Kings Hill

Updated 16 March 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Kings Hill is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service did not have a manager. This means that the provider and nominated individual were legally responsible for how the service is run and for the quality and safety of the care provided. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.

What we did

We reviewed information we had received about the service since the last inspection. We sought and received feedback from the local authority safeguarding team and commissioners of the service. We did not ask the provider to complete a Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection

Inspection activity took place on 12 January 2022. We visited the agency and spoke with the provider, a senior carer and the person who used the service.

We reviewed the person’s care plan and daily notes. We saw the training record, supervisions and spot checks for the staff member employed by the service. We also looked at quality checks and audits. We were not able to look at any staff files as the provider told us they did not have access.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We requested documents that were not available at the inspection. This included medication records, staff files and training records, incident reports and confirmation the service’s rating was available on the provider’s website. We received all of this information within three weeks of the inspection.

Updated 16 March 2022

About the service

Kings Hill is a domiciliary care service providing personal care to people in their own homes. It is registered to provide care for babies, children, younger adults, older people, people living with dementia, a learning disability or autistic spectrum, a mental health problem, substance misuse, eating disorder or physical or sensory disability. At the time of the inspection, there was just one person receiving personal care.

CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service

People had a positive experience from using the service. One person told us, “I am happy with it. I would not change anything”.

There continued to be no registered manager and the appointed nominated individual was not involved in the management of the service. We made a recommendation about the provider's understanding of the role of the Nominated Individual.

Quality monitoring systems continued to be insufficient to identify shortfalls and drive continuous improvement in the service. The service was not proactive. Improvements and changes were only made when we brought them to the attention of the provider.

Steps had not been taken to reduce the potential fire risk for people who used emollient creams. This was despite this risk being highlighted to the provider at our last inspection.

There continued not to be effective staff recruitment. Staff files were not available at the inspection visit.

We made a recommendation about communicating with people about their end of life wishes and preferences.

There were systems to support staff and check their skills and knowledge. However, these were only available to one of the two care staff employed at the service.

Improvements had been made to ensuring people received personalised care. Care plans contained individual information about people’s likes and dislikes and things that were important to them. The views of people who used the service had been sought.

Staff were up to date with all mandatory training with the exception of practical moving and handling. The provider booked this training for staff after the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Inadequate (published 23 April 2021) and it was placed in special measures. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified continuing breaches in relation to the management of medicines, staff recruitment and quality assurance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.