Kingsway View Care 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 the last inspection people were not consistently protected from the risk of abuse or improper treatment because systems and processes to safeguard people were not always followed. That was a breach of Regulation 13. The service had made improvements and is no longer in breach of regulations . Staff followed the process to protect people from the risk of abuse or improper treatment. The environment was clean and potential risks to people were identified and reduced. There were effective infection control processes. People were supported by enough of safely recruited staff who received training adequate to their role. People’s care records were up to date, and person centred. Medicines were managed safely; however further work was required to ensure that ‘as required’ medication were always accompanied by clear guidance for staff.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were encouraged and supported to raise concerns. They felt confident that they would be treated with compassion and understanding, and would not be blamed, or treated negatively if they complain. The comments included: “I would feel comfortable speaking [about concerns] to anyone but would probably speak to a senior carer first;” “Staff are happy to discuss anything. I am always comfortable speaking to them.” Relatives gave us examples of how lessons were learnt when incidents occurred. One relative told us, “I have raised a few questions on a couple of occasions, in the main about incidents with other residents (…). They explained what had happened and it was an accident.”

At our last inspection we found that safeguarding incidents were not always recorded or reported approprietly. The nominated individual told us how lessons were learnt from what went wrong and measures were put in place to increase the oversight and scrutiny of the service. Leaders evidenced that people’s and staff’s safety was their priority. Leaders were open and transparent about incidents and accidents that occurred, they recorded and reported them approprietly. Leaders encouraged people and staff to raise concerns and assured them they would not be treated negatively if they do so. Staff recorded incident and accidents when they occurred, and the managers had an effective system to analyse them for trends and patterns. Staff comments included, “We are always learning so always changing practice to meet the needs of people.”

Provider had relevant policies, including complaints, incidents and accidents policy and procedure, safeguarding, and whistleblowing policy. There was an effective process of oversight to review accidents and incidents. There was a Duty of Candour policy, and we saw examples of how it was applied in practise.

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.

People and their relatives felt safe at Kingsway View. When asked if they feel safe, the comments included, “Yes, most definitely,” “Totally safe. I can go to bed at night knowing my relative is safe and well cared for;” “Yes, I do. No concerns regarding staff and the way they interact and assist my relative. This is reassuring for us as a family.”

Leaders and staff understood their responsibilities to report safeguarding concerns and knew what to do if they had concerns about abuse or neglect. Staff were knowledgeable about how to spot indications of abuse and neglect and knew how to report it. Staff feedback included, "We all get safeguarding training on inductions - who you protect, how you protect, whistleblowing policies"; "Policies are in the staff room.”

Staff supported people safely with all aspects of care, for example mobility and assisting with food and drinks. We saw staff offering people choices and allowing people to make decisions, for example about what they would like to do or what they would like to eat.

Staff completed whistleblowing and safeguarding training and knew how to raise concerns. The service had system in place to ensure that Deprivation of Liberty Safeguards (DoLS) were applied for when needed. People’s rights were respected and their mental capacity to make individual decisions were correctly assessed, in line with the Mental Capacity Act 2005.

People and relatives felt that risks were adequately assessed and mitigated. When accidents occurred, measures were promptly put in place to reduce the risk of reocurring. Comments included, “My relative was falling a lot. They moved the relative to a room near the nurse’s station. They did this before I raised concerns.” “My relative’s mobility had declined, and incontinence had got worse. They have dealt with all this really well;” “Staff put measures in place to ensure that my loved one is less anxious. They have been so accommodating. They implemented this off their own back without me raising as a concern.”

Staff knew individual people risks and how to mitigate them. They had access to thorough risk assessments and care plans to guide them how to support people safely. Staff were updated about any new risks, for example in the handover meetings every morning. Staff’s comments included, "Usually care manager will assess and put the care plan together after initial assessment, then when the seniors deal with the reviews and changes"; "We discuss risks to people with families.”

People were supported in line with their care plans and risk assessments. For example, people who were prescribed specialist diet were offered food in line with their care plan and guidance. People who required mobility aids were supported to use them correctly.

Staff assessed and mitigated risks to people. They updated people’s risk assessments regularly to ensure the information was accurate. A restraint policy was in place to guide staff to only use restraint as a last resort in a way that was safe, lawful, and for legitimate purpose. People’s behavioural support plans were tailored to their individual needs and included information about triggers of distress and positive way of supporting people.

People and relatives confirmed the environment was well maintained and designed to meet their needs. One person had their room adapted to ease their anxiety and make it more suitable to their needs. Another relative said, “The home is very clean, modern, professional and purpose built. The bedroom is top draw.”

Staff had the facilities and equipment to meet people’s needs. Leaders completed regular environmental audits to make sure the environment was safe. Maintenance staff were employed to ensure that the environment was safe and well maintained. Staff feedback included, "We have maintenance staff. They have a maintenance book, or we can tell them about maintenance issues, and they will write it down. Issues are addressed quickly"; "We check each time we use specialist equipment.”

People were looked after in a safely maintained environment.

Arrangements to monitor the safety of the premises through regular safety checks were in place. There were processes to ensure that gas, electrical and fire safety checks were carried out regularly.

There was enough of appropriately trained staff to meet people’s needs. The comments included, “They have more staff now and the level of care is great. They are very attentive;” “Yes, definitely staff are well trained they know how to support my relative with care and mobility needs, assist with meals etc.”

Most staff agreed the staffing levels were sufficient to ensure that people received good and safe care. The comments included, “We have enough staff;” "The night staff would tell us if they couldn't manage." Staff confirmed they received training appropriate to their role. However, some staff would prefer more face-to-face training. The feedback included, “Training is OK, but a lot online. We also have training with [staff name] who does induction and refresher training.” Leaders managed staff’s performance through supervisions and appraisals.

On the day of our visit, there was enough staff. We did not observe anyone having to wait long for care and support. Staff were skilful and able to carry out their job confidently. However, we observed that some interactions of staff with people were task orientated and there were some missed opportunities to have quality time with people. We shared that feedback with the provider at the end of our site visit.

There were robust and safe recruitment practices to make sure that all staff, including agency staff were suitably experienced, competent, and able to carry out their role. Leaders worked out a suitable staffing ratio based on people’s needs and were willing to change it when people’s needs increased. Leaders had oversight of staff training matrix and took prompt actions if staff were delayed with completing training sessions.

People and relatives raised no concerns about infection prevention and control. They confirmed staff used personal protective equipment (PPE) and kept the environment clean and hygienic.

Staff completed regular cleaning to ensure cleanliness of the environment, infection prevention control and food hygiene. They understood their responsibilities around infection prevention and control. Domestic staff told us they had plenty of equipment and products to carry out their role effectively.

On the day of our site visit, the home was clean and hygienic. Staff were taking proportionate precautions to reduce the risk of spreading infection. For example, wearing PPE, including colour coded aprons and gloves, and washing and sanitising hands regularly.

The provider had systems and processes to assess and manage the risk of infection. Audits were completed to identify any areas of concerns and to drive improvements.

People and their families felt assured that the medicines were managed safely by competent staff. They were involved and informed about changes to their medicines. One person said, “My relative had lots of changes to medication and I have had a lot of feedback about it from the home.”

Trained staff, mainly senior carers were responsible for the management and administration of medicines. Staff followed medicines policy and people’s care plans when administering medicines. Staff were knowledgeable about people’s health conditions. Staff knew what to do when people refused medicines or if an error was made. The comments included, “If I made a medication error, I would own up to it, I would tell manager, complete error form and all that would be filled out and passed on to the manager, family would be contacted. You would contact 111 or GP for advice to find out any advice or danger to health."

Protocols were not always in place or were not detailed enough for ‘as required’ medication (PRN). This meant there was an increased risk that staff would not always be clear on when to administer this type of medicines. Provider rectified it immediately following our feedback. People had medication care plans that were regularly reviewed. The provider followed correct procedures for the receipt, storage, administration, and disposal of medicines. People were involved in decisions about their medicines whenever possible. When people lacked mental capacity to make decisions about their medicines, staff involved relevant people to reach decisions that were in people’s best interest. For example, people’s families and representatives, GP, and health care professionals.