One person told us, 'It's lovely here', and, another told us, 'I feel totally supported.'

Staff told us they were happy with the manager of the home and felt that they would be able to approach her if they had any concerns.

The home had a number of audits which were carried out regularly to ensure the quality of the service was good. Action plans created following audits showed the provider used the information gathered to think of ways to improve the service.

Is the service effective?

People who used the service were involved with the planning of their care and the level of assistance they wanted. If people did not want to be involved in planning their care the manager tried to get involvement from a relative or friend.

People's care plans gave details about their likes and dislikes, preferences and religious beliefs.

Everyone we spoke with said they were happy at the home. People who used the service told us they enjoyed living at the home and they liked the staff. One person told us 'They (the staff) are lovely.'

Staff told us they enjoyed working in the home and felt they were valued by the service and the people who lived in the home.

The home had a relaxed and friendly feel to it. People who used the service were encouraged to chat to staff and were treated with dignity and respect.

People who used the service were encouraged to participate in their own care planning and where they were not able to do this they had a family member or advocate to speak on their behalf.

We saw regular meetings were held with both staff and people who used the service. Minutes were taken and action points recorded and acted upon.

Staff at the home were taken through a comprehensive induction process when they started working at the home and there was an ongoing programme of training to ensure staff were equipped to deal with situations that may occur in the home.

We observed staff providing care and support to people throughout the inspection. There was a calm, friendly atmosphere around the home and people were seen to respond positively to the staff throughout. We saw people's care and welfare needs were met. People using the service said 'I'm walking much better than when I first came in here. My confidence and self-esteem has improved.'

The building was clean and well maintained. People we spoke with said 'They spring clean your room. It's always clean.' A visitor told us 'It's always warm and clean in here.'

People told us the staff treated them with dignity and respect. One person said about the staff 'They respect my wishes but at the same time encourage me.' Another said 'They afford me with privacy, dignity and respect.'

We saw people were fully involved in making decisions about their care. For example, some people had an advocate to speak out on their behalf and make sure any decisions made were in their best interests. One person said 'They ask my permission to weigh me every week.'

We found the home operated a good recruitment procedure. This helped to make sure only the right staff were employed to work in the home.