Background to this inspection
Updated
25 August 2018
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 is 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 26 and 28 June 2018 and the first day of inspection was unannounced. This meant the people who lived at Kara House and the staff who worked there did not know we were coming. Inspection site visit activity started on 26 June 2018 and ended on 28 June 2018.
The inspection team consisted of one adult social care inspector 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. This person had personal experience of elderly people.
We reviewed the information that we held about the service, including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.
We contacted the local Healthwatch organisation and the local authority commissioning team to obtain their views about the provider. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. No concerns were raised about the service provided at Kara House residential home.
We spoke with twelve people who used the service, two relatives, a visitor and 14 members of staff; including the registered manager, a director, two senior staff, four care workers, members of the administration team, maintenance and domestic staff and the cook. Several residents had communication difficulties or dementia and were not able to communicate with us, therefore we observed the way people were supported in communal areas and looked at records relating to the service.
Some people who used the service were unable to tell us about their care therefore we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people who cannot tell us about their care. We observed care and support at lunch time in the dining room. We looked at the kitchen, the laundry, a number of people’s bedrooms with their permission and saw the outside spaces available for people using the service.
We reviewed five people’s care records in detail. We looked at four staff recruitment files and records in relation to staff training, supervisions and appraisals. Supervision is an accountable, two-way process, which supports, motivates and enables the development of good practice for individual staff members.
We looked at the systems and processes in place for monitoring and assessing the quality of the service provided by Kara House and reviewed a range of records relating to the management of the service; for example, medication administration records (MAR), maintenance records, audits on health and safety, accidents and incidents, policies and procedures, complaints and compliments.
Updated
25 August 2018
This inspection took place on 26 and 28 June 2018 and the first day of inspection was unannounced. At our last inspection in December 2016 we rated the service requires improvement. We carried out this inspection to see if the provider was meeting all legal requirements.
Kara House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Kara House is a large detached home in Sale. Accommodation for people is situated over three floors. A basement area provides storage areas and offices for managers, senior staff and a staff room. There are three large lounges and a large extension provides space used as a dining area or for activities. There is access via steps and a ramp to a fully enclosed garden, with a level paved area with seating. The care home accommodates up to 39 people in one adapted building. At the time of this inspection the home was providing care and support for 32 people.
The home has 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.
Person centred care plans and risk assessments were in place. These provided guidance and information about people’s support needs, their likes, dislikes and preferences and how to mitigate any identified risks. Staff we spoke with knew people and their needs well. Care files were reviewed each month. People and their families, where appropriate, were involved in these reviews and felt well informed about care and support provided.
The home had effective systems for ensuring concerns about people’s safety were managed appropriately. A safe recruitment process was in place. Staff completed a thorough induction programme and regular checks were made on their development, knowledge and well-being in the role. Staff received refresher training on an annual basis and for staff who wanted to undertake additional on- line training in subject areas that were of interest to them these were made available.
Improvements had been made to the home. The ground floor décor was neutral in colour with photographs and pictures displayed in corridors and the service was clean and well maintained throughout.
The service was working within the principles of the Mental Capacity Act (2005). A capacity assessment tool was used and applications made for a Deprivation of Liberty Safeguard (DoLS) if a person lacked capacity. The Care Quality Commission were informed of any authorisations granted.
Staff had regular supervisions. Staff meetings were held, which were open discussions. Staff were given the opportunity to make suggestions on how to improve practice. Staff felt supported by and involved with the service.
People we spoke with expressed satisfaction with the food and drink provided in the home. They told us that meals were good and there was always plenty to eat and drink. We saw that people were consulted about the meals on offer and for new menu ideas.
There were policies and procedures in place around respecting equality and diversity, so that people were treated equally. People told us they felt included and not discriminated against.
People we spoke with were complimentary about the service. One visitor explained to us how well care workers knew their relative and how involved their family member had been in the care planning process. Staff had the preferences and wishes of people at the centre when arranging their care and support in conjunction with them.
Kara House had a complaints policy in place. Issues raised verbally had been recorded and responded to.
An activities programme was in place. The activity coordinator carried out group activities and sessions but also devoted time for individuals who preferred one to one activities or going out in the community. People’s cultural and religious needs were being met by the service.
We received positive feedback about the leadership and management within the home from staff, people who used the service and their relatives. It was clear that people living at the home knew who the registered manager was and considered they were a regular presence in the home.
The service worked in partnership with other agencies including health professionals, local authority representatives and volunteers. Quality assurance systems were in place. Incidents and accidents were monitored to identify if there were any patterns or trends. Residents and relatives meeting were held and a survey had been completed with the responses being positive.