This unannounced inspection of Kendal Care Home took place over two days on 30 September and 6 October 2015. During our previous inspections on 8, 9 and 12 February 2015 we found the service was not meeting all the regulations.
This was because at our inspection on 8, 9 and 12 February 2015 there was not verifiable evidence that all staff in the home had received induction training and appropriate training for their roles. Care plan assessments did not always reflect a person-centred strategy and changes were not always reflected in care plans. The registered provider had not made sure that all aspects of service provision and record keeping were being regularly monitored for effectiveness.
We also carried out a focussed inspection on 2 June 2015 following concerns raised by other agencies and individuals in relation to the levels of suitably qualified staff being deployed in the home to meet people’s needs. We found on the day of our visit, 2 June 2015, that there was an adequate level of staff on duty to provide basic personal and nursing care. However the nursing support available to people did not reflect an emphasis on person centred nursing care but more on completing nursing care tasks.
Following the inspection on 2 June 2015 the registered provider wrote to us and gave us an action plan saying how and by what date they intended to improve training provision and recording, care planning and person centred care. At the inspection on 30 September 2015 we found that the care plan assessments and reviews of assessments to help ensure that people received care that met their needs were still not satisfactory. We also found that the registered provider had not made sure that all aspects of service provision and record keeping were being regularly monitored for effectiveness. Staff training was being better organised and monitored but some staff still lacked appropriate training and support for their roles. Whilst we could see changes had begun to improve service provision in these areas they had yet to be fully effective.
At this inspection we also found that there were others breaches of regulations that had an impact on people living in the home. These were in medicine management, recruitment of staff, making sure that care planning was person centred and that all needs had been assessed and risks well managed. We found that systems had not always been effective in making sure people’s nutrition and hydration needs were well monitored and not all records required by regulation were up to date. We found that a systematic approach to determining the range of skills needed and gender mix of staff on duty to meet people’s preferences and needs not always being used. Agency staff were being brought in to try to maintain staff numbers. Some agency staff had not been well supported in their roles and responsibilities in the home
Kendal Care Home provides nursing and residential care for up to 120 older people, some of whom are living with dementia. The home is over three floors and has a passenger lift for access to these. There are three suites in the home and all the bedrooms are single occupancy with ensuite facilities. Each of the three units has communal dining and lounge areas. There is a cinema room for people to use. The home is set back from the main road, with level access grounds. There is ample car parking for visitors. During our inspection there were 75 people living there.
The service did not have a registered manager in post at the time of this inspection or at the time of our inspection in February 2015. 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 and associated Regulations about how the service is run. The registered manager had resigned from their post in March 2015 and their replacement left in August 2015 before registering with CQC. The registered provider is currently trying to recruit a suitable person for this post.
We found that on the residential unit people has some very positive things to say about the way the unit was run, the unit manager and their care and support. The two other units where there was nursing care provided for people, some of whom were living with dementia, were perceived less positively by relatives. They told us about the lack of leadership and management on the units and the frequent use of agency staff who did not know people well.
We found that the registered provider had started to make improvements in providing a consistent training programme for staff and providing mandatory training. However we found that training for specific roles and responsibilities was not consistent for all care and nursing staff to support them to safely effectively fulfil the requirements of their roles. This was evident because staff had not worked within the requirements of the Mental Capacity Act 2005.
We found that the management of medicines in the home did not always follow policies and procedures and current best practice and medicines were not always given as prescribed by the doctor. Most of the people we looked at had photographs and their allergies recorded on their medicines records which reduces the risk of medicines being given to the wrong person or to someone with an allergy and is in line with current guidance.
The systems used to assess the quality of the service had not identified all the issues that we found during the inspection. Whilst we found that some aspects of the quality monitoring processes were being done well others were less well monitored. The standard of some clinical record keeping was not adequate. The registered provider had not ensured that an effective system was in place to make sure the nutritional and hydration needs of people were accurately recorded and monitored. We also found that care and risk assessments had not always been reviewed and updated.
We found that people living at Kendal Care Home were able to see their friends and families as they wanted and go out when they wanted with them. There were no restrictions on when people could visit them. We could see that people who were able to made day to day choices about their lives in the home and were able to follow their own faiths. People living there and visiting relatives told us that staff were polite and caring and “Work extremely hard”.
We have made a recommendation about making sure confidential health checks were carried out with people before they started work. Confidential health questionnaires help the registered provider to support physical or mental health conditions which are relevant to a person’s capability for the role.
You can see what action we told the provider to take at the back of the full version of the report.
This unannounced inspection of Kendal Care Home took place over two days on 30 September and 6 October 2015. During our previous inspections on 8, 9 and 12 February 2015 we found the service was not meeting all the regulations.
This was because at our inspection on 8, 9 and 12 February 2015 there was not verifiable evidence that all staff in the home had received induction training and appropriate training for their roles. Care plan assessments did not always reflect a person-centred strategy and changes were not always reflected in care plans. The registered provider had not made sure that all aspects of service provision and record keeping were being regularly monitored for effectiveness.
We also carried out a focussed inspection on 2 June 2015 following concerns raised by other agencies and individuals in relation to the levels of suitably qualified staff being deployed in the home to meet people’s needs. We found on the day of our visit, 2 June 2015, that there was an adequate level of staff on duty to provide basic personal and nursing care. However the nursing support available to people did not reflect an emphasis on person centred nursing care but more on completing nursing care tasks.
Following the inspection on 2 June 2015 the registered provider wrote to us and gave us an action plan saying how and by what date they intended to improve training provision and recording, care planning and person centred care. At the inspection on 30 September 2015 we found that the care plan assessments and reviews of assessments to help ensure that people received care that met their needs were still not satisfactory. We also found that the registered provider had not made sure that all aspects of service provision and record keeping were being regularly monitored for effectiveness. Staff training was being better organised and monitored but some staff still lacked appropriate training and support for their roles. Whilst we could see changes had begun to improve service provision in these areas they had yet to be fully effective.
At this inspection we also found that there were others breaches of regulations that had an impact on people living in the home. These were in medicine management, recruitment of staff, making sure that care planning was person centred and that all needs had been assessed and risks well managed. We found that systems had not always been effective in making sure people’s nutrition and hydration needs were well monitored and not all records required by regulation were up to date. We found that a systematic approach to determining the range of skills needed and gender mix of staff on duty to meet people’s preferences and needs not always being used. Agency staff were being brought in to try to maintain staff numbers. Some agency staff had not been well supported in their roles and responsibilities in the home
Kendal Care Home provides nursing and residential care for up to 120 older people, some of whom are living with dementia. The home is over three floors and has a passenger lift for access to these. There are three suites in the home and all the bedrooms are single occupancy with ensuite facilities. Each of the three units has communal dining and lounge areas. There is a cinema room for people to use. The home is set back from the main road, with level access grounds. There is ample car parking for visitors. During our inspection there were 75 people living there.
The service did not have a registered manager in post at the time of this inspection or at the time of our inspection in February 2015. 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 and associated Regulations about how the service is run. The registered manager had resigned from their post in March 2015 and their replacement left in August 2015 before registering with CQC. The registered provider is currently trying to recruit a suitable person for this post.
We found that on the residential unit people has some very positive things to say about the way the unit was run, the unit manager and their care and support. The two other units where there was nursing care provided for people, some of whom were living with dementia, were perceived less positively by relatives. They told us about the lack of leadership and management on the units and the frequent use of agency staff who did not know people well.
We found that the registered provider had started to make improvements in providing a consistent training programme for staff and providing mandatory training. However we found that training for specific roles and responsibilities was not consistent for all care and nursing staff to support them to safely effectively fulfil the requirements of their roles. This was evident because staff had not worked within the requirements of the Mental Capacity Act 2005.
We found that the management of medicines in the home did not always follow policies and procedures and current best practice and medicines were not always given as prescribed by the doctor. Most of the people we looked at had photographs and their allergies recorded on their medicines records which reduces the risk of medicines being given to the wrong person or to someone with an allergy and is in line with current guidance.
The systems used to assess the quality of the service had not identified all the issues that we found during the inspection. Whilst we found that some aspects of the quality monitoring processes were being done well others were less well monitored. The standard of some clinical record keeping was not adequate. The registered provider had not ensured that an effective system was in place to make sure the nutritional and hydration needs of people were accurately recorded and monitored. We also found that care and risk assessments had not always been reviewed and updated.
We found that people living at Kendal Care Home were able to see their friends and families as they wanted and go out when they wanted with them. There were no restrictions on when people could visit them. We could see that people who were able to made day to day choices about their lives in the home and were able to follow their own faiths. People living there and visiting relatives told us that staff were polite and caring and “Work extremely hard”.
We have made a recommendation about making sure confidential health checks were carried out with people before they started work. Confidential health questionnaires help the registered provider to support physical or mental health conditions which are relevant to a person’s capability for the role.
You can see what action we told the provider to take at the back of the full version of the report.