We spoke with two people who used the service, and one relative of a person who used the service. We also spoke with the registered manager and a senior member of staff from Kingsley Healthcare. We looked at five people's care records. Other records viewed included health and safety checks, staff meeting minutes and quality assurance records. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?This is a summary of what we found;
Is the service safe?
One person we spoke with told us, "I sometimes don't feel safe", but didn't wish to share the reasons why they didn't feel safe. Another person we spoke with told us, "I feel safe, I think I'm OK."
We found that people were not always being protected from the risks of malnutrition or dehydration. However, the service already had some plans in place to address these issues.
We found that people were not always being protected from the risks of developing a pressure sore, or a worsening in a current pressure sore. The service did not always take preventative steps to protect people at risk. However, the service had already identified some of the issues raised, and already had plans in place to rectify these issues.
Is the service effective?
People's care records showed that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. The care records for people were regularly reviewed, but contained information that was out of date, or conflicted with other care documents.
Is the service caring?
We observed that staff did not always interact with people using the service in a caring way. We observed staff displaying annoyance or frustration with people using the service, whom they were trying to support. We observed staff speaking to people using the service in a way which did not promote the person's right to choice, or encourage them to allow staff to help them.
We observed that care staff repeatedly ignored one person using the service throughout our inspection, who would have benefited from interaction with staff.
People using the service told us they did not have a lot of interaction with staff. One person told us, "Oh, it's nice to speak to someone." When asked if they had conversations with people often, the person told us "No, staff don't have time to speak to me, and I'm stuck in this bed."
Another person using the service told us, "Thank you for talking to me. People don't often have time to talk to me."
This meant that we did not feel assured that people's emotional and social needs were being met by staff.
Is the service responsive?
The service had already taken some action to address shortfalls in the service, which were identified by the Suffolk Safeguarding team.
However, some issues identified during our inspection had not been previously identified by the management of the service. This meant that we could not be assured that the staff working at the service, and the management of the service were responsive to people's changing needs.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way.
The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed.