Archived: Kinross

Updated 30 April 2020

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

This inspection was carried out by two 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

Kinross 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 did not have a manager registered with the Care Quality Commission. This means the provider was legally responsible for how the service is run and for the quality and safety of the care provided. The provider’s operations manager had commenced the registration process to become the registered manager with the Care Quality Commission (CQC). In this report we have referred to the operations manager as ‘the manager’. In addition, a newly appointed manager was in post at the time of the inspection they were in their induction period and had also started the registration process we have referred to them as the ‘new manager’.

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 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 four people who used the service and seven relatives about their experience of the care provided. We spoke with the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with ten members of staff including the manager, new manager, deputy manager, quality assurance manager and general manager, two senior care workers, two care workers and a housekeeper. We observed care in communal areas of the home and during lunchtime to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at six staff files in relation to recruitment and four staff supervision records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We sought feedback from the local authority and professionals who work with the service. We continued to seek clarification from the provider to validate evidence found. We looked at staff rotas, training data and quality assurance records. The provider sent us information about the improvement actions they had taken since the inspection.

Updated 30 April 2020

About the service

Kinross is a residential care home providing personal care for up to 29 people aged 65 and over, including people living with dementia. At the time of the inspection they were supporting 13 people. Accommodation is arranged over two floors connected by stairs and a passenger lift. There is a range of communal areas on the ground floor including a dining room and two lounges.

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

People and their relatives said the service provided safe care and we found improvements had been made since the previous inspection. The provider had introduced tools and systems to promote people’s safety and these were being embedded into the service. The provider acted promptly to address any concerns we found during the inspection. Staff knew about the risks to people and acted to provide safe care. Environmental risks were assessed, monitored and acted on. Safeguarding processes were known and followed to protect people from abuse.

The provider assessed staffing levels to meet people’s needs. We received some mixed feedback about staffing levels, but our observations were that people’s needs were met. Checks were carried out to help ensure only suitable staff were employed. This process was improved during our inspection. We have made a recommendation about the recruitment process to check applicants have the right values and skills to support people safely.

People’s medicines were managed safely, and the service was working with health and social care professionals to review people’s needs and provide effective care.

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. However, the policies and systems in the service did not always support this in practice. The Mental Capacity Act (2005) had not always been consistently applied, in line with legislation and guidance.

People and their relatives spoke positively about the food provided and people’s dietary needs were met. People’s weights and fluids were monitored when a risk was identified, and action taken had resulted in positive outcomes for people.

People, relatives and professionals told us staff were kind and caring and our observations confirmed this. Staff completed training in a range of topics to support them to meet people’s needs effectively. Care plans had been reviewed and the service was continuing to make information person centred so people’s preferences were known.

Improvements had been made in the décor and furnishings of the home and further work was planned. Activities were available and people’s communication needs had been assessed and were met.

A system was in place to monitor the safety and quality of the service people received. This was being embedded into the service and actions arising were monitored and checked for completion. People, staff and relatives were asked for their views and these were being acted on. Staff told us they were well supported by managers and it was evident improvements in the service had been made. This was confirmed by people, staff and other professionals.

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 inadequate (published 23 November 2019) and there were multiple breaches of regulation. We varied the conditions of the provider’s registration to require them to submit monthly audits of the service to enable CQC to monitor improvements. 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. However, the provider was still in breach of one regulation

This service has been in Special Measures since January 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating. We also followed up on action we told the provider to take at the last inspection.

Enforcement

We have identified a breach in relation to Regulation 11, consent to care and treatment. Please see the action we have told the provider to take at the end of this report.

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.