Archived: Kingsley House

We found the following examples of good practice.

The registered manager ensured there were effective infection prevention and control (IPC) procedures in place to prevent the transmission of infection; the environment was clean, hygienic and well-maintained.

The staff were provided with the necessary personal protective equipment (PPE), PPE stock levels were well managed, and staff were observed wearing the appropriate PPE during the inspection.

The registered manager ensured that staffing levels were effectively managed and careful consideration was given to the deployment of staff. Consistent staff were allocated to individuals that required full support, meaning there was less cross over of staff across within the home.

Regular testing was in place for people living at the home and staff who worked there. High risk and most vulnerable people and staff had been identified and appropriate support measures had been implemented.

Relatives were supported to maintain regular contact with people who lived at the home. For example, skype visits were taking place and a 'visiting pod' was in place; the pod had been designed to help facilitate socially distanced visits between people and their loved ones.

The registered manager ensured that the most recent / relevant COVID-19 policies, procedures and guidance were effectively communicated; staff confirmed that they were fully informed and updated on the most recent COVID-19 arrangements.

Further information is in the detailed findings below.

Kingsley House is a three storey Victorian property providing care and support for up to 16 people with mental health needs. The home is situated in the centre of New Brighton close to shops and community facilities and to the river-front. There are good public transport links to all parts of the Wirral and Liverpool. At the time of the inspection there were 15 people living in the home.

Kingsley House 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.

Kingsley House had a registered manager who has worked at the home for a number of years. 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.

We looked at how the service managed it’s recruitment of new staff and had minor concerns over how some records were maintained. The manager was open to the feedback and was making improvements whilst the inspection was taking place.

We spoke with five people who lived in the home who all gave positive feedback about the home and the staff who worked in it. They told us that the staff supported people to live their lives as independently as possible.

Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. We found staff were knowledgeable about the support needs of people in their care. We observed staff providing support to people throughout our inspection visit. We saw they had positive relationships with the people in their care.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were kept safely with appropriate arrangements for storage in place. We did suggest that the service ensured that two staff check and sign hand written medication records.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected.

Care plans were person centred and driven by the people who lived who lived in the home. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. They also regularly spoke with the people who lived in the home. The provider also provided close scrutiny of the service and was a regular presence in the home providing activities for people such as swimming and the gym and providing support for the manager.

Kingsley House is a three storey Victorian property providing care and support for up to 16 people with mental health needs. The home is situated in the centre of New Brighton close to shops and community facilities and to the river-front. There are good public transport links to all parts of the Wirral and Liverpool.

During our visit we saw that the home was in need of redecoration and bathrooms and communal areas looked unkempt and required new fixtures and fittings to provide a safe and comfortable home for people to live in.

This is a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Premises and equipment. You can see what action we told the provider to take at the back of the full version of this report.

Safeguarding incidents were recorded properly and the local authority had been notified as required. The manager had not informed the CQC of two incidents that had occurred.

We recommend that the provider ensures that notifications of safeguarding referrals and other incidents are sent to the CQC as required so that we can check that relevant action has been taken.

Personal emergency evacuation plans (PEEPs) were in place for all of the people living at the home, however there was no information relating to people smoking in their bedrooms, which was a risk to all living at the home.

We recommend that the provider implements a robust system to ensure staff monitor people smoking in their rooms to ensure the safety of all living at the home.

There was a range of quality assurance systems in place to assess the quality and safety of the service and to obtain people’s views. A satisfaction questionnaire had been sent out in 2016 and people’s feedback had been positive.

We recommend that the provider maintains a record of actions taken to address issues identified in audits and house meetings and to show the improvements made.

At the time of the inspection there was 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.

During our visit we spoke with four people who lived at the home. They all spoke positively about the home and the staff supporting them. People told us the staff were kind and caring. They said their needs were responded to promptly and whenever they asked for help, staff were always on hand to provide it. We observed interactions between staff and people who lived at the home that were pleasant, kind and compassionate. It was clear that people felt comfortable with the staff who supported them. Staff we spoke with spoke fondly of the people they cared for.

People’s care records were person centred and contained information about their needs and preferences and information about how to manage people’s individual risks. People’s care plans contained information about what people could do independently and provided guidance to staff on how to support this.

Accidents and incidents were recorded appropriately. The records had not been updated to reflect that appropriate action was taken by the manager and staff to prevent further incidences. Staff knew what to do if any difficulties arose whilst supporting somebody or if an accident happened.

The home used safe systems when recruiting new staff. These included obtaining Disclosure and Barring Service checks. New staff had an induction programme to ensure they were competent in the role they were doing at the home. Records showed that staff had adequate training and supervision in their job role and the registered manager had plans in place to commence staff appraisals in April 2017. Staff we spoke with felt supported and sufficiently trained to provide safe and appropriate care.

People we spoke with told us there were enough staff on duty to meet their needs. They told us they felt safe at the home and they had no worries or concerns. They told us they got enough to eat and drink, the food was good and they had plenty of choice. We saw that people’s weight was monitored regularly to ensure they maintained a healthy weight.

The service complied with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and its associated codes of practice in the delivery of care. Staff we spoke with had an understanding of their role and obligations in maintaining people’s rights.

Group activities were provided and we saw that staff also took the time to sit and chat to people in addition to meeting their support needs. This promoted their well-being.

The culture of the home was open and transparent. Everyone we spoke with told us the home was well led and the manager was always available to discuss anything they needed to.

Records reviewed showed that an assessment of people's needs and abilities had been undertaken. Care plans showed how the needs of people were to be met. Plans covered physical, emotional, mental health, social, communication and behavioural needs and each care plan had its own associated risk assessment. There was instruction to staff about how needs and risks should be managed. People told us "I love being here, it is my home" and "I didn't feel safe before I came here. I want to stay, it is a good place".

We were notified by Wirral Borough Council prior to inspection about a safeguarding incident. We found that the incident had been investigated and addressed appropriately and that immediate action had been taken to ensure people's safety.

We found that premises were not of an adequate standard to ensure people's comfort and safety. We discussed this with the provider who said that improvements to the premises were already planned and our findings would be included in that plan. We asked the provider to send us a copy of the improvement plan.

There were systems in place to appraise and supervise staff and staff spoken with felt well supported to carry out their role. However not all necessary documentation was in place to ensure people were protected by staff whose identity had been clarified and who were appropriately skilled to carry out the role. We discussed this with the manager who said that action was being taken to make sure the missing documentation was received.

We saw that audits of staff files, care plans, medication and finance had been implemented over the last few months and these were to continue on a regular basis. A new system was being introduced whereby each member of staff would be responsible for a different audit such as first aid, fire safety, food hygiene and infection control. We saw evidence that these had begun.

We found that care records were improved, the information contained in plans had been written in a person centered way. We saw that reviews were taking place monthly and included the service user. We saw from records and from conversations with individuals that people were more involved with organising their lives and achieving new goals.

We saw from staff training records that staff were better equipped to recognise signs of abuse as they had completed training for safeguarding vulnerable adults, deprivation of liberty and the Mental Capacity Act.