Background to this inspection
Updated
21 June 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 9 and 10 May 2017 and was unannounced. It was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
During the inspection we spoke with six people living in the home and the relatives of three people. We made general observations of the care and support people received throughout the inspection. We spoke with the registered manager, office manager, four members of care staff and one member of kitchen staff. We also looked at other information we held about the service, including any statutory notifications. A notification is information about important events which the provider is required to tell us about by law.
We reviewed five people’s care records and three people’s medicine and administration record (MAR) charts. We viewed three staff files in relation to recruitment as well as induction, training and supervision records. We also looked at a range of quality monitoring reports undertaken by the manager and office manager.
Updated
21 June 2017
This inspection took place on 9 and 10 May 2017 and was unannounced.
Kingsgate residential home provides accommodation and care for up to 33 people, many of whom would be living with dementia. At the time of our inspection 29 people were living in the home.
A registered manager was in post, who was also the provider. 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.
During this inspection, we found that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration) regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.
We found that there was a breach of the regulations because there were no in depth audits of people’s medicines and staffs’ competency was not regularly assessed in this area. The registered manager was also in breach of the regulations because risks to the environment were not always monitored and people’s individual risks were not always documented in their care records. There were plans in place to address these concerns and the registered manager was already in contact with a management consultant in health and safety.
A further breach of the regulations was found because the registered manager did not notify us of significant events relating to the people who lived in the home. A notification is information about important events which the provider is required to tell us about by law.
During our inspection visit we found that there was a lack of effective systems in place to monitor and assess the quality of service being delivered. There was a lack of auditing in a number of areas such as health and safety, people’s care plans and medicines. Since our visit improvements have been made with regards to auditing.
There were no meetings for people who lived in the home but the registered manager would speak with people and people felt able to approach staff if they had any concerns or suggestions about the service. Staff meetings did not take place regularly but there were plans to implement more regular meetings.
Accidents and incidents were recorded appropriately and the necessary post-accident observations took place where people had suffered an accident.
Staff knew what constituted abuse and what procedures they would follow if they were concerned that someone was being abused. There were safe recruitment practices in place and all staff had the relevant safety checks to ensure that they were suitable to work in a caring environment.
All new staff completed an induction to their role and there was ongoing training for all members of staff. Staff were further supported through regular supervisions and appraisals.
Mental capacity assessments were not always in place for those people who lacked capacity but we saw that no one was being unlawfully deprived of their liberty. Staff understood the principles of the Mental Capacity Act 2005 and had received training in relation to this.
People were able to make choices about how their care and treatment was delivered. Where people needed support with decision making, staff would support people with this.
People were supported to maintain a healthy intake of food and fluid and people were consulted about what meals they would like to eat. People were able to choose where they would prefer to eat their meals.
Where concerns arose regarding a person’s health or wellbeing, prompt advice and referrals were sought from the most relevant healthcare professional.
Staff were kind and attentive to people’s needs. Staff knew people’s care and support needs well and supported people to access and maintain their interests and hobbies. People’s privacy was respected and their dignity was consistently upheld.
No complaints had been made about the service but there was a complaints procedure in place and people felt able to make a complaint if needed.