Kite Hill Care Home

We found the following examples of good practice.

¿ There were very clear infection control processes in place for staff and essential visitors to the premises. The service had ensured there were prominent signs to explain the personal protective equipment (PPE) process required. There was a designated area for putting on and taking off PPE, which was provided to ensure the correct standards of PPE were worn, following government guidelines.

¿ People were supported to understand what Covid 19 was and why the current changes to their care and support were needed. Where people were identified as being at a higher risk of infection or needed to self-isolate for a 14-day period, staff supported them in creative ways, which included regular checks and individual activities in their rooms, to ensure the impact of social isolation was minimised.

¿ There were safe visiting arrangements for people and their relatives, which utilised the outside space at the service. Visits were spaced out, so that social distancing rules could be observed. All visitors were given clear information, which meant they understood how to maintain people’s safety whilst visiting. Staff supported people to understand the processes around visits to reduce risks.

¿ Changes to the environment had been considered and acted upon in order to comply with social distancing as much as possible. For example, the seating in the lounge had been spaced out so that people could be sat apart. In addition, there was a process in place to reduce the amount of people in the communal areas at any one time. The registered manager told us, people had been placed into two groups, so the first group accessed the lounge on one day then the second group the next day. This reduced the amount of people that were mixing together and meant, if they had an outbreak of Covid 19 in one group, it would lessen the risk to the other group. People had been supported to understand the reasons for this and were given additional support in their rooms on the days they did not use the lounge areas.

¿ The service was very clean and there were PPE stations throughout the communal areas, in every bathroom and in each person’s bedroom. There was clear signage, reminding people to wash their hands and wear PPE.

Further information is in the detailed findings below.

Kite Hill Care Home is a care home providing accommodation and personal care to older people. The service can support up to 30 people. At the time of the inspection the service was providing support to 25 people. Kite Hill Care Home is a large building that has been adapted to suit the needs of people living there. It has a large communal lounge and dining room, a quiet lounge and an accessible garden with two levels, linked by an outside lift. Accommodation is based over three floors and there is a passenger lift in between floors for people with mobility needs.

People’s experience of using this service and what we found

People and their relatives we spoke with, all gave us positive feedback about the home and told us that staff were kind and caring. The environment was warm and homely, and we observed staff speaking to people with kindness and respect.

The home had a consistent staff team who understood the needs of people well. We saw staff upheld and promoted people's rights relating to equality and diversity, and safe recruitment procedures were followed.

Individual and environmental risks were managed appropriately. People had access to appropriate equipment where needed, which meant people were safe from harm. Staff understood their safeguarding responsibilities and knew how to keep people safe from harm.

People received their medicines safely. There were systems in place to ensure that medicines were securely stored, ordered and disposed of correctly and safely However, we found communication systems used to follow up on medicines ordered, were not always robust. Immediate action was taken by the management team to improve the systems used by the end of the inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.

Activities had been developed in line with people's wishes and specific needs. Dedicated staff were employed to provide activities, and these were varied and interesting to promote health and well-being.

People were treated with dignity, and their privacy was respected. People's care plans contained detailed information about them and their care and support needs, to help staff deliver personalised care. The management team reviewed the care and support provided to people to make sure it continued to meet their needs.

Staff used positive communication techniques with people so that they felt listened to and valued according to their individual needs.

The provider had systems and processes to monitor quality within the home. The manager understood their regulatory responsibilities and shared information with stakeholders in a timely way.

People, their relatives, staff and external professionals were all positive about the management of the service and told us the manager was very supportive and approachable.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 30 November 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Kite Hill Nursing Home is registered to provide accommodation for up to 30 older people. There were 28 people living at the home at the time of the inspection. The home is a large extended property and accommodation is arranged over two floors. All bedrooms were for single occupancy and many had ensuite facilities. Bathrooms and toilets were provided on both floors. There was a lift and stairs available to access the first floor. There was also an external lift to facilitate access to a patio and rear garden area.

Kite Hill Nursing Home is a ‘care home’. People in care homes receive accommodation, nursing and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. We found the home to be clean and well maintained throughout the inspection.

A registered manager was in place. 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.

Quality assurance process had not identified areas for improvement found during this inspection, including around the safe management of all medicines, risk management systems, wound care and inconsistencies in care plans. When we identified concerns to the provider’s nominated individual and the registered manager took action or committed to consider how things could be improved.

The premises and equipment were safely maintained. Incidents or accidents were reviewed and action taken to reduce the likelihood of any reoccurrence.

Sufficient numbers of care and ancillary staff were deployed to meet people's needs. Checks were made to ensure staff were suitable to work in a care setting. Staff were trained and felt supported and valued.

People's nutritional needs were assessed and people were supported to eat and drink. There was a choice of food. People’s health care needs were monitored and referrals were made to other services appropriately to ensure there was a coordinated approach to people's care.

People were treated with kindness, respect and compassion. People's privacy and dignity were promoted. People were supported to have choice and control of their lives and staff promoted independence where possible.

Care and support were centred on the individual needs of each person and staff responded promptly when people's needs changed. People and external health professionals were positive about the service people received.

Staff supported people to receive end of life care that helped ensure their comfort and their dignity.

Activities were provided seven days per week offering a range of mental and physical stimulation.

There was an effective complaints procedure in place. People and their relatives confirmed they were listened to and changes were made when requested.

Staff were organised, motivated and worked well as a team. They felt supported and valued by the management team.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There was a registered manager in place. 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 and relatives were positive about the service they received. They praised the staff and care provided. People felt safe at the home. Care staff knew how to prevent, identify and report abuse.

Staff followed legislation designed to protect people’s rights and freedom to help make sure decisions were only taken in the best interests of people, although this was not always documented.

People received personalised care from staff who understood their needs and they were supported to make choices. At the end of their life people received appropriate care to have a comfortable, dignified and pain free death. Care plans provided comprehensive information about how people wished to be cared for and staff were aware of people’s individual care needs. Individual risks to people were managed effectively.

People had access to healthcare services and were referred to doctors and specialists when needed. Reviews of care involving people or relatives (where people lacked capacity) were conducted regularly. Staff recognised that people’s needs varied from day to day and responded effectively. The provider had identified a need to increase activities staff and was recruiting to these posts.

Suitable arrangements were in place for managing medicines administered by nurses. Although However, self-administration procedures were not sufficiently robust.

People were also positive about meals and the support they received to ensure they had a nutritious diet.

Plans were in place to deal with foreseeable emergencies and staff had received training to manage such situations safely. There was an environment maintenance and improvement program in progress.

The provider had identified a need for additional staff at busy times of the day due to an increase in people’s needs; they were taking action to provide this. Safe recruitment practices were followed. Staff provided effective care; they were suitably trained and appropriately supported in their role.

Staff treated people with kindness and compassion and formed caring relationships with them and their relatives. Staff protected people’s privacy, promoted their independence and involved them in planning the care and support they received.

People liked living at the home and felt it was run well. There was a clear management structure in place. Staff understood their roles, were happy in their work and worked well as a team.

There was an open and transparent culture. The provider encouraged staff feedback and visitors were welcomed. Complaints, when received, were investigated and responded to. Quality assurance processes were in place to assess key aspects of the service. Where these had identified a need for improvement action had or was being taken.

We looked at six care plans and saw they were individualised and included the necessary information to inform staff as to the specific care people required. We saw these were reviewed on a regular basis. We observed care in the communal areas of the home and saw staff interacting with people in a positive way. One member of staff said 'Staffing at the moment is fine. You have time to chat to people when you are with them doing personal care for example'. We also saw there were two members of staff dedicated to helping people to engage in both individual and group activities.

We found the home had effective systems in place to protect people from abuse. One of the people we spoke with told us 'my wife knows I am safe when I am in here'. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We found the provider had an effective quality assurance system and they sought the views of people who used the service and their families through regular surveys.

People experienced care, treatment and support that met their needs and protected their rights. Care plans were person centred and documented people's wishes in relation to how their care was provided.

The provider did not have an effective system in place to assess and monitor the quality provision of the service. We looked at incident records; these had not been completed in full and did not show us that the provider had looked at lessons learnt from incidents.

We spoke with a person's family, who told us that they thought care was good and that they felt listened to and involved in their relatives care.