Kilmar House

Updated 16 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 17 May 2018. The inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has experience of using or caring for someone who uses this type of service. Their area of expertise was in older people’s care.

We reviewed the Provider Information Record (PIR) and previous inspection reports before the inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make. We also reviewed the information we held about the service and notifications of incidents we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we spoke with seven people, three relatives and one visiting healthcare professional. We looked around the premises and observed care practices during our visit. We also spoke with the registered manager and three care staff.

We looked at three people’s care plans and associated records, Medicine Administration Records (MAR), three staff recruitment files, staff duty rosters, staff training records and records relating to the running of the service.

Updated 16 June 2018

We carried out an unannounced comprehensive inspection of Kilmar House on 17 May 2018. Kilmar House is a ‘care home’ that provides care for a maximum of 15 adults. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection there were 12 people living at the service. The accommodation is over two floors in both the main house and the annexe. The annexe is joined to the main house via a corridor on the first floor and through an external door on the ground floor and is only used by people who are independently mobile. A shared lounge and dining room are on the ground floor and a smaller lounge on the first floor. The first floor is accessed by two sets of stairs one of which has a stair lift. There is also a passenger lift.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People received care and support that met their needs because there was a stable staff team who had the skills and knowledge to provide responsive and personalised care. People told us they were happy with the care they received and believed it was a safe environment. Comments included, “Yes definitely feel safe, because there’s always someone around and I can use the call bell”, and “They keep an eye on me and I feel sure they do all they can for me.”

We spent much of the inspection in the shared lounge and dining room observing and talking with people. There was a calm and relaxed atmosphere at the service throughout the day of the inspection visit. People and staff welcomed us into the service and were happy talk to us about their views of living and working there. We observed people had good relationships with staff and each other. People spoke positively about staff and their caring attitude. Comments included, “I’m happy that [person] is here. Staff know what they are doing”, “Everything is done for my relative, I don’t have to worry as I don’t live near and that helps me” and “I am very happy living here. I’m part of this family the family I never had.”

People's independence and wellbeing was promoted because staff had developed positive and meaningful relationships with people. People were encouraged and felt confident to make decisions about their daily lives. The culture in the service was one where there were no unnecessary rules or routines put in place to suit staff, rather than the people that used the service. People told us they made their own choices about their lives, commenting, “I was asked to change rooms and chose at that time not to”, “They ask me, never tell me”, “I choose how I spend my time doing what I choose to do. They suggest things like where to eat my lunch or whether or not I want to sit outside and I decide what I want to do.”

People’s care plans contained personalised information about their individual needs and wishes and people were involved in the planning and reviewing of their care. These care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted.

Incidents and accidents were logged, investigated and action taken to keep people safe. Risks were clearly identified and included guidance for staff on the actions they should take to minimise any risk of harm. Risk assessments had been kept under review and were relevant to the care provided.

Safe arrangements were in place for the storing and administration of medicines. Staff supported people to access healthcare services such as occupational therapists, GPs, chiropodists, district nurses and opticians.

People were supported to eat a healthy and varied diet. Comments from people about their meals included, “They come round in the morning and ask what we would like for lunch and if there is nothing I want they will find something else”, “I have an allergy and am always given lots of choice, I enjoy the food here”, “If I don’t like the choice of food I can choose something else that I would like” and “There is plenty of it and they can have seconds.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

There were sufficient numbers of suitably qualified staff on duty to meet people’s needs in a timely manner. Staff knew how to recognise and report the signs of abuse. Staff were supported to develop the necessary skills to carry out their roles through a system of induction, training, supervision and staff meetings.

There was a positive culture within the staff team and the management provided strong leadership. There were opportunities for staff to raise any concerns or ideas about how the service could be developed. People and their relatives all described the management of the service as open and approachable. “It’s a very good home here, it has a good reputation”, “They run the home very well and the staff are all kind”, “It’s organised and they care” and “They are very good here. They get the right staff.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The service had a suitable complaints procedure.

Further information is in the detailed findings below.