The Kensington Care Home is registered with the Care Quality Commission (CQC) to provide care and support to 35 older people, some of whom may be living with dementia. The building is a combination of old and new single storey buildings. All accommodation, bathrooms and toilets are on the ground floor, some of the newer rooms have en-suite toilets. The home is situated in the centre of Immingham close to local amenities. It is on a main bus route providing access to Grimsby, Cleethorpes and outlying villages around North East Lincolnshire.

This inspection took place on 8 December 2016 and was unannounced. The service was last inspected December 2015 and was found to be compliant with the regulations inspected at that time. However, it was rated as requires improvement because there were some practise issues and some recommendations made.

At the time of the inspection 23 people were living at the service.

Currently there is no registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Due to this the service can only be rated as requires improvement in the well-led domain.

People were cared for by staff who understood the importance of protecting them from abuse. Staff had also received training in how to recognise abuse and how to report this to the proper authorities. Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service. Procedures were in place which ensured people were not exposed to the risk of cross infection and the service was clean and tidy. People’s medicines were administered safely and staff had received training in this area. The medicine training was updated regularly. Systems were in pace to enable people to administer their own medicines with staff support if this was appropriate.

People were provided with a wholesome and nutritionally balanced diet. People’s choices were taken into account when devising menus and the cook asked people about their preferences for meals. Those people who had a poor appetite were provided with a fortified diet to ensure they received the right amount of nutritional intake. People were provided with snacks and hot and cold drinks. Staff monitored people’s dietary needs and health care professionals were contacted if anyone was experiencing any difficulties, for example, difficulty with swallowing or a poor diet. Staff had received training which equipped them to effectively meet the needs of the people used the service. This training was updated regularly and staff were supported to gain further qualifications and experience. New staff underwent a thorough induction which assessed their competency in stages; this ensured people were cared for by staff who had the right skills and experience to meet their needs. Systems were in place to ensure anyone who used the service that needed support with making informed decisions were protected by legislation, and any decisions made on their behalf was least restrictive and were made in their best interest.

People were cared for by staff who understood their needs, respected their privacy and upheld their dignity. People had good relationships with the staff and there was a lot of friendly banter and laughter around the service. People or their representatives were involved with the formulation of care plans. This ensured people received care which was of their choosing. Staff made sure people were involved in their care and took the time to explain to them what they were doing when providing support in personal care tasks. They also ensured people were safe and were not distressed by any actions undertaken, for example, when using lifting equipment.

Information was available to staf

The Kensington is registered with the Care Quality Commission (CQC) to provide care and accommodation for a maximum of 35 older people, some of whom may be living with dementia. Accommodation is provided in single rooms and there are ample communal areas for people to use. The location is on a main road, with good public transport links and is close to local amenities. There is a large enclosed court yard for people to use and a large garden.

This inspection took place on 02 November 2015 and was unannounced. This is the first inspection of the service since the new registered provider took over ownership.

At the time of the inspection 18 people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were cared for by staff who understood the importance of recognising and reporting abuse, to keep people who used the service safe. Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service. People’s medicines were handled safely and staff had received training in this area. The service was clean and free from any unpleasant odours. Some of the restrictors on windows required attention and some trip hazards in the court yard and people’s patio doors were brought to the registered manager’s attention during the inspection. They had identified these issues and included them to be addressed in the ongoing renewal and repair plans.

People were provided with a nutritious and varied diet which was of their choosing. Their weight and dietary intake was monitored by staff and health care professionals were contacted when needed. People who needed help and support with making decisions were enabled by staff who had received training in how to uphold people’s rights and choices. Staff had received training in how to meet people’s needs and were supported to gain further qualifications and experience. People were supported to access health care professionals when required. While the service was clean and tidy it would benefit from clearer signage and more distinctive décor to aid those people who were living with dementia. We have made a recommendation about this, it can be found in the main body of the report.

Staff were seen to be kind and caring and understood the needs of the people who used the service. People had been involved with the formulation of their care plan documentation and had attended meetings about their care. Staff understood the importance of treating people with respect and upholding their dignity.

Staff had access to documentation which described the person and their preferences. This had been formulated with the person’s input or their representative where appropriate. People undertook activities and there are plans to make links with the local community to expand people’s experiences and interests. People were able to make complaints and raise concerns; these were investigated, wherever possible, to the person’s satisfaction.

The service was well managed and the registered manager undertook audits to ensure the service was safe. The registered manager consulted with the people who used the service and others who had an interest in their welfare about the running of the service. They formulated action plans to address any shortfalls and were supported by the registered provider to make improvements when required. The management style was open and inclusive and both staff and people who used the service found the registered manager approachable and accessible.