Kingsland House

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• 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

There were adequate numbers of trained staff on site to keep people safe. We saw staff supporting people during the inspection. People and staff we spoke to told us staffing levels were safe. We received mixed feedback about staffing levels at the home before the inspection. Some relatives had complained to CQC that staffing levels were low. However people we spoke to on the day of the inspection told us there were enough staff to look after them safely.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We received mixed feedback about staffing levels at the home. Several relatives told us there were insufficient staff to support people safely, and had contacted CQC about this before we visited, and again during the assessment. Relatives told us there were not enough staff at night-time. On the day of the visit people at the home were mostly positive about the staff, and most people said there were enough staff. Some people said they occasionally had to wait when they rang the bell, but they did not think this was unsafe. One person said she waited a long time for staff if she used her call bell. A person told us “Staff always seem busy, they don’t really spend time chatting to us, but I guess they are not paid for that.” Another person told us “Staff are really lovely and helpful.” One person said staff supported them with exercises to keep them mobile, and this had improved their confidence and made them feel safer.

The manager told us there had been staff changes since the previous manager left. New staff were trained, or in training, and there was a dependency checker in place which was used as a starting point for the staffing numbers. The manager said she always added more staff to the rota than the tool suggested and audited call bells, and watched care at the home to ensure then numbers of staff was appropriate. The deputy manager told us they planned to carry out spot checks at night to ensure staff were able to support people safely and were working as a team. The manager told us there was a change in culture needed at the home and the senior team were working on this. They said staff were encouraged not to rush, to take time to do things well. Staff were told not to walk past a problem, but to stop and deal with it. The manager said they carried out spot checks and received feedback from senior staff. Staff told us there were enough staff to provide safe care. They said there were times when it could be difficult, such as when a staff member was off sick, but in general they said there were enough staff. One member of staff said if they were struggling they would call the manager and she had come in to help them in the past.

Staff did not always demonstrate appropriate knowledge for the tasks they carried out. We saw a person who appeared to be asleep being supported to eat while in an unsafe prone position. The inspector spoke to the staff about this at the time, and they removed the food, but when asked said they did not think what they were doing was unsafe. We saw some people wait for call bells to be answered. Call bell records we looked at on the day did not reflect these wait times, although the area manager said she was aware that staff did not always understand their responsibilities to answer call bells. Supervisions for staff had addressed the gaps in their skills and knowledge but people were still waiting for bells to be answered during our visit. We looked at care on Memory lane, this is an area of the home that caters for people living with dementia. While there were enough staff to keep people safe, people did not appear to have stimulation or activities they were interested in.

The manager used a dependency checker to ensure there were enough staff to support people’s needs safely. The manager also explained how audits and checks were used to ensure the staffing levels were correct. For example there were call bell audits looking at waiting times. The manager said they would look to see if any staff teams recorded longer wait times than others. There were also audits to look at falls or skin tears which could point to incorrect staffing levels. The manager carried out daily walk arounds to look at care.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.