Kimberley Grace Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Kimberley Grace Care Home provides accommodation and personal care for up to 17 older people. Some people also have dementia related needs.

This was the service’s first inspection since being newly registered on 8 June 2017.

The inspection was completed on the 10 and 11 October 2018 and was unannounced. At the time of the inspection, there were 16 people living at Kimberley Grace Care Home.

The service had a registered manager in post and they were formally registered with us on 30 May 2018. 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.

Improvements were required to the service’s governance arrangements to assess and monitor the quality of the service. The current arrangements had not identified the issues we found during our inspection. The registered provider lacked oversight as to what was happening within the service to make the required improvements. Suitable arrangements were not in place to review and investigate events and incidents and to learn from these. Although issues were highlighted as part of the service’s quality assurance arrangements, systems in place did not ensure these were addressed, followed-up and lessons learned.

Although people told us they were safe, suitable arrangements were not always in place to act when abuse had been alleged or suspected. Medication practices and procedures required strengthening to ensure these were in line with good practice. Not all people’s care and support needs and risks to their safety and wellbeing were recorded and detailed within a care plan. The nutritional and hydrational needs of people using the service required improvement as it was not possible to determine if their diet was satisfactory or not.

The deployment of staff required improvement as communal lounge areas were often left without staff support. Suitable arrangements were required to ensure all staff training was up-to-date. Where staff were promoted to a more senior role, they had not received an appropriate induction and mentor arrangements were not effective. Although staff received regular supervision, where performance issues were raised, these had not always been followed up and monitored.

The management team had not ensured the service was being run in a manner that promoted a caring culture and care provided was task and routine led rather than person-centred. People were not offered regular opportunities to participate in regular leisure and social activities.

People’s healthcare needs were supported and people had access to a range of healthcare services and professionals as required. The registered provider’s arrangements for the prevention and control of infection at the service was satisfactory. People’s capacity to make day-to-day decisions had been considered and assessed. Nonetheless, care was needed to ensure information recorded was accurate and not contradictory.

Complaint management arrangements were appropriate and people told us they were confident to raise issues.