Kingsfield Residential Care Home provides accommodation for up to 27 people who require personal care and support, some of whom are living with dementia. The home also supports people with mental health needs and physical disability.

The home is an older property that has been adapted and extended for its current use and accommodation is arranged over three floors and there is a stair lift to assist people to access the accommodation on the two upper floors. The bedrooms in the home vary in size and layout and there are three double bedrooms. There is a garden to the rear of the home and an outside smoking area that is wheelchair accessible and has outdoor seating. There is parking available at the front and side of the home for staff and visitors.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Some people were living with dementia and had limited verbal communication but those did speak with told us they were happy and well cared for and felt safe living at the home. We were told the staff were “kind” and “very nice”. Relatives also made positive comments about the levels of staffing and staff approaches and care and told us they were confident that people living at the home were safe.

People who were able told us they were liked the food provided and enjoyed their meals. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

The service had a complaints procedure that was made available to people on their admission to the home and their relatives. People we spoke with and their relatives told us they had no complaints about the service.

Staff had been recruited safely, were being appropriately trained and supervised in their work. We observed that they had the skills, knowledge and understanding required to support the people who lived there. Staff had received safeguarding training and understood their responsibilities to report unsafe care.

Staffing levels were observed to be sufficient during the day to meet the needs of people who lived at the home. We noted that additional staff were being introduced during the busy late evening and early morning periods to help make sure that an increase in dependency levels could be addressed.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported and were clear about the care people wanted and had received. They had been kept under review and updated when necessary to reflect people's changing needs.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to help make sure they had the competency and skills required.

The registered manager had used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service, satisfaction surveys and staff and resident meetings to seek the views of people about the service. We found that records were well kept and up to date. Equipment had been serviced and maintained as required.

The service followed the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions themselves. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

This unannounced inspection took place on 19 November 2014. We last inspected Kingsfield Residential Care Home (Kingsfield) in November 2013. At that inspection we found the service was meeting the regulations that we assessed.

Kingsfield provides accommodation for up to 27 people who require personal care and support. Accommodation for people living there is arranged over three floors and there is a stair lift to assist people to access the accommodation on the upper floors. The home is an older property that has been adapted and extended for its current use. The bedrooms in the home vary in size and layout and there are three double bedrooms. There is a garden to the rear of the home and a smoking area that are wheelchair accessible and private and has accessible outdoor seating. There is parking available at the front and side of the home for staff and visitors.

The service had a registered manager in post. 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.

People living in the home told us that they felt safe living there and friends and relatives we spoke with were satisfied with the care provided. We spoke with people in their own rooms and those who were sitting in the communal areas and were told by people that they felt “Well looked after”.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions themselves. The service worked well with external agencies such as social services and mental health professionals to provide appropriate care to meet people’s physical and emotional needs.

People were able to see their friends and families as they wanted and go out into the community with support. There were no restrictions on when people could visit the home. All the visitors we spoke with told us that staff were “friendly” and “available” when they wanted to speak with them. They told us that they were made welcome by the staff in the home. The atmosphere in the home was open and inclusive. People were asked for their views of the home and their comments were acted on.

The staff on duty we spoke to knew the people they were supporting and the choices they had made about their care and their lives. The decisions people made about their care and daily activities were respected. People had a choice of meals and drinks, which they told us they enjoyed. People who needed support to eat and drink received this in a supportive and respectful manner. We saw that people were supported to maintain their independence and control over their lives as much as possible.

All of the people that we spoke with told us that routines in the home was flexible to meet their needs and choices about their lives. The registered provider had a procedure to receive and respond to complaints and people told us they knew they could speak to the manager about anything that concerned them.

The home had moving and handling equipment and aids to meet people’s mobility needs and to promote their independence. The home was being maintained and we found that all areas were clean and free from unpleasant odours.

Safe systems were in place for the recruitment of new staff and for the induction and ongoing training and development of staff working there. This was monitored to help make sure staff employed in the home were well trained and competent to carry out their duties. The staff employed were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to a senior person in the home.

People living at Kingsfield Residential Home told us that they were “settled" and "content" living there and were "very happy" with the support they had received. We spent time talking to people living there and observing daily life in the home including at lunch time. We did not receive any negative comments about the standard of personal care and attention people had received. People told us the food was “excellent” and "very good".

From our observations and conversations with people living there we found they had received the support they needed and were given choices about their care and their social activities. We observed that staff encouraged people to maintain their independence and control over their lives and make their own decisions. We saw that people were comfortable and confident with the staff on duty. We were told that staff were "Very helpful and patient."

There were sufficient staff to support people and meet their social and personal care needs. We were told “I think the staff are very good" and "They always come when I call them". Staff worked well with other agencies to coordinate people's care and support with other services and agencies involved with their care. The service had robust recruitment processes in place to help make sure that the staff providing care and support were suitable to work with older adults.

The standard of record keeping and monitoring in the home was good. Records were up to date and accurate and well organised.

People living at Kingsfield told us that it was "a good place to live" and that they "liked" living there and were "happy" with the services and support they received. We spent time talking to people living there and observing daily life and during lunch. We did not receive any negative comments about the standard of personal care received, the food served, the cleanliness of the home or the staff approaches and support.

People living there and their relatives said that they had not needed to complain about care. Records showed that complaints had been managed appropriately and people told us they had confidence in the manager to investigate. One person told us, "All the staff are very good, I am happy and have never had to complain. They told us that if they needed to complain they would "Speak to the manager, she's very nice."

People in this service were protected from harm and abuse because there were suitable policies and procedures in place. Staff had been trained in how to recognise abuse and to deal with any concerns. We were told that,

"They look after me very well and give me a hand when I need it."

"The staff are very kind and check on me at night."

"They're grand lasses, easy to get on with and we have a good laugh at things."

All those we spoke with gave positive feedback about how their privacy and dignity were maintained and how they felt involved in their care because staff asked them what they wanted.