Archived: Kingston Court Care Home

Updated 9 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 checked 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 provide a rating under the Care Act 2014.

This inspection took place on 17 and 18 April 2018. The first day was unannounced.

The inspection was carried out by two adult social care inspectors, an inspection manager, a specialist professional advisor in tissue viability 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. The expert by experience who accompanied the inspector had experience in the care of older people.

Prior to the inspection we gathered and reviewed information we held about the service including statutory notifications we had received. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We spoke with health and social care professionals and asked their opinion of the service.

We observed people’s care and support in all areas of the home. We spoke with 10 of the people who used the service, five relatives and 23 staff including the registered manager, care staff, nurses, kitchen staff and maintenance staff. In addition we consulted two representatives of the local authority, reviewed 11 care records and various other records relating to the service such as training records and equipment maintenance logs. We walked round the building and with permission entered people's rooms.

Updated 9 June 2018

This was an unannounced inspection that took place on 17 and 18 April 2018. We previously inspected this service in December 2016 and found the following breaches of the Health and Social Care Act; Regulation 10 Dignity and respect; Regulation 12 Safe care and treatment; Regulation 14 Meeting nutritional and hydration needs; Regulation 17 Good governance and Regulation 18 Staffing. In December 2016 we rated the service as 'Requires Improvement'. Following the last inspection we met with the provider and asked them to complete an action plan to show what they would do, and by when, to improve the service.

Kingston Court Care Home is situated in the grounds of the Cumberland Infirmary in Carlisle.

Kingston Court is a 'care home'. 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.

The home accommodates up to 74 people in a purpose built building with three floors. At the time of our visit there were 63 people living there.

The home had a suitably qualified and experienced registered manager. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service to support this practice required further development; we made a recommendation about this.

The service provided structured activities for people who lived at Kingston Court. People told us they welcomed these activities and enjoyed them. The service intended to develop in this area and create a broader range of activities.

Risk assessments and care plans provided guidance for staff in the home. People in the service were involved in the creating of support plans and were able to influence the content. The management team had ensured the plans reflected the person centred care that was being delivered.

The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and talked to us about how they would identify any issues and how they would report them appropriately. Risk assessments and risk management plans supported people well. Arrangements were in place to ensure that new members of staff had been suitably checked before commencing employment. Any accidents or incidents had been reported to the Care Quality Commission as necessary and suitable action taken to lessen the risk of further issues.

The registered manager ensured that there were sufficient staff to meet people's needs in a timely manner. Our findings corroborated this. Staff were suitably inducted, trained and developed to give the best care possible. We met experienced and kind team members who understood people's needs as well as new staff who were keen to learn.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary. They accessed hospital appointments as a matter of routine.

We saw that an assessment of needs was in place and that the staff team analysed the outcomes of care for effectiveness. People were very happy with the food provided and we saw well prepared healthy meals that staff supported and encouraged people to eat.

The home itself was clean and comfortable on the day we visited. Suitable equipment was in place to support people with their mobility.

We observed kind, patient and suitable support being provided. Staff knew people well. They made sure that confidentiality, privacy and dignity were maintained. Staff were suitably skilled in providing end of life care.

The registered manager had successfully improved the home since our last inspection and intended to develop it further. Staff were able to discuss good practice, issues around equality and diversity and people's rights.

Complaints and concerns were suitably investigated and dealt with and good records management was in place in the service and there was a quality monitoring system in place which was used to support future planning.