Archived: Kirkwood Care Home

Updated 20 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Kirkwood Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Kirkwood Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used information gathered as part of monitoring activity that took place on 14 September 2022 to help plan the inspection and inform our judgements. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time in communal areas observing the care and support provided by staff. We spoke with 5 people who used the service, 5 relatives and 9 members of staff including care workers, senior care worker, senior support manager and registered manager. We reviewed a range of records. This included 4 people's care records and multiple people's medicine records. We reviewed 5 staff recruitment files and a variety of records relating to the management of the service.

Updated 20 June 2023

About the service

Kirkwood Care Home is a residential care home providing accommodation and personal care to up to 20 people. The service supports older people and people living with dementia in one building. At the time of our inspection there were 17 people using the service.

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

The service had some areas of safe practice but in general people were not safe. People were at risk of harm because the provider did not always manage risks well. Medicines were not managed safely. There were enough staff to keep people safe. Robust recruitment checks were not completed before staff started working at the service. People were safeguarded from abuse; the management team had improved their safeguarding processes. Systems were in place to control infection.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff usually received the training and support they needed for their role. The service consulted other professionals when they wanted advice and guidance, and health professionals visited on a frequent basis. However, the monitoring of appointments such as podiatry was poor, which meant people’s health needs could be overlooked. People were provided with a nutritionally balanced diet but their dining experience and feedback about the quality of food was mixed. People lived in a suitable environment although the physical decoration throughout the service was not consistent.

There was a lack of consistency in people’s experience and how well the service was managed. Systems to assess and monitor the service did not drive the required improvements. Care records were inconsistent and not always accurate.

Feedback was consistently positive about the changes the registered manager, who had only been in post for 6 months, had made. Improvements included, communication, staffing and environmental. People were confident they would make further improvements. One relative said, “I have seen changes with the new manager, it’s more organised and I think she is a lot more approachable and listens and it seems a happier place in many ways.”

The service was developing systems which gave people more opportunities to share their views. Staff had daily handovers where they received key information. A visiting professional told us the service worked effectively with their team.

The provider was responsive to the inspection findings and sent information to show they were taking action to address shortfalls identified at the inspection.

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

Rating at last inspection

The last rating for this service was good (published 2 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This focused inspection was planned to only cover our findings in relation to the Key Questions Safe and Well-led. However, we inspected and found there was a concern with ensuring consent to care and treatment was in line with law and guidance, so we widened the inspection to include the Key Question of Effective.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kirkwood Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management, consent to care, recruitment of workers, medicines management and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.