Kings 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

The provider had now ensured they had effective systems and processes in place to assess risks to people's health, safety and wellbeing, and to analyse accidents and incidents over time to introduce preventative measures to keep people safe. People were safe at Kings Court and people told us they felt safe and well cared for. The registered manager ensured policies were in place to guide staff in keeping people as safe as possible while encouraging choice and freedom. Accidents and incidents were investigated and staff learned from them. Staff carried out pre assessment check to ensure they could provide the necessary care for people. Risks were reduced and staff supported people to take positive risks so that they continued to enjoy life. The home was uncluttered and equipment was safe. The registered manager told us of redecorating plans. While there were some confusing or restrictive aspects to the home, on the whole signs and the layout of the home worked for people. There were enough staff at the home to support people safely. The home was clean. Medicines were managed safely and reviewed regularly.

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 safety was important to the provider, and any adverse events or incidents were reported, reviewed and reflected upon. One person explained to us why he needed residential care and said, “I know that if ever I need something, or if I am not in good health, there is always someone here to help.”

The registered manager told us incidents and accidents were fulling investigated so staff could learn from them, and to ensure incidents were not repeated. For example the registered manager told us about a complaint that had been fully investigated. The registered manager shared with us the learning from the incident, and how the learning had been shared with staff to “enhance the service and improve the quality of care.”

Staff followed standard accident and incident reporting procedures. These included instructions for the registered manager to ensure the causes of any incident were carefully examined and appropriate actions were identified to make safe any hazardous conditions and prevent recurrence of any incident.

Some people told us they had access to health professionals when they needed them. However a relative told us the service did not assist with continuity of care, they said “[My relative] has lived here for around a year now. They have developed ulcers on their feet, on their heels, since they have been here, but they are having some treatment for them. There was a hospital meeting last week and I went along. The hospital recommended that their feet be raised and to do a bit of exercise but they [the home] said they couldn’t do that and said I should try to take them for walks”.

While some relatives felt the home could do more to support people, the provider told us they worked with a range of professionals. This included when planning for people to move into the home. The registered manager explained how they ensured people had sufficient quantities of any prescribed medicines, if they were admitted from hospital, for example. The home worked closely with community matrons, district nurses, speech and language therapists and dieticians. The registered manager said, “We work with the dementia team as well and can refer people for a dementia assessment. We discuss any cases with the GP initially.”

We asked the local authority if they had any experience of working with the home and they told us that while the evidence they had was limited, they had no concerns about the service and how staff there managed people as they moved between services.

There was a comprehensive pre-administration process to ensure the service could meet people’s needs. The registered manager also had a hospital pack in place for each resident that ensured a smooth transition to hospital should the need arise. People’s care plans included reminders for staff of what to do if a person’s physical or mental health needs changed and who should be involved in the ongoing care.

People told us they felt safe living at the home. One person said, “Goodness, I am safe here, safe in all ways. We are fortunate, the carers have time for everybody and are also very, very nice people.” People commented on the kindness of staff and how this made them feel safe. Relatives and visitors felt the caring nature of staff when supporting their loved ones contributed to people feeling safe.

The registered manager had a good understanding of safeguarding and how to keep people safe. They explained, “I notify CQC the moment a safeguarding happens.” We saw a copy of the multiagency safeguarding policy was readily available for staff to access.

Information about safeguarding, how to report a concern, and examples of different types of abuse, was on display on a staff noticeboard. We saw people were able to move freely around the home, and in the garden, without restraint.

The registered manager had access to, and followed, the local authority safeguarding guidelines.

People’s risks were identified, assessed and managed safely. People were encouraged to be as independent as possible, and also provided with staff support when required. One person was unable to move without staff support. They told us, “It is frustrating sometimes when staff don’t want you to do things. For example, I would like to go to the toilet on my own, but I have to find and reach out for my buzzer to get someone to come. Having said that, staff do come along pretty quickly.”

Staff understood people’s risks and supported people safely. The registered manager told us, “We talk with people and discuss any risks with them. The majority of people would not understand how risks might affect them, so we would make a Best Interests decision.” (A decision taken in a person’s best interests occurs when a person is assessed as lacking capacity to make a specific decision independently.)

We observed staff supporting people appropriately throughout the day to mitigate any potential risks. For example, we saw 2 staff supporting a person to transfer to a chair. The transfer was done safely and carefully, with staff speaking to the person throughout, providing clear instructions to support their safety.

Policies were in place to guide staff in ensuring people were able to take positive risks. Support plans included sections to record the best way to communicate with them, as well as their emotional support needs. Where a person wished to smoke, the care plan was clear in how staff should support the person to allow them to continue smoking while staying safe.

People were supported in a safe environment that met their needs. People who could walk independently had rooms on the 2nd floor of the home, and had access to stairs and a lift. People on the first floor had a separate lounge, and people on the ground floor had access to larger communal areas. New flooring had been laid recently, and parts of the home were redecorated, with colours chosen by people to aid their orientation around the home.

The registered manager told us about the new flooring and redecorating that was taking place. Parts of the home were being refurbished, with plans to improve the décor and structure.

The home provided a safe but sometimes restricted environment for people. Fire doors were functional, and clear signage supported people to access various parts of the home. There were 2 lounges, one on the ground floor and the other on the first floor. The ground floor lounge was a larger communal area. However the lounge on the first floor was small and quite restrictive. In the small lounge armchairs were placed around the walls with a television on one wall. There was little room for people to stretch their legs or walk around. The room appeared to be mainly used by people who had limited mobility, and who spent their day sitting in the armchairs. One person wanted to eat their lunch in this lounge, but was told by staff there was not enough space, so they ate their lunch in their room.

There were audits in place to guide the registered manager on checks around the home and the environment. Maintenance and fire risks were regularly assessed. The pre-admission policy ensured thought was given to the person’s environmental needs, for example any equipment they might require.

Residents and visitors considered that staff numbers were generally acceptable and sufficient. Those people that were able did not notice any difference to staffing levels at weekends and did not recall any specific incidents or behaviours caused by low staff numbers at any time. People reported they had use of working call bells at all times and staff regularly reminded them to use them, when necessary. People said call bells were always responded to and usually in good, or very good, time. There were no reported cases of bells not being responded to. One person said, “Yes, I do have a call bell and I do use it. Staff always come to see what I want and they are usually quick too.”

The registered manager told us the staffing levels were safe and effective. He said there were 6 care staff, plus two managers, on duty during the day. He said he often gave care himself as a member of the team. He said, “I do enjoy my job, I like to be ‘hands on’. That’s how you understand being part of the team.” Staff said staffing levels were usually sufficient and that the registered manager was good support. Staff said they felt well trained to carry out their roles. A newer staff member said “I know more now than I did before. If I needed support, I got support.” At night, there were four care staff, with similar levels at the weekend. New staff had the opportunity to complete health and social care qualifications after completing their probation. One staff member told us they had time to chat with people, and felt staff levels were sufficient overall.

There were sufficient staff to meet people’s care and support needs. We saw staff were quick to respond to people when needed.

Staff were recruited safely, with relevant checks completed to ensure their suitability. The registered manager used dependency assessments for people to ensure sufficient staff at all times. Staff were trained for their roles and this was audited and monitored. Regular staff meetings allowed the manager to talk to staff about any changes in people’s care needs and to remind them of any policies, new training etc.

The home provided people with a clean and well-maintained environment. People’s rooms were cleaned regularly by housekeeping staff and people commented positively, with no-one reporting any problems with lost items, the standard of equipment or facilities.

The registered manager told us that there had been an outbreak of COVID-19 in the home last year and an outbreak of Norovirus in January last year. People had received COVID-19 booster injections. Staff were trained in the use of personal protective equipment (PPE) and of the importance of good hygeine practice. The manager told us they ensured staff continued to follow Public Health England guidance to reduce the risk of COVID-19 reoccurring.

The general environment appeared and smelled clean and we saw housekeeping staff undertaking cleaning in all parts of the home. Our observation of the environment raised no concerns about safety or cleanliness. Some of the home decoration looked ‘tired’, particularly on the upper floors, but there were plans in progress to redecorate the home. People’s laundry was managed well. The laundry room was clean and well organised. We saw windows had been opened to let in the fresh air.

There were cleaning staff at the home who understood their role and followed appropriate procedures to keep the home clean. All staff understood their responsibility to reduce the risk of infection and followed infection control guidance. There were posters and training to assist staff in keeping up to date with any changes to the requirements related to COVID-19. Audits were completed by the registered manager to ensure compliance with the procedures and policies of the home.

People received their medicines as prescribed and these were administered by trained staff. We saw a staff member giving people their medicine at lunchtime and this was done sensitively and kindly. People had no concerns about the provision and administration of their medicines.

The registered manager told us the local medical practice, with on-site pharmacy, reviewed each person’s medicines regularly. The home was part of a project, ‘Medicines Optimisation in Care Homes’ under the Sussex Community NHS Trust and each person’s medicines was reviewed. A staff member told us they had medicine’s administration training, but only senior staff administered medicines.

There were policies and training in place to ensure staff managed people’s medicines safely. The hospital admissions and discharge policy, for example, reminded staff of the importance of a safe handover with any medicine changes recorded. There was a covert medicines policy in place for anyone who needed this, with clear explanations for staff.