Kynance Residential Home

Updated 18 May 2018

We carried out this comprehensive 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 inspection took place on 5 and 10 April 2018 and was unannounced. It was completed by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed all information we had received about the service, including previous inspection reports, the provider’s action plan for improvement and notifications. Notifications are information about specific important events the service is legally required to send to us.

During the inspection, we spoke with 11 people who use the service and four family members. We observed care and support being delivered in communal areas of the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, the two deputy managers, six care staff, two nutritional assistants, a cook and a housekeeper. We also received feedback from two health and social care professionals who had contact with the service.

We looked at care plans and associated records for six people and records relating to the management of the service, including: duty rosters, staff recruitment files, accident and incident records, maintenance records and quality assurance records.

Updated 18 May 2018

Kynance Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation for up to 32 people. There were 28 people living at the home at the time of the inspection.

The home was based on two floors connected by a passenger lift, in addition to a basement where the kitchen and laundry are located. There was a good choice of communal spaces where people were able to socialise, including a conservatory that was used as the dining room. All bedrooms had en-suite facilities.

The inspection was conducted on 5 and 10 April 2018 and was unannounced.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection, in February 2017, we rated the service ‘Requires improvement’ and identified breaches of Regulations 9 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to protect people effectively from the risk of choking and had failed to ensure people's care needs were met in a personalised way. The provider wrote to us, detailing the action they would take to address the concerns.

At this inspection, we found action had been taken to address all areas of concern and there were no longer any breaches of regulation.

The management team had made significant improvements to a range of processes and procedures, making them tighter and more robust to help ensure people were supported consistently in a safe and personalised way.

Three nutritional assistants had been appointed to support people to eat and drink safely and ensure their nutritional needs were met. This had helped people maintain a healthy weight.

Other individual and environmental risks to people were managed effectively. Risk assessments had been developed for all identified risks and people were involved in risk taking decisions.

People felt safe living at Kynance. Staff knew how to identify, prevent and report abuse. Safeguarding investigations were thorough and identified learning to help prevent a reoccurrence.

There were enough staff to meet people’s needs in a timely way. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed.

Arrangements were in place for the safe management of medicines. People received their medicines as prescribed. The home was clean and staff followed best practice guidance to control the risk and spread of infection.

People’s needs were met by staff who were competent, trained and supported appropriately in their role. Staff acted in the best interests of people and followed legislation designed to protect people’s rights and freedom.

People described Kynance as homely. Some adaptations had been made to make the environment suitable for the people who lived there, including level access to an outside space.

People were supported to access healthcare services when needed. Staff made information available to other healthcare providers to help ensure continuity of care.

People were supported by kind, caring and compassionate staff. Staff made people feel they mattered by creating a family atmosphere and celebrating important events. They knew people well and supported people to maintain relationships that were important to them.

Staff expressed a commitment to treating people according to their individual needs, wishes and preferences. They protected people’s privacy and dignity. They encouraged people to remain as independent as possible and involved them in decisions about their care.

People’s needs were met in a personalised way. Each person had a care plan that was centred on their individual needs. Staff empowered people to make choices and responded promptly when people’s needs or preferences changed.

Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.

People had access to a range of activities. They knew how to make a complaint and felt any concerns would be listened to and addressed effectively.

People and their relatives felt the service was run well. Staff were organised, motivated and worked well as a team. There was a clear management structure in place and the registered manager had access to appropriate support.

There were effective quality assurance systems in place. People were consulted about the way the service was run and staff acted on feedback provided.

People described an open and transparent culture within the home, where they had ready access to the management and visitors were welcomed at any time.