Kings Lodge Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff received training to allow them to support people safely and effectively. Medicines were safely managed and administered. People’s concerns were listened to and acted upon. Risks to people’s health and support were assessed and managed well by staff. Staff were trained in safeguarding and understood how to protect people from the risk of abuse. The environment of the home was safe, clean and met people’s needs

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People we spoke with said they could tell staff about and make changes to suit them. People also told us, "It was clear that they [the service) was always looking to improve and that the service feels like it has a open and honest culture."

The registered manager was confident that staff were reporting all incidents as this is checked during regular monitoring. Staff are asked about any incidents that have occurred and check they have completed incident reports. The registered manager told us that they were using the reporting system to develop trends analysis and gave the example of falls analysis as an example of improved learning. Complaints system and processes were in place. The registered manager stated that being available and always accessible for relatives helped to resolve issues as they arise. Duty of candour letters were completed when accidents or safeguarding incidents had occurred. Duty of candour is a requirement that ensures providers are open and transparent with people who use services.

Incident reporting systems were in place, and staff understood their role in ensuring that incidents were raised appropriately. Reports viewed were clear, detailed, considered any safeguarding risks and identified any learning. There were processes to ensure that lessons are learnt when things go wrong, and from examples of good practice. The provider had reviewed its policy and procedures following a death at the service. The provider reviewed areas of policy to ensure that procedures were robust and provided staff with the guidance they needed.

Feedback from people and relatives regarding safe systems and transitions was positive. One person told us, “The staff ask me questions about my care.” Another person told us they felt in control of the care and support provided. They said, “The staff help me. They help me to be independent. The staff always contact the doctor if I ask them to.” Relatives told us people’s care was regularly reviewed and they felt involved in their family member’s care. One relative said, “They always ask [my family member] about their care and they involve me. They asked me questions about my family member’s likes and dislikes. Various relatives told us, their family member was safe living in the service. The registered manager carried out a surveys with people to gather their views and feelings. In addition, they carried out a resident’s meeting to encourage people to speak about the care they received.

The provider worked well with other health and social care professionals. One staff member said, “We work in partnership with other organisations. We listen to people and encourage them do more.” Another staff member told us, “We all work together with other agencies to keep people safe. If an agency, such as the SALT team, make changes we are all told about it in handovers and team meetings.” The SALT (Speech and Language Therapy) team provide assessment and treatment for people with speech, language, communication and swallowing difficulties. Another staff member told us, “We are all cogs in a bigger thing so we have to click together.” The registered manager told us initial assessments were completed prior to people moving into the service. Referrals were made to health and social care professionals when people’s needs changed.

Visiting professionals told us the provider worked effectively in partnership with them and kept them informed of any changes. One visiting professional said, “The provider contacts my service for assistance, advice, and professional support when people’s needs change.” Another told us, “They engage with us very well.”

The provider carried out initial assessments to ensure people’s care and support needs were safely assessed prior to moving into the service. When people’s needs changed, the provider sought advice from appropriate health professionals and raised referrals to other healthcare agencies.

People told us they felt safe living in the service. One person told us, “I do feel safe here, I’d tell the registered manager if I didn’t feel safe.” Another person said, “Of course I feel safe. The staff are all very caring here.” People told us they felt able to raise concerns. One person said, “I would tell a staff member if I wasn’t happy.” Relatives told us people were safe living in the service. Another relative told us “They communicate with me very well. They ring me if anything is wrong.”

Staff received safeguarding training and were confident to raise concerns. One staff member said, “I would report all concerns to my line manager. I am downstairs and I know signs and triggers. If they did not do anything, I would go to the local authority safeguarding team.” Another staff member said, “I can raise concerns with the registered manager. They are a very good manager.” Staff told us people were safe living in the service. One staff member said, “We know our residents very well, we know if something is wrong.”

We observed staff supporting people safely. People appeared to be comfortable in the presence of staff who were respectful and kind in their attitude. Staff knew people well and were skilled in anticipating issues and redirecting people before incidents occurred. We observed a staff member who was quick to intervene when an altercation began between two service users, they used distraction techniques and redirected people effectively to defuse the situation ensuring that people remained calm and safe. Staff completed incident forms for these occasions, and the incidents were appropriately followed up by the management team.

The provider raised safeguarding concerns with the local authority safeguarding team in accordance with their legal requirements. Incidents and accidents were recorded and we reviewed minutes of staff meetings where lessons learnt were shared staff more widely. Call bells were monitored regularly to ensure people were not neglected. The provider investigated patterns of incidents and accidents and reviewed ways to reduce these from recurring, such as falls reduction strategies.

People told us they could choose how to spend their day and staff respected their decisions. One person said, “They explained to me about some of the risks I take, I’m aware of them but they support me anyway to ensure I am kept safe because I don’t want to stop doing the things I enjoy.” Another person said, “They ask me about my care and what I would like and what I need.” A further person told us, “They help me to shower, and I can have one when I want. My care is how I like it.” Relatives told us they felt involved when managing risks for their loved one’s. One commented, “They try and keep them [Loved one] independent while ensuring they are safe at the same time.”

Staff knew people well and told us about their risk assessments. Staff told us about people’s care plans and people's likes and dislikes without referring to documentation. One staff member told us about a person requiring their food soft due to the risk of choking. Staff told us risks to people's health and well being were discussed and reviewed. One staff member said, “We discuss people’s risks in team meetings and during handovers.”

People moved around the service freely and were not restricted by staff. We observed staff speaking to people about risks and respecting their choices. A few minutes later a different staff member encouraged the person to eat something else staff had offered, the person agreed. This showed staff member’s used different strategies to support people whilst respecting their choices. We observed staff member’s engaging in activities with people in communal areas and encouraging people with communication and mobility difficulties to engage in a variety of activities.

Mental Capacity assessments and best interests’ decisions were in place to manage risk. For example, we reviewed best interest decisions for people who required sensor mats and bed rails to reduce the risk of falls. Risk assessments were completed and accessible to staff. Care plans detailed risk to people from health conditions such as diabetes and documented how staff were to respond to concerns safely.

People told us they felt safe and secure around the home. People had personal evacuation plans in place that guided staff to support them in the event of an emergency. These considered any physical, emotional or sensory needs that would impact them.

Staff had received fire awareness training and understood the actions they should take should a fire occur. Staff were clear about the regular safety checks to be carried out. Staff told us they participated in regular training around all aspects of environmental safety. Records confirmed staff training and regular safety checks on equipment.

People were cared for in safe environments that met their needs. Facilities, equipment and technology were well-maintained. There were effective arrangements to monitor the safety and upkeep of the premises. Equipment used to support people’s needs looked well maintained and in good condition. Bathrooms and communal facilitates were of good design and cleanliness.

Regular maintenance checks of the environment were completed, while records confirmed that equipment was serviced, and quality monitored. Fire safety processes and checks were completed regularly, while records showed regular testing and auditing of equipment and systems within the premises.

People told us there was enough staff to support them safely. One person said, “ “I think there’s enough staff as I don’t really have to wait a long time for staff to provide me with care. When I ring my buzzer, they [staff] come.” Relatives told us staff knew their family member well. One relative said, “All of the staff know my family member by their name, they are all brilliant.” Relatives told us there were enough staff to care and spend time with their family member safely. One relative said, “There’s plenty of staff here, fewer on a weekend, but still enough.” Another relative told us, “The carers all have enough time to talk to [my family member], they like that.”

There was a range of training courses available to staff. However, some staff had not completed all the training courses despite working in the service for several months. Staff had completed the core mandatory courses. One staff member said, “Training is very good. There are a lot of hands-on training which is good.” Another staff member said of this training, "It was brilliant. We also had the Dementia bus here recently - that was brilliant training." Another staff member confirmed the training was good but stated that first hand care was more important. They said, " Training Is really good. It's better to experience this with the residents. Its better with that. Staff told us there was enough staff on duty to keep people safe. One staff member said, “There are enough staff on duty. We have regular supervision with our line managers, any problems or risks to people are discussed.”

There were enough staff on duty to support people safely. Observations in communal areas like lounges and dining areas was good. Good staffing numbers observed. We did not observe anyone waiting for staff attention or delays in people receiving support. Staff observed patiently transferring people from their rooms to communal lounge areas and dining room on bespoke equipment. We observed staff responding promptly to people and sitting with people to enjoy a conversation or engage in an activity. Staff supported people safely and in accordance with their care requirements.

The provider used a training matrix to record staff attendance on training. The provider used a dependency tool to work out the number of staff needed on duty to keep people safe. A dependency tool is used to collate information about the needs (or dependency) of people who need care and support, how many staff are needed. We reviewed the rotas; the provider was working in accordance with their dependency tool. There were additional staff working as supernumerary to relieve pressure during busy times, such as at lunch or responding to accidents or incidents. Staff were recruited safely. The provider carried out preemployment check to ensure only suitably checked and qualified staff were employed to support people.

People told us they felt the service was clean. One person said, “They always say can I come in and clean. I am happy its clean.” Another person said, "I am happy with the frequency and standard of cleaning here."

This was an area that has improved significantly. Staff told us, "We have regular infection, protection and control quizzes. All staff complete the Local Authorities own training. We have hand hygiene spot checks and we are having glitter bug and led torch checks." These check staff hand hygiene and the effectiveness of how staff are cleaning.

Personal Protective Equipement (PPE) usage was observed and seen consistently used by staff. There was an effective waste and laundry management system in place and the service smelt clean.

there was an infection control champion in place. Infections discussed in weekly clinical meetings including likely causes There were preventative measures in care plans and appropriate risk assessments.

People told us they received their medicines safely, one person said, “They [staff] bring me my tablets daily, they [staff] have never forgotten them or missed them.” Another person told us, “They [staff] give me my medicines 3 or 4 times daily. The staff don’t ever forget.” Relatives told us people received support to manage their health conditions and their conditions were reviewed by health professionals.

Staff received safe handling of medicines training and their competencies were regularly checked. One staff member told us, “Only nurses and senior leaders administer medication and completed the associated administration tasks. However, care staff were aware and knowledgeable of this process.”

There were improved processes since the last inspection. Medicines were store appropriately and safely. Staff ensured medicines were consumed before moving on to the next process. People were not rushed, and MAR (Medicine Administration Records) were completed competently. Safe handling of medicines policy was in place. People received their medicines in a dignified way. There were clear protocols in place for people who received 'taken as required' medicines, for example when the person experienced pain or constipation.