Kenton Hall 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

At our last inspection we rated this key question good. The rating for this key question has remained good. This meant people were safe and protected from avoidable harm. The service was operating safely. The management team had identified some aspects of the safe domain required improvement and were in progress with this. The management team fostered a learning culture. There was an effective process in place to ensure people had smooth transitions between other healthcare services. People were safe from the risk of harm. Risks were managed and mitigated safely. There were occasions when risks were not managed as well as they could be, the manager took action to rectify this during the inspection. People felt that the service relied on too many agency staff. The provider had already recognised this and recruitment was in progress. Medicines were generally managed safely, supporting records were sometimes inconsistent, however we identified no impact on people from these inconsistencies.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt the service had a learning culture. One person said, “I had a lot of issues in the beginning, time went on, it got better.” A relative said, “I can discuss my views.”

Staff felt that the culture was positive and open to learning. Comments included, “Managers are so supportive,” and “The day shift and night shift have handovers including all staff to promote learning.”

Processes were in place to ensure a learning culture was fostered. A change of management took place within the last 6 months and significant learning and improvement had been put in place during that time. Lessons had been learned from incidents, accidents and other events in the service and across the provider’s wider portfolio.

People felt they received safe and effective support from different care services. A GP visited the home weekly to conduct a ward round. A relative commented, “I like that the GP comes in every week and will speak to me.” Another relative said, “Staff were trained at the [local hospital] on [specialist equipment] to support [person] fully when they transitioned to the service.” One person said, “If I ask, they will discuss [my medicines] with me, they will contact the GP about me not sleeping if I want them to.”

Staff worked with, and felt supported by, health and social care professionals. They felt confident working with other agencies.

We received positive feedback from professionals involved with the service. Their comments included, “Staff at Kenton Hall have been very receptive of the training I have provided,” “Staff have asked me for advice on various clinical issues and taken my advice on board,” and “There are pockets of real dedication from staff. Difficulties sometimes occur when the regular staff aren’t here.”

Systems were in place for staff to work with people and partners to establish and maintain safe systems of care. Care handovers between other healthcare services was managed safely, monitored and changed as needed.

People felt safely cared for. When asked if they felt safe here one person said, “I think so, [staff] definitely watch you closely.”

The manager and staff recognised their responsibilities and duty of care to raise safeguarding concerns.

People appeared to be happy, comfortable, and safe in their surroundings.

There were effective systems, processes and practises to ensure people were safe from the risk of harm and abuse. Policies and procedures were available, and staff had attended safeguarding training and updates to refresh their knowledge and understanding.

People told us they were involved in making decisions about their care and support. One person commented, "Some of the staff coax me to eat. They will offer me things to tempt me.”

Staff supported people safely and used appropriate equipment safely. Staff did comment that they did not always have time to read people’s care plans thoroughly, particularly agency staff.

Staff were available to support people when they needed support. During meals there were enough staff to support people eat safely, however staff had to rush to do this at times.

Risks were assessed and mitigation put in place to minimise risks where possible. Most people had risk assessments for all key aspects of their care. We found occasions where some aspects of record keeping were out of date or inconsistent. The manager took action to update these records immediately. Staff recorded interactions and care on an electronic care planning system. However, there were not enough handheld devices available for staff to record notes contemporaneously. The provider gave assurances that this would be rectified quickly.

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

People gave mixed feedback about the quality of staff skills and knowledge. When asked about the staff one person said, “Some days, not everyday, I have a problem. It’s the agency staff that make it difficult.” Another person said, “You see lots of different staff, and agency. You get to know them then they leave. They are confident.” Relatives said, “The agency staff don’t know the residents all that well. The permanent staff know them much better.” People felt that staff were suitably trained to provide support to them.

Staff gave mixed feedback about the staffing levels. Some staff felt there were enough staff and others said there were not always enough staff particularly at mealtimes. Staff felt they received good quality training and received support from managers when they needed it.

Observations showed there were usually enough staff available to support people when they needed help. On some occasions staff appeared very rushed such as mealtimes. Agency staff did not approach people with the same level of friendliness as permanent staff.

Recruitment processes were robust. Appropriate records were in place to support this. The provider had recognised the staffing issues in the service and was in the process of recruiting additional staff. After the inspection the manager confirmed 3 new starters were carrying out their induction, with more new starters on the recruitment pipeline. This meant there should be a reduction in the reliance on agency staff moving forward.

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.

Records demonstrated that people were receiving their oral medicines as prescribed. However records for topical medicines did not describe which cream was being applied and to where. We found on some occasions creams were being applied which were not prescribed. Guidance to support staff in the safe administration of when required medicines were in place and contained person specific information for staff to follow. Care plans were in place and contained information to enable staff to care for people. However, we found for people with complex conditions such as diabetes that more detailed information such as blood glucose parameters and what to do in emergency was required.

Staff told us they did not have enough handheld devices to enable them to record contemporaneous care and we saw evidence of this whilst on inspection. The leadership team informed us that more handheld devices to record care were being ordered.

Medicines were stored securely and safely, including controlled drugs. Temperature monitoring was taking place however we found recordings of high fridge temperatures with no action documented. Processes in place to record the use of thickener (medicine used to thicken food or fluids for people with swallowing difficulties) required improvement. We found records which demonstrated thickener had not been administered as prescribed as well as inconsistencies from staff relating to how much thickener was administered. We also found some staff had limited knowledge about new nutrition guidelines relating to thickener which is essential to enable them to administer this safely.