On the days of our unannounced inspection of Kerria Court we found that 44 people were living at this care home. We spoke to seven people who lived there, and also spoke with the relatives of two people, members of staff and with three health care professionals who were visiting the home. In July 2013 we inspected the home and at that time found that the home was non-compliant with three of the essential regulations. We issued compliance actions to ensure these areas of non-compliance were addressed and to ensure the service improved for people living at Kerria Court. We conducted this inspection to follow up on the issues of concern and see what progress had been made. Generally we found that many improvements had been made although the home had not yet achieved full compliance in all of the regulations we assessed.
We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
Staff we spoke with understood their role in safeguarding the people they supported. Staff demonstrated no tolerance for abusive practice and told us they felt confident to raise any concerns with the manager.
People in the home appeared relaxed and comfortable with the care staff who were supporting them. People confirmed they felt safe living at the home and the relatives of two people who lived at the home told us they thought people were safe. One person who lived at the home told us, 'I feel very safe here. If I wasn't happy I would talk to the manager. I've never been unhappy.' Another person told us, 'I've never had any abuse; if I did I would report it straight away. Usually the staff are very good and respectful'.
Records showed that all the equipment and services such as the gas and fire safety
system had been maintained and serviced regularly.
There was sufficient numbers of staff in place to meet people's needs. We observed that people were not left unsupervised in the lounge area and that people who were in their bedroom had a call bell within easy reach.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made under this legislation for any person living at the home , we found that the registered manager understood their responsibilities in relation to the law.
Is the service effective?
People told us that they were happy with the care they received. Comments from people included, 'It's very good, I'm quite happy here, I wouldn't want to go anywhere else.' Another person told us, 'I can't find fault.'
We spoke with the relatives of two people who lived at the home. They told us they were happy with the care provided. One relative told us, 'The home is excellent. This is the fourth home we've tried. I wish we had found it earlier.'
People's health and care needs had been assessed and risks related to people's health had been identified. However some of the care plans and risk assessments lacked details of the support people needed. The care plans were therefore not all able to support staff to meet people's needs in a consistent way.
We found that where people needed support from health professionals this was available. Records showed that people were able to see a doctor, optician or a chiropodist when needed. Assessment of people's nutritional needs had been completed and people were weighed regularly. All of the staff we spoke with were aware of the need to monitor people's weight regularly and advised us they would take action if any unexpected weight loss was observed.
Is the service caring?
We saw that staff were kind and caring in their approach to people. Our observations of interactions between staff and people using the service confirmed that staff knew how to support people. People who lived at the home were complimentary about the staff who supported them. One person told us, 'The staff are all very nice.'
People living at the home were mostly satisfied with the activities on offer but we did receive comments about people wishing they could go out of the home more. Comments from people included, 'The carer is taking me to the shop across the road this morning. They always take me once a week' and 'The care is very good here but I would like to go out more.'
We saw that there were menus offering people a choice of meal. We found that the food choices took account of people's cultural preferences. People were asked to choose the meal they wanted and, if they did not want either choice, we saw that an alternative was offered.
Is the service responsive?
We found from our previous inspection that the provider had taken some action to rectify concerns identified. During this inspection we identified a number of issues about which the provider took immediate action to rectify or improve the situation and to ensure people's care and support needs were being met.
At our last inspection we had identified that Improvement was needed to the systems in place to seek people's feedback about the service. At this inspection we found that meetings had taken place with people to seek their views. We found that a survey had been sent to the relatives of people who lived at the home. People were informed of the outcome of the survey and the actions taken in response in a newsletter. One person told us, 'We have had a residents' meeting, I've been to it, it was quite useful'.
We saw that there was a copy of the home's complaints procedure available to the people who lived in the home and those who may represent them. This contained the information necessary if they wanted to raise an issue.
The provider took account of complaints and comments to improve the service. One person who lived at the home told us, 'Because of my chest, I complained about smokers in the garden and they split the chairs and put the smokers further away.' A relative told us, 'The management and staff act on any concerns raised, they respond very quickly.'
Is the service well-led?
The service was led by a registered manager, who was supported by a district manager. Both were present during our visits to the home. Staff, relatives and people living in the home told us that the managers were accessible and took account of their comments.
The district manager told us that to improve the supervision and day to day running of the home the care manager had recently moved from an upstairs office to downstairs. The district manager also told us that it was intended to complete an overall service improvement plan for the home to enable improved tracking of actions taken to address any issues identified as needing improvement.
The findings of our visit identified that a number of improvements regarding record keeping were needed. This had also been identified by the provider's own audits and work was underway to achieve this.
The provider may wish to note that whilst improvements have been made, sporadic incidents where the home has not performed as well as it should and the home's history of not meeting regulation mean that the service needs to demonstrate that the quality of the service continues to be improved and sustained