19 September 2018
During a routine inspection
Kenmore is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Kenmore is registered to provide nursing and residential care for up to 26 people. At the time of the inspection 16 people were living at the home.
At the time of the inspection the home did not have a registered manager in place. The registered manager had left the organisation in March 2018, an acting manager had been in post since then. A new manager had been recruited, they had commenced employment on 17 September 2018, they had not yet commenced their application to register with the Care Quality Commission. 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.
People told us they felt safe. Risk assessments were in place and people received appropriate care and support where a risk was identified. Many of the previous concerns regarding medicines had been addressed although further work was required to ensure records provided sufficient detail.
Previous concerns regarding the risk of Legionella had been addressed. Equipment was serviced and maintained. Work was still to be done to meet the recommendations of a recent fire risk assessment.
Improvements had been made to staff recruitment. Staff efficiency had been improved by the introduction of walkie talkies.
New staff received an induction when they commenced employment. Most staff were up to date with their training requirements. Although some topics were listed as being ‘one off’, this meant staff did not receive refresher training in that subject. Staff were now being supported through regular supervision.
People spoke positively about the meals at Kenmore. Staff supported people to eat and drink, patiently and with discretion. We identified one person who had recently lost weight, however, their records had not been updated to reflect this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, records did not always evidence the requirements of the Mental Capacity Act 2005 had been consistently met. We have made a recommendation about meeting the requirements of Mental Capacity Act.
People and relatives told us staff were caring and kind. Staff treated people with kindness, respect and compassion. People told us staff respected their choices and staff encouraged people to retain their independence and life skills.
Staff and a number of volunteers supported people to engage in a range of activities both in the home and in the community.
Peoples care records had been updated and reviewed to ensure they were person centred and reflective of their care and support needs. Although no one at the home was receiving palliative care, the home was due to re-commence its work towards achieving accreditation for end of life care
Many of the issues raised at our previous inspection about a lack of effective governance had been addressed. The acting manager had ensured the registered providers programme of audits was implemented. These helped track the progress of the service in addressing the failing identified at our previous inspection. The acting manager had ensured regular meetings were held with staff, residents and relatives, improving communication between people, relatives, staff and management. Feedback about the acting managers conduct and approach was consistently positive.
The service is no longer in Special Measures. This is the first time the service has been rated Requires Improvement.