Archived: Kingsley Court Care Home

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This inspection was carried out to assess what the provider had done in response to the action we had told them to take following our last inspection. This was in relation to the safe management of medicines.

This is a summary of what we found.

Is the service safe?

We found the service was safe because people were protected against the risks associated with medicines.

This inspection was carried out because at an inspection in May 2014 we had concerns that medicines were not handled safely and we judged the service to be non compliant with this outcome.

During this inspection we saw that appropriate arrangements were in place in relation to the recording of medicines. We saw evidence of people's current medicines on the Medicines Administration Records (MAR). We saw that there were records of medicines received into the home and all people had their allergy status recorded to prevent inappropriate prescribing. We looked in detail at the MAR of 28 people who lived in the home. On one floor we saw no omissions in any of the records and all our audits of stock could be reconciled. On another floor we saw four gaps in recording adminstration but our audits of supplies indicated that the medicines had been given. On the third floor we identified several omissions in recording administration but could clarify the reason in most cases.

We looked at the regular audits the home was carrying out and heard about the training given already and planned for the next month. The provider had mostly rectified all the concerns identified at the previous inspection and was continuing to drive forward further improvements in the safe handling of medicines.

Overall we were assured that medicines were being given as prescribed.

We spoke with six people using the service, eleven relatives and visitors of people using the service and seventeen staff. The staff included the manager, the administrator, four nurses, ten care staff and one activities coordinator.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

Relatives confirmed they were happy with the service and felt their family members were being cared for safely. Risks were assessed and reviewed regularly to ensure people's individual needs were being met safely. Staff had undertaken training on the Mental Capacity Act 2005 and were aware of their responsibilities in relation to Deprivation of Liberty Safeguards. Further work was required with medicines management to ensure arrangements were safe and being followed effectively. Recruitment practices were robust and being followed.

Is the service effective?

Care records reflected people's individual needs, choices and preferences and staff had the knowledge and skills to meet these. People had the support and equipment they needed to enable them to be as independent as possible. People had access to healthcare professionals to meet their needs. People told us they were happy, well cared for and treated with respect. People and their representatives were involved with the development and review of the care records, so they could express their views and have these included.

Is the service caring?

Staff treated people with kindness and were gentle and patient when supporting and assisting them with daily routines. Privacy and dignity were respected. Staff listened to people and changes were made as a result of this, to better meet people's preferences and wishes. Comments we received included 'staff are always polite', 'I know (relative) is very well looked after.' and 'It's lovely here. I'd happily have a relative of mine living here.'

Is the service responsive?

Satisfaction surveys had been carried out recently and people were able to express their views. Action was being taken to address any issues identified. People's care records were reviewed regularly so any changes to their care were identified and records maintained up to date. People and their families said they felt able to raise any issues and the manager recognised the importance of dealing with any concerns promptly, so concerns were addressed. . Comments about the service included 'A total turnaround and all for the best' and 'lots of people I can speak to and I feel very confident if I had any gripes to voice them.'

Is the service well-led?

The manager had been in post since 1 April 2014 and had applied for registration with the Care Quality Commission. The manager demonstrated good leadership skills and was supportive to people using the service, relatives and staff. One member of staff commented about the management of the service 'they always have time for you.' The majority of relatives we spoke with told us there had been a marked improvement in the service in the past four months and they were able to raise any concerns with the manager, who listened and took appropriate action to address them. The provider had in place systems to monitor the quality of the service and where shortfalls were identified action plans with timescales were drawn up to address them.

Although the majority of staff treated people with dignity and respect, some did not. For example, a door was not closed when someone received personal care. Meetings took place for people and their relatives so they could share their views about the service and systems were in place to keep people up to date with events and changes in the home.

Some people and relatives were happy with the service provided. However others were not and did not feel the standard of care provided was consistently good and carried out in a safe manner.

Procedures for the management of medicines were in place but were not always being followed, putting people at risk of not receiving their medicines as prescribed.

Staff recruitment procedures had not always been followed when carrying out checks prior to employing people and this could place people at risk of not being cared for by suitably vetted staff.

Systems were in place for monitoring and assessing quality assurance. However our findings at this inspection indicated that these were not effective and shortfalls were not being identified promptly so they could be addressed.

We received a mix of comments from people about the care they received that included; 'I am fine here, the girls do their best', 'I am safe and looked after' and 'I am here for a short stay and I like coming here while my (relative) has a rest and the girls are very nice'. Others told us, 'the staff don't really have time to sit and talk to me they just come in and do what they have to do and go' and 'I do not sleep well and I feel very lonely at night'. We received comments from relatives including, '(x) is cared for quite well and I am happy to leave (x) in the care of the staff when I go home' and 'as [x] cannot speak I think they are ignored sometimes. The staff do not seem to have enough time - they always seem rushed.'

The environment of the home was appropriately maintained and we saw that maintenance and redecoration was ongoing to ensure the home was safe and pleasant for the people who use the service.