Background to this inspection
Updated
12 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 30 November 2016 and was unannounced. The inspection team consisted of three inspectors and an expert by experience. An expert by experience is someone who has had experience of caring or living with someone who would use this type of service.
Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. We also reviewed the Provider Information Return (PIR) submitted by the registered manager. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke with four people who lived at the service and five relatives. If people were unable to express themselves verbally, we observed the care they received and the interactions they had with staff. We spoke with six staff, including the registered manager. We looked at the care records of four people, including their assessments, care plans and risk assessments. We checked how medicines were managed and the records relating to this. We looked at four staff recruitment files and other records relating to staff support and training. We also checked records used to monitor the quality of the service, such as the provider’s own audits of different aspects of the service.
The last inspection of the service took place on 14 and 15 January 2016 where we identified six breaches of regulation.
Updated
12 January 2017
Kettlewell House nursing Home offers personal and nursing care for up to 29 people who are living with moderate to severe dementia. There are a further 10 care suites available on site, including four flats in the grounds where more independent adults live. At the time of our inspection, staff were providing care and support to 37 people.
The inspection took place on 30 November 2016 and was unannounced.
There was a registered manager in post. 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection.
We carried out this fully comprehensive inspection to see what action the provider had taken in response to the shortfalls we had previously identified. We found during this inspection that the provider had made the improvements needed and was now meeting the regulations.
People were safe because there were enough staff on duty to meet their needs. Risks to people had been assessed and measures implemented to reduce these risks. There were plans in place to ensure that people would continue to receive their care in the event of an emergency. The provider made appropriate checks on staff before they started work, which helped to ensure only suitable applicants were employed and staff understood safeguarding procedures.
People were supported by staff that had the skills and experience needed to provide effective care. Staff had induction training when they started work and on-going refresher training in core areas. They had access to regular supervision, which provided opportunities to discuss their performance and training needs.
Staff knew the needs of the people they supported and provided care in a consistent way. Staff monitored people’s healthcare needs and took appropriate action if they became unwell. People medicines were stored safety and administration practices for medicines were robust.
The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s best interests had been considered when decisions that affected them were made and applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe.
People enjoyed the food provided and could have alternatives to the menu if they wished. People’s nutritional needs had been assessed and staff were knowledgeable on people’s individual likes and dislikes in relation to food. Information contained in people’s care plans helped staff to ensure that people received the care they required.
People had positive relationships with the staff who supported them. Relatives said that staff were kind and caring. The atmosphere in the home was calm and relaxed and staff spoke to people in a respectful manner. Staff understood the importance of supporting people to remain independent as well as treating them with respect and allowing them their own privacy.
The registered manager provided good leadership. Relatives told us the service was well run and that the registered manager was open and approachable. They said the registered manager had always resolved any concerns they had. Staff told us the registered manager provided good leadership and they felt supported by her. They said they worked well as a team to ensure people received the care they needed.
The provider had an effective quality assurance system to ensure that key areas of the service were monitored effectively. Where suggestions had been made these were used to develop and improve the level of care that was provided to people.