Kingsbury Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People received safe care and treatment from staff who understood their healthcare needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks. At the last inspection in August 2022 the provider was in breach of regulations because they failed to ensure appropriate and safe staffing in the home. Staffing was now regularly reviewed by the registered manager and staff received better support and training, so people’s experience of care overall improved. The provider ensured people were safe and received care which met their individual needs, protected their rights and safeguarded them from abuse and neglect. Medicines were managed safely by competent staff. The home environment was safe, and staff followed good infection prevention and control practice.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s relatives told us when things needed addressing and lessons were learnt, they were involved and communicated with.

Staff were aware of changes made to the service based on lessons learnt and told us these were regularly discussed. One staff member said, “[There are] various ways, [managers] are always giving feedback through chats, handovers etc.; but then we also have one to one meetings and staff meetings.”

The registered manager analysed incidents, accidents and complaints to identify any common themes, patterns and lessons learnt. Action was taken to address lessons learnt, for example, around individual people’s care, how the service was run or training needs for staff. Lessons learnt were discussed during various staff meetings, enabling staff to reflect and share ideas of how to improve things further.

People and their relatives told us staff supported them to access different health and social care services when needed and their care was well-coordinated.

Staff and managers were able to explain how they communicated with other services, assessed and reviewed people’s needs and ensured smooth transitions between healthcare and social care services.

Professionals working with the service were complimentary around how staff worked with them and as a team to address people’s changing needs. Comments that were shared with us included, “I couldn’t believe how nice your care team staff and how welcoming all of you are to all the guests and residents of your care home. You and your care home are truly living up to all your values and principles of fundamental care and support to all the residents and their visitors including professional people like us when we come to review the residents safeguarding and protection of their rights issues. Truly a magnificent service you all are providing.”; “I was impressed with the level of person-centred care the team managed to achieve in a relatively short period of time.”

People’s changing needs and new admissions were discussed within the staff team during regular meetings, care was well-organised and monitored daily. When needed, staff referred people to other services, such as GP, community mental health teams, speech and language therapy or social services for additional help. People could use short term care when they needed to.

People and their relatives told us the home was safe. One person said, “It does feel safe. I suppose it is because of the environment. Everything is nicely kept and there is always a carer around.” A relative told us they would know how to raise any concerns, “My relative has never complained about anything. I’m sure if there had been something she was not happy with she would have said something. I would see the manager if there was something that needed mentioning.”

Staff could identify signs of possible abuse or neglect and were aware of their responsibilities. Staff told us how they would recognise someone may be at risk, “Some people will tell us, others will change their behaviour. If this happens we inform the manager, team leaders so all protocol is followed.”; “Keep your eye out for any new skin tears, bruises, scratches that don’t seem familiar. Report it straight away.” Staff told us how they would report any concerns, “Make sure all management team know. If they don’t do anything I would call social services or CQC.”; “We would report it straight away to ensure it is dealt with. We have a whistle-blowing policy and would go to the local borough safeguarding.”

Staff treated people well, with kindness and attention. People were not unnecessarily restricted. There were positive interactions between staff and people.

The provider had a clear safeguarding policy in place and guidance for staff on how to raise concerns. Incidents, accidents and staff feedback were reviewed and acted on. When required, the registered manager investigated safeguarding concerns, worked well with the local authority and took action to protect people from harm. Deprivation of liberty safeguards applications were submitted to the local authority when people’s liberties were restricted to receive necessary care and treatment. This was monitored by the registered manager and reflected in people’s care plans.

People and their relatives told us staff were competent to provide care safely. One relative said after explaining particular risk to their loved one and how this was addressed by staff, “We are totally happy with the care. [Person] is in a very safe space.” Another relative told us, “The safety aspect of the home is fine. There is no danger of her falling as she always uses the frame. I actually think it has prolonged her life living here. Even with carers at home she was not doing well. She did not eat properly, and she kept falling. I feel that it is a safe environment for her.”

Staff knew people’s individual risks and how to support them safely. Staff commented, “I know [people’s] individual needs. Sometimes, for example, someone with mobility needs need to be reminded of walking aids. We are constantly observing, monitoring”; “For example, when you support people with eating, you make sure people are sitting up straight so they are not at risk of choking”; “When we see a resident is not capable and their needs have changed, I will raise with my senior and they would do an assessment.” The clinical lead told us, “I try to teach the nurses where to go for guidance if they are unsure. We work very well with the mental health (team). Staff need to understand the recommendations and we have worked hard with them, so they know the importance of why they are doing things in a better way for residents.”

Staff supported people to remain safe and well and were aware of potential risks. For example, we saw a staff member patiently encouraging one person to sit up when eating to ensure risk of choking was reduced. Staff walked alongside people and helped people to sit down in a caring way which protected people from falls.

People’s care and clinical records included information around individual risks and support staff needed to provide. For example, risks around mobility, falls and equipment use, skin integrity, health conditions, eating and drinking were assessed. The service used an acoustic monitoring system which was effective in minimising disturbance for people during welfare checks, especially at night, but also helped staff to offer assistance when needed to reduce the risk of falls.

People and their relatives told us the environment was safe.

Staff were aware of safety procedures and their responsibilities around maintenance and health and safety in the home. For example, staff explained to us what they would do in the event of a fire alarm, “There will be a fire marshal on each floor, they will go, identify the threat and then advise other staff who will be keeping people calm.”, “Reassure everybody, let them know fire exits, let the fire marshals deal with the fire side of things. Take the residents out appropriately in the correct order.” Another staff member said, “We have enough equipment and if there is something we need, requests are taken care of immediately.”

The environment was safe and well cared for. Care equipment we saw was in good working order. There was no clutter, and the home was accessible for people with mobility needs. The corridors were wide, and people’s names or items of reference were on people’s doors which helped them to orientate themselves in the home.

The registered manager ensured health and safety and maintenance checks were regularly completed and appropriate certification was in place. Personal emergency evacuation plans and fire safety measures were in place. The provider had a business continuity plan which provided guidance on contingency plans in case of various emergencies and untoward events that could affect the service.

People overall told us they could access support when they needed it and felt staff were competent. One person said, “It’s alright I suppose. Most of the time you can find someone if you need them. There’s normally someone on the desk. I don’t usually use the call-bell as I don’t like to bother them. There’s always someone going up and down the corridor.” A relative told us, “There always seems to be adequate staffing levels.”

Staff we spoke with told us staffing in the home had improved since the last inspection. One staff member said, “Now we have nurses on all floors, it feels much better.” Another staff member said, “I do (feel there are enough staff). If you have a good team on, then 3 is enough but sometime 4 are needed. I appreciate how difficult it is to recruit. Continuity of care is so important and that has been a lot better.” Staff received good training which helped them in their roles. Staff commented around the training on offer, “The management encouraged us. They really push us with free courses and to gain qualifications. It helps us to know why we are doing things. Things like first aid and changing catheter bags, how to apply creams, positive behaviour support, dementia care. It’s given us the insight into how [people] feel.”; “The clinical training is the best I have had in care homes. They want you to learn and understand.”; “Induction was very good and very helpful.”; “Managers do supervisions and competency checks.”

Staff were attentive to people’s needs and no one needed to wait for support. Staff made sure there was always someone in the lounge with people. They chatted with people and offered support when they thought they may be struggling to understand where they were or what was asked of them. Everyone who needed support with eating in their room, was assisted by staff who took their time to help people to safely enjoy their meal.

Staffing levels were monitored by the managers and there were clear systems in place to ensure safe staffing in the event of any emergencies. Staff training was reviewed and addressed additional training needs in relation to people’s needs and risks. Staff were up to date with training. There were clear refresher dates and upcoming training expiry dates showed in staff records and we saw proof of booked courses to ensure no training expired. Staff were supported to complete competency checks, for example for catheter care, pressure area care, insulin administration. New staff were recruited safely.

People and their relatives told us the home was always clean and staff followed good infection prevention and control practice. One person said, “The carers do wear aprons and gloves when doing personal care. Everything is kept clean.” A relative commented, “Everything always looks clean-clothing, bedlinen.”

Staff knew how to protect people from the risk of infections. One staff member told us, “We wear aprons during personal care, wear gloves and wash hands and sanitise hands.” Staff told us they had access to personal protective equipment and domestic staff oversaw daily cleaning of the home.

The home was very clean. The laundry was managed safely. Staff were observed to wear personal protective equipment when required, hand sanitiser was available.

The provider had an up to date infection prevention and control (IPC) policy in place. The registered manager completed regular IPC audits and where improvements were identified, action was taken. Infectious diseases outbreaks were appropriately reported, and guidance was followed to minimise risks to people. Lessons learnt from outbreaks were identified and addressed.

People told us they received their medicines safely and at the correct times. One person said, “I seem to be given medication throughout the day. They seem to know what they are doing.” Another person told us, “They bring me my medication every day. If I don’t feel well, I’ll tell the nurse. They’re very good.”

Staff we spoke with and observed supporting people with their medicines, were aware of safe practice. One staff member told us, “Medicines are very clear here. All the nurses work together, so we can double sign and check queries out with each other.”

Medicines were stored safely. Staff completed appropriate records when supporting people with their medicines and there were regular audits in place. ‘When required’ and high-risk medicines were managed in a safe way. The provider had a medicines management policy which was in line with national best practice guidance for care homes.