This unannounced inspection took place on 9 November 2016. This residential care home is registered to provide accommodation and personal care for up to 51 people who may have dementia or mental health needs. At the time of our inspection there were 51 people living at the home.

There was 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 felt safe living in the home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required to keep them safe and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job. People had risk assessments in place which identified and managed people’s known risks, and appropriate arrangements were in place to manage and store people’s medicines.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person. People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People had their healthcare needs managed in a way that was appropriate for each person and people’s nutritional needs were well supported.

People received support from staff that treated them well and prioritised their needs. People were relaxed and comfortable around staff and staff understood the need to respect people’s confidentiality. People were supported to maintain good relationships with people that were important to them and the home had good links with advocacy services to ensure people had the support they required.

People were encouraged to make their own personal choices and to be in control of their own lives. The Registered Manager was making progress to ensure people’s care plans reflected people’s interests. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did.

People at the home reacted positively to the manager and the culture within the home focussed upon supporting people to receive the care they needed and to be as independent as possible. Systems were in place for the home to receive and act on feedback and policies and procedures were available which reflected the care provided at the home.

During our inspection visit to Kingsthorpe Grange, we spoke with four people who were living at the service, a visiting relative, a volunteer, five members of the care staff and the registered manager.

People living in the home expressed satisfaction with the care and service they

received. They told us they were well looked after by all the staff and one person

told us that they liked this home better than their previous placement. They also told us they were able to have cultural food that they enjoyed.

Another person said “It’s nice here and the care staff are nice too”. They also told us they knew how to make a complaint and said “I will speak to the staff in the office and I know they will listen to me”. People also told us that the activities in the home were very good and they joined in with some of the sessions.

We also spoke with a relative who told us that the “People living at the home did lots of activities and the place was lovely and very clean”. They also said “The staff are fantastic and very caring” and they observed care staff speak to people in a kind and dignified manner.

We observed that all staff on duty had a calm and kind manner when working with

individual people. Several people were not able to hold meaningful conversations

with us, but we saw from their responses and body language that they were happy

with the way staff treated them.

We found the provider had systems in place to meet people’s health and welfare needs. People had individual care plans which were supported by risk assessments and daily care records to meet their needs. We also found that medicines were handled safely. We saw that the provider had a complaints system in place to ensure that any complaints raised were handled appropriately.

During our inspection visit to Kingsthorpe Grange we spoke with four people living in the home, two visiting professionals, five members of staff and the registered manager. We used a number of methods to help us understand the experience of people living at the home. This was because most of the people living at the home had dementia, and we were unable to have a detailed conversation with most of them. We there fore used our observation skills to help us understand their experiences.

People living in the home expressed satisfaction with the care and service that they received. They told us that the home was “homely” and staff looked after them well. One person told us “I like it here and the staff are lovely” and they spoke to them in a dignified manner. Another person told us “we do lots of activities and I like cooking best because we can taste the food”.

We observed that all staff on duty had a calm and kind approach when working with individual people. Several people in the dementia unit were not able to hold meaningful conversations with us, but we saw from their responses and body language that they were happy with the way staff were treating them

On the day of the site visit, there were 50 people living in the home. The home had people with different needs living on the first floor and downstairs. We spent time talking to people and staff on both floors of the home.

To help us to understand the experiences people have, we used our Short Observational Framework for Inspection (SOFI) tool when the people were having lunch. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences.

The people we spoke with told us that they liked living at the home and they liked the staff. They said they did lots of different activities and enjoyed this. Some people told us that the food was lovely and some said it was ok. All the people told us that the staff spoke to them nicely. One person said the staff helped them with their personal care needs, and always closed the door behind them.

We observed staff interacting with people in a positive manner. They told us that they enjoyed working at the home and with the people.

The relatives we spoke with told us that the “home has a homely atmosphere” and “staff were very caring and excellent with the people”. The activities in the home were said to be “very good and lots of them” and people enjoyed them.

This unannounced inspection took place over two days on 30 November 2015 and 1 December 2015. The service provides treatment and support for up to 51 people who require nursing support and may have dementia or mental health needs. At the time of our inspection there were 50 people living at the home.

There was 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 felt safe living at Kingsthorpe Grange however staff were not adequately deployed to ensure people’s needs were met at all times. Risk assessments were not always complied with due to the way in which staff were deployed.

This was a breach of regulation and you can see what action we told the provider to take at the back of the full version of this report.

Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. The recruitment practices were thorough and protected people from being cared for by staff that were unsuitable to work at the service. Accidents and incidents were regularly analysed and action was taken to prevent similar incidents reoccurring. People were supported to take their medicines appropriately.

Staff received good training and were confident with the support they received from senior members of staff and the registered manager. Appropriate arrangements were in place to support people who did not have the mental capacity to make decisions about their care and people’s healthcare needs were met effectively and in a timely manner. People were supported to eat and drink well and have a balanced diet.

Staff were pleasant and kind to people however despite opportunities to do so, there were limited engaging or meaningful conversations with people and most conversations were task led and did not focus on the person. People were supported to express their views and make decisions about their care and staff promoted and encouraged people’s independence. Relatives and visitors were welcomed and arrangements were in place to support people with their end of life wishes.

People’s needs were assessed before they began using the service and care plans were produced which reflected how people liked to receive their care. People were asked about their hobbies and interests and activities were arranged to accommodate this. People made great progress whilst at Kingsthorpe Grange and the service accommodated people’s changing needs. People were encouraged to make suggestions to improve the service and complaints were handled appropriately.

Staff and people using the service had great confidence in the registered manager and there was a clear ethos to learn from incidents and consistently improve the service to provide the best care possible. The registered manager held regular meetings with the staff and they felt able to contribute their own ideas about improvements that could be made. The provider showed regular involvement and support for the service and good quality assurance systems were in place.

The Commission had been made aware of an incident that had occurred at the service which was being investigated by the Coroner. We will continue to liaise with the provider and Coroner on this matter until an outcome is reached. Part of this inspection considered matters arising from that incident to see if people using the service were receiving safe and effective care.