Archived: Kirklands

Updated 24 May 2017

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 to provide a rating for the service under the Care Act 2014.

This inspection of Kirklands took place on 2 May 2017 and was unannounced. Two adult social care inspectors and an expert by experience carried out the inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We spent time speaking with and observing people who lived in the home within the home’s communal areas and spoke with people in private. During the inspection we spoke with 13 people who lived in the home, seven relatives, five of the care staff, including a team leader, a visiting health care professional, the registered manager, the deputy manager, the cook, the laundry assistant and the organisation’s in house care and dementia advisor.

We looked in detail at care plans for eight people living in the home, their medication records and their care plans relating to the use of their medicines. We looked at medicines storage and records for the receipt and disposal of medicines for people living in the home on both floors. We observed medicines being handled and discussed the management of medicines with the staff involved in this.

We looked at records that related to how the home was being managed and looked at the staff training and supervision records. We looked at the recruitment records for the new staff working in the home. We looked at records relating to the maintenance and management of the service and records of checks or ‘audits’ being done to assess and monitor the quality of the service provision.

Before our inspection, we reviewed the information we held about the service. We spoke with commissioners of the service. We looked at the information we held about statutory notifications sent to us about incidents and accidents affecting the service and people living there. A statutory notification is information about important events that the provider is required to send to us by law. We looked at the information we held on safeguarding referrals, concerns raised with us and applications the registered manager had made under Deprivation of Liberty Safeguards (DoLS).

Before the inspection, the provider completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.

Updated 24 May 2017

This unannounced comprehensive inspection of Kirklands took place on 2 May 2017. This was a planned comprehensive inspection to follow up on requirement notices made at the previous inspection in February 2016.

At that inspection we found the service was not meeting all the regulations that we assessed. The requirement notices were in relation to medicine management because people had not received their creams and ointments as their doctor had intended. Also because people's care records were not person centred and did not reflect up to date information about people's care and support needs. At the last inspection, the management of risk and the use of effective monitoring systems were found to be in need of improvement. We issued four requirement notices and asked the registered provider to tell us how they were going to make the improvements required. The registered provider gave us an action plan setting how what they were going to do to improve and the timescales to carry out the improvements. At this inspection 2 May 2017, we found that all the requirement notices had been met and the changes and improvements stated in the action plan had been completed.

Kirklands is owned by Anchor Trust which operates residential and other care services for older adults. Kirklands is registered to provide accommodation and personal care for up to 40 older people, some of whom may be living with dementia. Accommodation in the home is provided on two floors and all bedrooms are for single occupancy and have ensuite toilets. There is a lounge and dining room on each floor. The home is situated in a residential area of Cockermouth and was purpose built twenty years ago. It is within walking distance of all the local amenities. There is a garden for people living there to use and this is secure, private and has accessible outdoor seating. There is parking available at the front of the home for staff and visitors. There were 36 people living at the home at the time of our inspection.

The service had a registered manager in post at the time of this inspection. 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 living in the home told us that they felt safe living there and relatives we spoke with told us they were “very pleased” with the care being provided. We saw that the people who lived there were being well cared for and were relaxed and comfortable in the home and with the staff that were supporting them. People told us the staff were “kind” and “always did their best”. The atmosphere within the home was friendly and inclusive. Everyone we spoke with praised the staff that supported them. We saw examples during the inspection of staff giving people their attention, offering reassurance and displaying empathy

We found that all areas of the home used by the people living there were clean and tidy. People told us they had a choice of meals, snacks and drinks. The people who lived there told us that the food was “very good” and “always good” and that they enjoyed their meals.

People who lived at Kirklands told us that care staff were available to help them when they needed assistance and that staff respected their privacy. People were able to see their friends and families as they wanted. There were no restrictions on when friends and relatives could visit people the home. People were supported to follow their own interests, practice their religious beliefs and see their friends and families as they wanted.

Systems were in place for the recruitment of staff and for their induction and on going training and development. We have made a recommendation that the service consider routinely including checks on the previous employment of new staff.

Staff told us they had received training in safeguarding adults and the training records confirmed this. Staff we spoke with knew the appropriate action to take if they believed someone was at risk of abuse. The staff we spoke with were confident that the registered manager would follow up any concerns about people’s safety and take action promptly.

We looked at the risk assessments in place for people and these included risk assessments for skin and pressure area care, falls, moving and handling, mobility, nutrition and the safe use of bedrails. The district nurse had done assessments of peoples’ skin integrity and had advised and supported the care staff on this subject. We saw that where appropriate referrals had been made to other professionals such as physiotherapists and occupation therapists.

During this inspection we looked at the way medicines were managed and handled in the home. We found that medicines were being stored and administered safely and records were kept of the medicines kept in the home, their use and disposal.

The registered manager used a range of methods to get feedback from people living, working and visiting home and promoted open communication. People living at Kirklands were involved in deciding what went on in their home and in projects such as their new shop and garden renovations.

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 support this practice. We saw that the registered manager had applied to relevant supervisory authorities for deprivation of liberty authorisations for people. We saw that people who had capacity to make decisions about their care and treatment had been supported to do so. We have made a recommendation that the service improved checks on forms about resuscitation and evidence of who had a power of attorney.