Background to this inspection
Updated
10 October 2019
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 Care Act 2014.
Inspection team
The first day of inspection was carried out by one inspector and one 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. The second day of inspection was carried out by two inspectors.
Service and service type
Kirkella mansions is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with four members of staff including two senior carers, one care worker and the activities coordinator. We also spoke with the provider, registered manager and assistant manager. We spoke to two visiting health professionals. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and the providers policies and procedures.
Updated
10 October 2019
About the service
Kirkella Mansion is a residential care home providing personal and nursing care to people aged 65 and over and people living with dementia. The service can support up to 40 people. At the time of inspection 24 people were using the service.
People’s experience of using this service and what we found
At the last inspection we found concerns regarding medication management, risk management, infection control, fire safety and good governance. Although some improvements were seen at this inspection we had continued concerns with regards to medication, risk management and good governance.
Medication was not managed safely, we could not be assured people received their medication as prescribed and risks to people were not always mitigated. Accident and incidents were not recorded correctly or monitored effectively so lessons could not be learnt.
Governance systems in place had failed to make the required improvements. Quality monitoring and governance systems had been implemented but were not robust. They had not identified some of the shortfalls identified at this inspection.
People told us they felt safe. There was adequate staff to meet people’s needs. The service was clean, and staff had knowledge of how to prevent the risk of spread of infection.
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 supported people with their health care needs and we received positive feedback from health professionals.
Staff were kind and caring and treated people with respect.
We observed limited activities on offer during the inspection. We made a recommendation regarding the provision of activities. People were happy with the care they received and told us care was delivered in line with their preferences.
People and staff were positive about the management team and the support they received.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 21 September 2018) and there were two breaches 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 not enough improvement had been made/ sustained and the provider was still in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to medication management, risk management and governance systems at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.