Kenwood Care home is a nursing and care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

Kenwood care home can accommodate 32 people across two floors, each of which has separate adapted facilities. The service provides care to older adults. People live in their own bedrooms and have access to communal facilities such as bathrooms, lounges and activities areas. At the time of our inspection, there were 28 people living at the service.

The provider is required to have a registered manager as part of their conditions of registration. 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 a registered manager in post.

At our last inspection in January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We found people were protected against abuse or neglect. People had personalised risk assessments tailored to their support requirements. We saw sufficient staff were deployed to provide people's support.

The service was clean and infections were prevented and controlled.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practise.

Staff received good induction, training, supervision and support. This ensured their knowledge, skills and experience were appropriate for their caring roles. People's care preferences, likes and dislikes were assessed, recorded and respected.

We found there was appropriate access to other community healthcare professionals. People were supported to maintain a healthy lifestyle. People had adequate nutrition and hydration to ensure their wellbeing.

People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Medicines were managed safely. Staff had received relevant training and regular medicine audits were taking place.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. A complaints book, policy and procedure were in place. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

The home was well led by an experienced registered manager and the provider had systems in place to monitor the quality of the service, seek people's views and make on-going improvements.

People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.

Staff treated people with respect and as individuals with different needs and preferences. Staff understood that people’s diversity was important and something that needed to be upheld and valued. Relatives we spoke with said they felt welcome at any time in the home; they felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained detailed information about how to provide support, what the person liked, disliked and their preferences. People who used the service along with families and friends had completed a life history with information about what was important to people. The staff we spoke with told us this information helped them to understand the person.

The care staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

Risk assessments were in place for a number of areas and were regularly updated, and staff had a good knowledge and understanding of pressure sore management and prevention.

There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Medicines were managed safely. Staff had detailed guidance to follow when administering medicines. Staff completed extensive training to ensure that the care provided to people was safe and effective.

People were satisfied with the food provided at the home and the support they received in relation to nutrition and hydration.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. A complaints book, policy and procedure were in place. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).We found that the service was working within the principles of the MCA, and conditions on authorisations to deprive people of their liberty were being met.

The management team provided good leadership and people using the service, relatives and staff told us they were approachable, visible and supportive. We saw that regular audits were carried out by the provider’s head office to monitor the quality of care.

We spoke with six people who used the service, two relatives of people who used the service and three members of staff including the manager and area manager.

All the people we spoke with told us they were able to make their own decisions regarding their care. We found consent was both requested and recorded for people who used the service.

Although some medicine records were not always accurate or comprehensive, medicines were administered and stored appropriately.

All the people we spoke with had no concerns with any equipment they used. Although we saw an example of broken equipment, most equipment we saw was fit for purpose. Appropriate measures had been taken to ensure equipment was maintained.

The service had assessed the needs of people who used the service to ensure appropriate staffing levels were maintained. Staff were appropriately skilled and trained to meet people's needs.

Although some professional development was not comprehensive, the provider had regular professional development in place for staff.

We spoke with five people who used the service and their relatives and four members of staff including the manager. Most of the people we spoke with felt their privacy and dignity was maintained and had been involved in their care. We observed people being supported in a dignified way.

Most of the people we spoke with were happy with the care provided and felt their needs were supported. Although there were times we found staffing levels were stretched to meet the needs of people who used the service, we found the provider had appropriate arrangements in place to ensure people were cared for safely.

Generally people were content with the rooms and the environment they lived in. We found the premises was fit for purpose and was well maintained.

Although we were informed of some concerns regarding staff welfare, we found staff were appropriately checked and went through a robust recruitment process before they were employed.

Most people who used the service told us that they were able to feedback their views on the service in a variety of ways and these views were taken into account. We found the provider undertook monitoring of the quality of the service to ensure it met peoples' needs.

People who use the service told us that staff were kind and respected their privacy. They were able to express their views and were involved in making decisions about their care and treatment. We spoke to the manager about developing more individualized activities and they plan to review the programme and undertake further activities training.

Relatives were positive about the care their family member received. One relative said her mother was “always clean” and a person living there said “food is good”. Care records showed that people had access to healthcare professionals such as doctors, dentists, opticians and chiropodists.

Staff were aware how to protect people from abuse. Training was up to date and a member of staff told us they had a lot of training. We found that staff had been trained in safeguarding and training has now been booked in relation to the Mental Capacity Act 2005, Deprivation of Liberty safeguards and challenging behaviour.

The service is taking appropriate action to minimise the risk of harm to people in the home by undertaking appropriate recruitment and staffing checks. Staff files for recent recruits confirmed the home’s policy was being followed and that people should not start work until the CRB check had been received.

People who use the service and their representatives expressed satisfaction with the care provided and they indicated that the needs of people who use the service had been attended to. They made positive comments about staff and stated that staff had treated them with respect and dignity.

Staff were appropriately recruited and they were knowledgeable regarding their roles and responsibilities. Staff were knowledgeable regarding the individual needs of people who use the service. We observed that people who use the service were regularly supervised by staff and staff were noted to be interacting with people in a friendly manner. However, there is a need to review the frequency and programme of activities provided as some people who use the service had activities which were organised infrequently.

People who use the service indicated that they had been well treated. There were appropriate safeguarding arrangements in place and staff had received safeguarding training.

People who use the service said they were satisfied with the accommodation provided. We noted that the home was clean, tidy and some areas had been redecorated. The required health and safety checks and inspections had been carried out. Some deficiencies were noted but these had either been rectified or arrangements were being put in place to deal with them soon after our visit.