This inspection was unannounced and the visits took place on 26, 31 October and 16 November 2016. The staff and registered provider did not know that we would be visiting. Kings Park Nursing Home is a purpose built care home and is registered to provide accommodation for up to 40 people who require nursing and personal care. At the time of our inspection there were 38 people living at the home.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People told us they were happy with the service and felt the staff did a good job. We heard how people felt the home was well-run and that the registered manager was extremely effective.
We found that a range of stimulating and engaging activities were provided at the home. There were enough staff to support people to undertake activities in the home and community. We saw people went on trips to museums and local pubs as well as the airport. On the day of our visit people were making baubles for the Christmas trees.
People’s care plans were tailored for them as individuals and created with them and their family involvement. People were cared for by staff that knew them really well and understood how to support them. We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful. We saw that they were aware of how to respect people’s privacy and dignity. Staff also sensitively supported people to deal with their personal care needs.
Staff were supported and had the benefit of a programme of training that enabled them to ensure they could provide the best possible care and support. Staff were all clear that they worked as a team and for the benefit of the people living at Kings Park Nursing Home. Their comments and feedback fed into the continuous improvement of the service.
The registered manager understood the complaints process and detailed how they would investigate any concerns. They actively sought people’s views and acted upon suggestions. They had also promoted a reflective learning culture in the home, which allowed staff to look at even the smallest of incident to determine what lessons could be learnt.
The registered manager and staff had a clear understanding of safeguarding. The registered manager acted as a champion for people and would raise complaints and safeguarding matters when this was needed.
We found that there were enough staff on duty to meet people’s needs. The registered manager had closely considered people’s needs and ensured there were sufficient numbers of staff. For the 38 people using the service there were two nurses, a senior carer and six care staff on duty during the day and then a nurse and six care staff overnight.
The registered provider had provided care staff with access to a development programme that allowed them to become competent in providing clinical care such as wound and catheter care. They also became trained to take blood and monitor people’s health. This programme was near completion for some staff and the registered manager told us the intention was that the staff would be employed within the home as a clinical support.
Where people had difficulty making decisions we saw that staff worked with them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations.
We reviewed the systems for the management of medicines and found that people received their medicines safely. Medicines were closely managed and this ensured people received their medication exactly as prescribed.
People told us they were offered plenty to eat and we observed staff to assist individuals to have sufficient healthy food and drinks to ensure that their nutritional needs were met. The cook provided a home cooked healthy diet and also provided a range of fortified meals for people who needed extra calories to ensure they maintained their weight. People were supported to manage their weight and nutritional needs.
People were supported to maintain good health. The staff had formed good links with the Consultants, GPs, dieticians, speech and language therapists, tissue viability nurses, community nurses and the falls team.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people. The staff team was stable and a number of the staff had worked at the home for over four years.
The service had a strong leadership presence with a registered manager who had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. Thorough and frequent quality assurance processes and audits ensured that all care and support was delivered in the safest and most effective way possible.