This comprehensive inspection took place on 23 and 24 February 2017 and was unannounced.

Kingswood Manor is a period building in its own grounds. It is registered to provide accommodation for persons who require nursing or personal care to up to 44 people; there were 42 people living at the home at the time of this inspection. The building has two upper floors which contained most people’s rooms, a ground floor which mainly contained the communal lounge and dining room as well as offices and another two bedrooms for people nearing their end of life. There was a large basement area which contained the kitchen. A passenger lift gave to access all floors as well as a central stairway.

The home required a registered manager. 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. There was a registered manager in place who had been in post for several years.

At our previous inspection on 04 and 09 November 2015, we had found breaches of regulations 12 and 17 of the Health and Social Care Act 2008 in respect to safe care and treatment and the lack of suitable quality assurance processes. The home then undertook to immediately address these concerns. At this inspection we found that the home had made the required improvements immediately after that inspection and we saw that they had been sustained.

We toured the home and noted that most of the carpeting had been replaced and rooms and communal areas redecorated. We looked at records relating to the safety of the premises and its equipment, which we saw were recorded as being checked and safe. The records showed that the required safety checks for gas, electric and fire safety were carried out.

People received sufficient quantities of food and drink and had a choice in the meals that they received. Their satisfaction with the menu options provided had been checked. Where people had lost weight this was recognised with appropriate action taken to meet the person’s nutritional needs.

Menus were flexible and alternatives were always provided for anyone who didn’t want to have the meal on the menu for that day. People we spoke with said they always had plenty to eat. We joined the lunch time meal where staff were observed to support people to eat and drink with dignity.

The provider had complied with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and its associated codes of practice in the delivery of care. We found that the staff had followed the requirements and principles of the Mental Capacity Act 2005 (MCA) when providing care. The staff we spoke with had an understanding of what their role was and what their obligations where in order to maintain people’s rights.

We found that the care plans and risk assessment monthly review records, were all up to date in the files, we looked at and there was updated information that reflected the changes of people’s health.

People told us they felt safe with staff and this was confirmed by people’s relatives who we spoke with. The registered manager had a good understanding of safeguarding. The registered manager had responded appropriately to allegations of abuse and had ensured reporting to the local authority and the CQC as required.

Accidents and incidents were recorded and monitored to ensure that appropriate action was taken to prevent further incidences. Staff knew what to do if any difficulties arose whilst supporting somebody, or if an accident happened.

We looked at rotas for shifts throughout the day and night. Staffing levels were seen to be appropriate. All the people and their visitors we spoke with considered there were adequate staff on duty. People were able to have person centred, 1-1 activities provided, to pro

This inspection took place on the 4 and 9 of November 2015 and was unannounced. The inspection had been triggered by information of concern. Kingswood Manor provided residential care and nursing care for up to 44 people. 40 people were living in the home at the time of our inspection.

The home required a registered manager. 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. At the time of our inspection there was no registered manager but the home’s manager had applied to become registered and was waiting for their application to be processed.

The home was a large detached Victorian building which was situated in its own grounds. It had recently been purchased and the new owners had renamed it as Kingswood Manor. The home was undergoing a planned refurbishment which included decorating throughout and installing new communal bathrooms and toilets, flooring and furniture. We saw that one large bathroom had been started and that the lounge had recently been completely refurnished, re-carpeted and decorated.

We found that generally people were safely supported with care and respect. People and their relatives told us they were happy with the home. Staff training was being updated and staff told us they felt supported.

We saw that medication recording had not been completed properly and that records were not kept in a secure place so that they remained confidential.

There had been some refurbishment work completed but some of the fire safety systems were not adequate, such as broken or badly fitting fire doors. The home addressed these works as soon as we reported them to the provider. The home was in a transition period with catering and there were still improvements to be made the standard of cleanliness in the kitchen and the provision of suitable food which met people’s needs.

The provider and manager were open and clear about the improvements still to be made to the home. Audits and checks to the home were inconsistently completed which meant that quality assurance was unreliable.

We have identified breaches of regulations relating to medication and record keeping, and the safety and the management of the home. You can see what action we told the provider to take at the back of the full version of the report.