Kinross is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The inspection took place on the 4 and 5 December 2018 and was unannounced.

The home is registered to accommodate up to 29 people, including people living with dementia care needs. There were 24 people living at the home when we visited. The accommodation is based on two floors connected by stairs and a passenger lift. There is a range of communal areas on the ground floor including a dining room and two lounges.

A registered manager was not in post at the time of the inspection. 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. The service was being run by a home manager who had applied to register with CQC.

We identified significant concerns about the safety of the service which put people at risk of harm. Although there was a comprehensive quality assurance system in place, this had failed to identify any of the concerns that were raised during the inspection. The duty of candour requirements were not fully followed when people came to harm.

There were not enough staff deployed, which meant people sometimes had to wait for support and staff were not always available in communal areas to support people. This also impacted on the ability of staff to meet people’s personal care needs and to effectively manage the laundry.

The laundry room was not fit for purpose and was not operated in a way that minimised the risk of infection and cross contamination.

Risks to the health and safety of people were not always managed safely. These included the risk of people developing pressure injuries, the risks posed by the use of equipment, infection risks and fire safety risks. Following the inspection, we alerted Hampshire Fire and Rescue Service to our concerns.

People’s medicines were not always managed safely. Some people did not receive their medicines as prescribed and risks relating to some medicines had not been assessed.

There were clear recruitment procedures in place, but these were not always followed to help ensure only suitable staff were employed.

Staff acted in people’s best interests but did not always record decisions they had made on behalf of people who lacked capacity.

Staff had completed a range of training relevant to their role, but training records did not confirm that all staff had completed all the training deemed essential by the provider and some training had not been effective.

We received mixed views from health and social care professionals about the support people received to access healthcare services. We found advice given by professionals was not always followed and staff were unable to confirm whether some referrals had been made.

Some adaptations had been made to the environment to make it supportive of the people who lived there, but there was a lack of signage to help people navigate around the building. Some carpets and furnishings were badly worn and there was not a plan in place for refurbishing the home.

People were offered a choice of food and drinks. Most people’s nutritional needs were met, although action was not always taken when people had lost weight.

People told us they were treated in a caring and compassionate way by staff, although a lack of staff compromised people’s dignity at times. Staff usually interacted with people in a supportive way; however, we observed two occasions where staff demonstrated a lack of consideration for people.

People were protected from the risk of abuse and staff understood their safeguarding responsibilities.