Archived: Kings Lodge

The focus of the inspection was to gather evidence to answer five questions : is the service safe, effective, caring responsive and well-led?

The name of an individual appears in this report as the registered manager but they are no longer connected with the service. This is because the person's registration had not been cancelled.

Is the service safe?

People were safe because staff had been trained in Safeguarding of Vulnerable Adults (SOVA). CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have been submitted, appropriate policies and procedures were in place to guide staff in making such applications.

The environment in which people were receiving care was suitably clean and arrangements were in place to protect people from the risks of infection. Equipment was in good supply and had been serviced and maintained to ensure people were not exposed to any hazards.

The service had made sure that it assessed risk comprehensively and had given staff clear guidance on how to work with people to minimise these risks occurring. People's medication was securely stored and the administration had been accurately recorded. We found an issue with recording of administering medication which had occurred on the day of our inspection but staff rectified this as soon as we raised it.

Is the service effective?

People's needs had been comprehensively assessed and their support plans had been updated. There was a key worker system in place which ensured the support plans were regularly reviewed to ensure people's changing needs were met.

People's religious needs were met by people choosing where and how they wished to worship if they chose to do so. The service maintained good relationships with people's families who visited their family members regularly. The service also encouraged family members to get involved in their relative's daily lives, for example by encouraging them to cook the person's favourite foods and bring this for them on their visits.

We observed that people's changing physical needs were being met; the service planned to construct a stair-lift, which would allow people with mobility problems to access the first floor independently.

Is the service caring?

Relatives we spoke with had no concerns about the safety of their family member living at the service. We spent time with people who used the service and observed them to be happy and well supported. We observed positive interactions between staff and people who lived at the service. Relatives we spoke with told us they were happy with the support their family member was receiving, with one telling us "I am quite happy with the support".

Is the service responsive?

We observed that the people who used the service had chosen how to decorate their bedrooms. One person had chosen a wall of their bedroom to be decorated with football wallpaper so that the wall resembled a football stadium. We spoke with this person who told us that they were very much enjoying watching the football World Cup. Staff had encouraged this person to pursue their interest in this event.

We saw that people's dietary needs were very carefully met with regard to people's cultural origins and hence their food preferences. For example, the service provided traditional English and Asian foods at each mealtime to reflect the cultural backgrounds of the people who used the service.

Is the service well-led?

Staff told us they were listened to when they made suggestions about how the service could be improved and that the manager acted upon some of these suggestions. Staff received clear guidance and up-to -date guidance on how to support people.

There was no registered manager in place at the time of the inspection visit. Relatives expressed concern about the frequency with which the manager of the service had changed in recent years but hoped the new manager would stay and consolidate the changes that had been made by previous managers.

We observed that the operations director was very aware of people's needs because they visited regularly and were clearly committed to maintaining a high quality of support to people who lived at the service. They also undertook regular checks of the service's performance.

Care records indicated that people's needs were being met. The care records contained comprehensive assessments and care plans. There was documented evidence that the healthcare needs of people were being met and this included details of appointments with healthcare professionals.

Our previous inspection in February 2013 found that the provider was not meeting the standard with regards to safety and suitability of premises. During our inspection in June 2013, we noted that the provider had addressed the necessary maintenance and decorative issues and shortfalls. We noted that the provider had taken the steps to provide care in an environment that was suitably designed and adequately maintained.

We observed that there were sufficient staff to meet people's needs and that staff interacted well with people who used the service. Staff received appropriate professional development.

We observed staff supporting people who used the service to safely access the community if they wished to do so.

We found that people were supported in promoting their independence and community involvement. Their diversity, values and human rights were respected. People seemed to like the staff and they were provided with care and support that met their needs. They felt safe and were listened to when they communicated any concern or anxieties.

People told us that they felt 'safe' at Kingslodge and staff demonstrated good understanding of appropriate safeguarding procedures to be followed if required.

Medicine were administered and stored appropriately.

People using the service voiced their concerns of the poor maintenance regime carried out by the provider and pointed out a considerable number of shortfalls to us.

We observed staff interacting with people safely and appropriately and people told us, that they "like staff and felt safe at Kings Lodge." We observed care workers to be busy, but carers did not appear to be rushed.