The Care Quality Commission
  • Care Home
  • Care home

Archived: Kew Gardens

1 Kew Road, Weston Super Mare, Somerset, BS23 2NP (01934) 629378

Provided and run by:
European Care (Combined) Limited

All Inspections

14, 16 April 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

This inspection was performed over two days, by two inspectors. At the previous inspection, we asked the provider to take action on four outcome areas. These related to consent, care and welfare, the home environment and quality assessment and monitoring. The provider sent us an action plan following the inspection which outlined how they would address the issues and when they would achieve compliance. At this inspection we found they remained non-compliant.

Below is a summary of what we found. If you would like to see the evidence supporting our summary please read the full report.

Is the service caring?

People said the home was supportive to them. One person told us 'I would recommend this place.' A person's relative described staff as 'exceedingly nice, sympathetic, kind and attentive.'

We saw staff were polite and kindly in approach. They asked people about day to day matters, such as if they would like to have a drink, if they were ready to be assisted to get up and if they wanted to listen to some music. During our observation we saw nearly all interactions between staff and people were positive.

Is the service responsive?

People told us the service responded to them in the way they needed. One person described how unwell they had been when they were admitted. They said the home 'treated me well and nursed me through a very difficult period.' A person told us 'I am fully involved,' with their care in the home.

Many of the people were living with dementia or other mental health conditions. We found the home did not show they had suitable arrangements for obtaining consent from people. There was also a lack of assessments made of people's capacity, under the Mental Capacity Act 2005.

We have warned the provider that they must take action to meet the requirements of the law to ensure there are suitable arrangements to obtain and act in accordance with the consent of people in relation to their care and treatment.

Is the service safe?

We saw the home were not following guidelines to ensure risk of infection was prevented for people. We saw a lack of cleanliness across a wide range of equipment, fittings and facilities across the home.

The home continued to not maintain an environment suitable for the people living there. The fire and safety officer had also asked them to make improvements. The provider had put action plans in place in relation to the home environment and fire safety. The plans were not yet due at the time of the inspection. There was a document in the home stating a warning notice had been issued from an approved gas maintenance company in relation to a gas fitment; more information on this is awaited from the provider.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. No applications have needed to be submitted from this home. Relevant staff we spoke with told us they had been trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to infection control. We will follow-up the provider's action plan to meet the requirements of the law to ensure the safety and suitability of the home environment, when they tell us their action plan has been completed.

Is the service effective?

The service provides care and treatment to people, including people with complex nursing needs. We saw the provider did not have suitable arrangements in place in relation to the treatment of catheters, unstable diabetes and prevention of pressure ulcer risk. The provider did not ensure care and treatment was being delivered in a consistent way. When we talked with staff, they reported on different approaches in meeting the care and treatment needs of people, for example in relation to continence management.

The provider kept some records relating to meeting people's needs, however other monitoring records were not in place. This included monitoring records for people who needed support with stoma management. Other records were not accurate, this included records relating to people's dietary and fluid intake.

We have warned the provider that they must take action to ensure they meet the requirements of the law relating to the care and welfare needs of people. We have additionally asked the provider to tell us what they are going to do to meet the requirements of the law in relation to maintenance of records.

Is the service well led?

The service had a registered manager in post. As the registered manager was also the registered manager for a home also owned by the same provider, they were not always available to manage this home. People told us they liked living in the home. One person told us they were 'happy here.'

We found the provider had arrangements to assess the quality of the service to people. However we found these arrangements were not effective in practice. The provider also did not have effective systems to ensure it identified and took relevant action in relation to health and safety. This included arrangements for monitoring the cleanliness of the home and prevention of tripping risk to people.

We have warned the provider that they must take action to ensure they meet the requirements of the law and have effective systems to assess and monitor the quality of service provision to people living in the home.

13, 18 November 2013

During a routine inspection

Decisions, where needed, to ensure people's safety and wellbeing had been made involving people's representatives and health and social care professionals. Legal requirements were met where people, in their best interests, had been deprived of their liberty. There were inconsistencies in the assessment of individual's mental capacity to make specific decisions about their health and welfare.

People and relatives we spoke with were positive about the care provided in the home. There were comprehensive assessments of people's health and social care needs. We found that the planning and delivery of care had not been effective. Systems were not robust to ensure reviewing and re-assessment of pressure care and treatment were safe, responsive and effective. We observed staff supporting and assisting people in a professional, sensitive and compassionate way.

There was generally a good standard of cleanliness in the home however there was no effective cleaning of the sluice room to ensure risk of cross infection was alleviated. Staff demonstrated a good understanding of infection control.

There were good arrangements for the administration and management of medicines.

There was a failure to maintain the home to an appropriate decorative standard. The facilities and design did not reflect the specific needs of people living in the home.

Systems were not effective to monitor and audit the quality of the service. There was a failure to identify shortfalls and need for improvements.

26 September 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

On the day that we visited there were 22 people living at the home. We spoke with seven people living at the home. They told us that they liked living at the home and the staff involved them in their care and treatment. People told us that they enjoyed the activities offered by the home. One person told us that they really enjoyed the 'crafty creations' activity and showed us some of the things they had made.

Everyone we spoke with told us that they liked the food at the home and they were given a choice. One person said 'the food is very good here'. A relative we spoke with told us staff were very proactive about encouraging their relative to eat and drink regularly. They also told us they were always encouraged to have a meal with their relative when they visited the home and were always welcomed by the staff.

We saw that people's needs around nutrition and hydration were assessed and plans put in place to meet these needs.

People told us they liked living at the home and felt safe. People told us that if they had any concerns they would speak to the manager. They were confident that their concerns would be dealt with.

Throughout the day we observed staff interacting with people living in the home. All the interactions we saw were appropriate and respectful. Staff responded appropriately to requests made by people and had time to sit and talk to people when they appeared anxious.

26 April 2012

During an inspection looking at part of the service

We completed an inspection at Kew Gardens on the 26 July 2011. At this time we found that although people, and their families, were involved in checking their assessment records there was little opportunity for them to be involved in making decisions and choices about the planning of their care. We completed this inspection to review the action taken in response to these concerns.

13 September 2011

During a routine inspection

The people that spoke to us were positive about how they are supported by the staff. Examples of comments people made included, 'the staff check on me ', 'I find them all very good', 'I like it here', and 'its not like home but they do their best' .

We found that staff are approachable and people can make their views known to them. Some people have dementia and cannot directly tell staff what their views are. We found that although people, and their families, were involved in checking their assessment records were accurate, there was little opportunity for them to be involved in making decisions and choices about the planning of their care.

We saw people being supported by staff to meet their needs. We saw staff spending time listening to people and talking to them in a warm, good humoured way.

We saw that care plans properly support and guide staff, to ensure people receive the care they need. We found that staff have not been formally assessed as competent to use the suction machine on people in the event of an emergency.

We saw people are mostly having their needs met in a timely and suitable way. We observed that for two people, there was an excessively long wait to be served their lunch. The two people had to observe those around them being served their main meal and desert before they were given lunch.

We found that there is enough staff employed to support and care for people properly so that their needs are met.

We saw that there are methods in place to seek the peoples views about the quality of service and care they get.

We saw that the environment is mostly suitable for the needs of people who use the service. For the safety of some people living in the home there are key pad restrictions on movement between some parts of the home. There are no arrangements in place for those people who do not require these safety measures to move about the home freely.

We found that there is enough staff employed to support and care for people properly so that their needs are met.

We saw that there are methods in place to seek the peoples views about the quality of service and care they get.

We found that there are therapeutic activities put on to aim to meet people's social needs. We found that there is a lack of purposeful and meaningful activities planned for the needs of people who have dementia.

We saw that the environment is mostly suitable for the needs of people who use the service. The stairs have gates that are controlled by locked key pad systems. The reasons for the use of this key