Our last comprehensive inspection of this service took place on 24 and 25 November 2016. We rated the service ‘Requires improvement’.

At this inspection we found improvements had been made in relation to medicines management. People using the service and their relatives told us staff were kind and caring and that the service had improved. However, plans to re-install kitchen facilities within the home had stalled. This meant the service was unable to provide meals that were freshly prepared and cooked on site. People’s views were not always positive when asked to comment on the quality of the food provided at mealtimes.

We rated the service ‘Good’ overall.

This inspection took place on 22 and 26 February 2018. The first day of the inspection was unannounced. The registered manager was informed that we would be returning for a second day to complete our visit.

Princess Louise Kensington Nursing Home 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 service is set out over three floors and provides nursing and accommodation to 44 adults with complex continuing care needs. An NHS rehabilitation unit occupies most of the ground floor and is operated as a separate registered service which was not visited as part of this inspection. Two upper floors are divided into four units. The first floor is primarily for people living with a diagnosis of dementia with the second floor providing nursing care and support to elderly frail residents. The home is fully accessible, with a lift serving all floors. There were 40 people living at the home at the time of inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Where possible, people were involved in decisions about their care and how their needs would be met. Where appropriate, relatives and healthcare professionals contributed to the care planning process.

Systems were in place to identify and reduce risks to people living in the home. Risk assessments and management plans were in place to mitigate risks in relation to people’s mobility, nutrition, personal care, physical and mental health and well-being.

People were protected from avoidable harm and abuse because the provider had effective safeguarding systems in place. Staff understood how to recognise the signs of abuse and told us they would speak to nurses and the registered manager if they had concerns about a person’s safety or welfare.

People's medicines were managed and administered safely. People's current medicines were recorded on medicines administration records (MAR) along with their allergy status in order to prevent any inappropriate prescribing. Medicines audits were completed weekly and checked by senior staff members.

The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss.

Recruitment practices ensured the right staff were recruited to support people to stay safe. Staff were appropriately trained and skilled to care for people and understood their roles and responsibilities. Staff received supervision and guidance where required and confirmed they felt supported by the registered manager.

Staff had received training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). These safeguards are there to make sure that people receiving support are looked after in a way that does

This is the first inspection we have carried out since the service registered with the Care Quality Commission (CQC) under a new provider in August 2015.

Princess Louise Kensington Nursing Home is set out over three floors and provides nursing and accommodation to 45 adults with continuing care needs. An NHS rehabilitation unit occupies most of the ground floor and is operated as a separate registered service which was not visited as part of this inspection. Two upper floors are divided into four units. The first floor is primarily for people living with a diagnosis of dementia with the second floor providing nursing care and support to elderly frail residents. The home is fully accessible, with a lift serving all floors. There were 40 people living at the home at the time of inspection.

The service had a manager in post that had completed the application and interview process to become the registered manager of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Medicines were not always being recorded and stored safely. Following a discussion with the registered manager we were informed that systems to better manage people’s medicines would be implemented to ensure that people consistently received their medicines safely, and as prescribed.

Where possible, people were involved in decisions about their care and how their needs would be met. Where appropriate, family members and health and social care professionals contributed to the care planning process. People using the service and their relatives held various different views in regards to the care their family members received, comments were not always positive in regards to staff and the support received.

Risks to people had been identified and management plans were in place to mitigate these risks. A range of risk assessments were completed in relation to the environment, people’s mobility, pressure area care, physical and mental health and well-being.

Steps had been undertaken to help ensure staff were safe to work with people living in the home. Staff were appropriately trained and skilled to care for people and understood their roles and responsibilities. Staff received supervision and guidance where required. Staff confirmed they felt supported by the manager who we were told was accessible and approachable.

Staff received training in safeguarding adults and policies and procedures were in place for staff to follow if they suspected harm. Staff understood how to recognise the signs of abuse and told us they would speak to nurses and the manager if they had concerns about a person’s safety or welfare.

Staff had received training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). These safeguards are there to make sure that people receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

Staff supported people to attend healthcare appointments as required and liaised with people’s family members, GPs and other healthcare professionals to ensure people’s needs were met appropriately.

People were provided with a choice of food and drink, and were supported to eat when this was needed. However, people’s views varied when asked to comment on the quality of the food provided at mealtimes. People’s dietary needs and preferences were not always respected and catered for. There were plans to re-install kitchen facilities in the near future so that all meals could be prepared on site.

The service