Archived: Kingfisher House

Kingfisher House is a residential care home providing personal and nursing care to up to 50 people. The service provides support to older people living with a physical disability or dementia. At the time of our inspection there were 43 people using the service.

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

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.

Baby gates had been placed on people’s bedroom doors to restrict access to others. However, alternative measures had not been explored. We feedback our concerns in relation to the use of baby gates. Immediate action was taken by the provider and an alternative measure was sourced.

Since our last inspection improvements had been made to care records and risk assessments. Risks to people were regularly assessed and appropriate measures were in place to minimise risk.

Staff were recruited safely. There were enough staff to meet people’s needs. People, relatives and staff gave us mixed feedback around whether there was enough staff. They told us they felt there needed to be more regular staff and less agency workers. One relative said, “If regular staff are on, I am happy, but I don’t like [person] being cared for by the agency, they want to see a familiar face.”

People told us they felt safe and there was a nice atmosphere at the home. People's medicines were administered and managed safely. Health and safety checks were regularly conducted. Accidents and incidents were recorded, and actions were taken to mitigate the risk of reoccurrence.

Complaints and concerns were responded to in a timely manner. There was an activities co-ordinator in place who provided a wide range of activities.

Feedback about the registered manager was positive. There were effective systems in place to monitor the quality and standard of the service. The provider worked with healthcare professionals to meet people's needs. The registered manager co-operated with the inspection and took swift action to reduce risks and improve the service.

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 requires improvement (published October 2023) and there were breaches in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider was no longer in breach of regulation.

Why we inspected

We carried out an unannounced focused inspection of the service on 3 May 2023. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, responsive and well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has remained rated requires improvement. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kingfisher House is a residential care home providing personal and nursing care to up to 50 people in a purpose-built building. The service provides support to older people and younger adults and people who may be living with a dementia and/or a physical disability. At the time of our inspection there were 41 people using the service.

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

There were ongoing concerns that care records and risk assessments had not been updated in response to people’s changing needs. Risks had not always been assessed or mitigated. Care records contained contradictory and incomplete information. The providers quality assurance systems remained ineffective and not identified the concerns with records noted during this inspection. We were not fully assured that all staff knew how to use PPE appropriately.

Since the last inspection improvements had been made to the management of medicines and records were appropriately completed. People said they felt safe, and staff knew how to identify and report any safeguarding concerns. Safe recruitment practices were followed.

People’s needs were assessed before they moved to Kingfisher House to make sure staff could meet their needs. 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 said the food was good, and staff worked to make sure people’s nutritional needs were met. A range of training the provider had assessed as mandatory was completed by staff.

A wide range of activities were provided by an enthusiastic and motivated activities co-ordinator who was supported by the staff team. Complaints and concerns were responded to in a timely manner.

Staff, people and relatives were complimentary of the current management team. Staff said they felt well supported and listened to. People and relatives were given the opportunity to provide feedback on the care and support they received.

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 requires improvement (published 20 January 2021) and there were breaches of regulation relating to safe care and governance. We recommended that full employment history of new staff was checked, and mental capacity records were fully completed. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the recommendations had been acted upon and some improvements had been made. However, the provider remained in breach of regulations. The service remains rated requires improvement.

Why we inspected

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

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service starting on 25 November 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

For the key question of Caring, which was not inspected, we used the rating awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

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

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified continued breaches in relation to care records, risk management and quality assurance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

Following the inspection site visit we wrote to the provider requesting an improvement plan and details on action that would be taken to improve the service. This was received. We will request an update on the action plan from the provider to understand how they will continue to improve the standards of quality and safety.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kingfisher House is a care home providing personal and nursing care for up to 50 people, including people who are living with dementia. There were 22 people living at the service at the time of the inspection.

Kingfisher House has accommodation over two floors with a large internal courtyard for people to use. People with nursing needs or living with dementia were accommodated on the first floor.

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

The provider's quality assurance systems were not fully effective and did not always identify gaps in records and checks.

The service had not always assessed the risks to people or put strategies in place to minimise them. Records about 'as required' medicines were vague and it was not always recorded if staff had applied prescribed creams. Training records were incomplete, so it was not always clear whether staff had clinical skills.

People and relatives had many positive comments about the service. They praised the care and kindness shown by staff. The home had a welcoming and friendly atmosphere. Staff were engaging with people and supported their dignity.

The home was clean, warm and comfortable. The accommodation was well-designed to support people to find their way around.

People said they felt safe at the home. There were enough staff to support them when they needed it and people said they felt well-cared for.

People said the quality of meals was good and there was enough to eat and drink. There was a good range of social events, activities and engagement to support people’s social care.

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 did not fully uphold this practice.

Staff followed the principles of choice and people were not unnecessarily restricted but records did not always show this. We have made a recommendation about this.

The provider vetted new staff to make sure they were suitable but did not always check their full employment history. We have made a recommendation about this.

The culture of the staff team promoted a positive experience for people. Staff enjoyed their roles and were keen for people to feel valued members of their local community.

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

Rating at last inspection

This service was registered with us on 4 December 2019 and this is the first inspection.

Why we inspected

This is the first inspection of the service.

The inspection was prompted in part due to concerns received about nutrition and hydration. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.

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 monitor the service.

We have identified breaches in relation to governance. Please see the action we have told the provider to take at the end of this report.

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.