Background to this inspection
Updated
10 March 2021
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.
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
This inspection was conducted by one inspector and an inspection manager.
Service and service type
Kingston Nursing Home 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 who was in the process of registering with the Care Quality Commission. A registered manager 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 announced the day before the inspection due to the current pandemic. This was so we could discuss any risks to people and the inspection team, and the level of personal protective equipment (PPE) required on the day.
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 professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We visited the service on 3 February 2021. Between the 3 and 17 February 2021, we sought further information and documentation from the provider. We spoke with two people who used the service about their experience of the care provided. We spoke with six members of staff including the manager, clinical nurse lead, senior care workers, care workers, the chef and the housekeeper.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at two 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. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
10 March 2021
About the service
Kingston Nursing Home is a residential care home providing personal and nursing care to 22 people aged 65 and over, at the time of the inspection. The service can support up to 47 people.
People’s experience of using this service and what we found
Following the last inspection in August 2020 improvements had been made to the care people received. The new manager and clinical lead with the support of the provider had made significant improvements in a short space of time. Whilst improvements had been made in a short amount of time and the service is no longer rated inadequate, the provider had yet to evidence sustained and continued improvements over a longer period of time.
Systems and processes had been introduced to ensure the service continued to improve. Numerous audits were regularly taking place to monitor the service. Policies and procedures had been put in place to ensure staff knew what was expected of them. Accidents or incidents were recorded and monitored, and learning was identified to reduce the risk of them happening again.
A refurbishment programme was underway at the location. The environment people lived in was improving which positively impacted on their experience of care. We have made a recommendation in relation to the environment.
People were protected from abuse and were treated with respect and dignity. Staff told us staffing levels
were good and were at a level where they could meet people's needs.
Improvements had been made to the management of medicines. People were supported by staff who had been trained to administer medicines.
Staff described the atmosphere and culture at the home as positive and enjoyed coming to work. They said they had observed the positive impact on people who they reported as ‘happier.’
Infection control procedures were in place and the home followed current government guidance to ensure people were protected from the transmission of infection. PPE stations were in place and staff had been trained to don and doff personal protective equipment. Cleaning staff knew how to ensure products were to be used to ensure effectiveness. Cleaning rotas and schedules were in place to ensure risks to people were minimised. Storage of excess PPE was an issue which the manager was looking into.
Rating at last inspection (and update)
The last rating for this service was inadequate (published 26 September 2020). This service has been in Special Measures since 26 September 2020. 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 inspected. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating. 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 coronavirus and other infection outbreaks effectively.
We carried out a focussed inspection of this service between18 and 24 August 2020. Breaches of legal requirements were found. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which refer to those requirements.
The ratings from the previous comprehensive inspection for those key questions, not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection. This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Kingston Nursing Home on our website at www.cqc.org.uk.
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.