King Charles Court

We found the following examples of good practice:

• Due to the clinical vulnerability of people living at the service, at the time of inspection, visiting was severely restricted. Where visiting was permitted (for example for people on end of life care) suitable infection control procedures were in place, in regard to visitors entering and moving around the building. For example visitors were accompanied around the building by staff, and only spent time in the person’s bedroom. A risk assessment and relevant checks with any visitors was also completed. Visitors were required to wear masks and, as necessary, other personal protective equipment (PPE).

• Staff had helped people to stay in touch with family and friends through phone calls, and through the internet.

• Good self isolating procedures were in place if people needed to isolate, and /or who were admitted to the service.

• Suitable testing routines had been arranged for staff and people who used the service.

• Robust admission procedures were in place, for example, the service requiring documentary evidence of Covid-19 test results before people moved in, followed by a period of self-isolation.

• The service was providing a range of social activities for people to help to keep them entertained and occupied.

• Staff had received suitable training and guidance regarding infection control, and how to respond to the Covid 19 pandemic. Throughout the inspection we observed staff demonstrating suitable knowledge of good infection control practice. Other staff training had also been maintained.

• The service had comprehensive policies and procedures in respect of Covid 19 and its implications on the running of the service. From our discussions and observations these had been effectively implemented.

• The service was very clean and had effective cleaning routines in place to ensure risks were minimised and people were kept safe. Additional cleaning hours had been arranged, since the start of the pandemic, to help keep hygiene standards to a high standard.

• The registered manager said staff sickness throughout the period of the pandemic had been limited and subsequently only a minimum of bank and agency staff had been used. When additional staffing was used, the registered manager said she was assured these staff did not work in any other care setting.

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. King Charles Court is a care home with nursing which offers care and support for up to 30 predominately older people. It is situated in the town of Falmouth. There are two floors accessed by a passenger lift. Where floors are split there is a stair lift. Each person has their own room which has en-suite facilities. There are two bathrooms with additional toilets located in both services. There is a lounge and dining area on the ground floor. At the time of the inspection there were 27 people living at the service. Some of these people were living with dementia.

There was a registered manager in place. 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 2008 and associated Regulations about how the service is run.

We observed staff providing support to people throughout our inspection visit. We saw they were kind, patient and treated people with dignity and respect.

People who lived at the service and their visitors told us they were happy living at the service and felt safe in the care of staff supporting them. One person said, “Nothing is too much trouble for them [staff].”

People visiting the service told us staff were attentive, kind and caring towards their relatives. They said their relatives were getting the best care possible and staff went above and beyond their expectations with the care provided. Comments included, “Absolutely excellent couldn’t wish for more,” “So safe always feel we can go away knowing [person’s name] is cared for” and “We chose this home because we knew they really care for residents living here.”

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

The premises were regularly checked and maintained by the provider. Equipment and services used at King Charles Court were regularly checked by competent people to ensure they were safe to use.

The environment was warm throughout, homely and welcoming. People frequently told us this was a ‘homely’ place to live and visit. People’s rooms were personalised to reflect their individual tastes. As Christmas was approaching some people had been supported to put up Christmas decorations in their rooms. The focus of the service was to treat people with kindness, compassion and respect and this was witnessed throughout the inspection.

The design of the building and facilities were appropriate for the care and support provided. One of two bathrooms was currently being used for storage of equipment. However, the registered manager informed us of the plans to redesign this bathroom in the near future so it is more suitable for people with limited mobility.

People visiting the service told us they were made welcome by friendly and caring staff and had unrestricted access to their relatives. They told us they were happy with the care provided and had no concerns about their relatives safety.

The service had sufficient staffing levels in place to provide the support that people required. People told us staff were responsive and available when they needed them.

Staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

Risks in relation to people’s daily lives were assessed and planned for to minimise the risk of harm. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The registered manager had a record which provided them with an overview of staff training needs.

Accidents and incidents were being recorded and reported and any lessons learned were shared with staff. The service learned by any mistakes and used this as an opportunity to raise standards. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

The way medicines were managed was safe. Staff responsible for the administration of medicines had the necessary competency and skills required. Medicines were stored securely and safely.

There was an emphasis on promoting dignity, respect and independence for people who lived at King Charles Court. There were examples of people improving and regaining their mobility. In one instance, a person was able to return to their own home, through the determination of staff and with the support of other health professionals. People told us staff treated them as individuals and delivered person centred care. Care plans confirmed the service promoted people’s independence and involved them in decision making about their care.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

There were a range of quality assurance arrangements at the service in order to raise standards and drive improvements. For example, audits to ensure quality in all areas of the service were checked, maintained, and where necessary improved. However, people told us that the organisation did not always keep them informed of changes occurring in a timely way. We have made a recommendation about this.

The registered manager, deputy manager and team leaders engaged with all stakeholders of the service. People’s views were taken into account through regular communication and surveys. The results of the most recent survey had been positive.

There was a system in place for receiving and investigating complaints. People we spoke with had been given information on how to make a complaint and felt confident any concerns raised would be dealt with to their satisfaction.

Comments included 'I am happy here, the staff are good', 'the food is lovely' and, 'can't think of anything I don't like'.

We saw there was appropriate care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which evidenced that people's needs were well understood and staff acted with respect and care in supporting people appropriately.

We saw people were supported with their meals and drinks. We found staff had attended training in the preparation and handling of food.

We found King Charles Court was warm, tidy and clean. We found people's rooms were personalised with their own furniture and pictures. We did note a strong odour in one person's room.

We checked the staff rotas and found there were sufficient staff to meet people's needs.

Each person had a care plan in place which stated their individual needs. People had access to a range of services including hairdresser, chiropodist and GP'S.

People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. People told us their rooms were 'nice' and 'comfortable'.

The staff were supported by the registered manager. Training had been provided for areas such as manual handling, fire safety and infection control.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

Staff demonstrated a good knowledge of the care needs of the people that lived at the home. Care plans were in place for all the individuals, however they did not always reflect the specific needs of the person.

One visitor explained that the home had invited them to eat with the person they had been visiting and the food had been 'excellent'. We saw people were offered drinks throughout the day.

People were protected from abuse by staff that were knowledgeable about this area.

We saw that appropriate systems were in place for obtaining medicines and for the disposal of unwanted medicines.

Staff stated they felt supported by the manager. We looked at the staff files for four people and saw that there was not an effective system in place to formally supervise all staff. Training had not been provided to all staff.