Prince Michael of Kent Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We assessed all quality statements in the safe key question and found areas of good practice. We found concerns with medicine management, risk assessments and recruitment of staff. The registered manager took prompt action to address the concerns identified. People and their relatives told us people were safely cared for, and they were happy living at the home. There were enough staff to support people and keep them safe. The home was clean and free from malodour. Staff assessed the risks in the home environment. They also carried out safety checks on the environment and equipment. There were suitable plans for emergency situations and how the staff should respond to these to keep people safe. The provider had systems for learning when things went wrong and making improvements to the service.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s and their relatives described staff and the registered manager as approachable and contacted them when things had gone wrong.

There were effective systems for responding to and learning from incidents and accidents.

Staff said they were encouraged to learn from incidents and were able to share their views, one staff member told us, " We are always encouraged to contribute to discussions and learn when things could have been done a better way". The registered manager spoke about the importance of learning from incidents and accidents’, they told us, "Staff are encouraged to learn when things go wrong and are involved in discussions about how to improve. "

The registered manager involved people and their relatives in how their care was being managed, we saw examples of effective joint working between staff and healthcare professionals. The registered manager spoke about the importance of recognising when people’s needs changed, "We refer to the doctor, for example one person had a number of falls so they were referred to the GP and their blood pressure was low. We look at each person and see is there an underlining issue".

There were clear procedures and partnerships in place to support people as they transitioned between services. People told us they had regular visits from health care professionals. One person said, "I had a [health issue] and it was reported to the district nurse and the doctor is coming today."

People were safeguarded from the risk of harm. People told us they felt safe, comments included, "I feel it is safe; it is the fact carers are around, and I have got a button to press, I feel more secure."

Staff we spoke with, had a good understanding of their responsibilities in relation to safeguarding people from harm. Comments included, “It is neglect when you don't treat the person as important. When you don't carry them along with what you are doing. Talk to them all the time, even if it is one way, they need to be considered “and " we want to protect them we do not want to wrap them in cotton wool, but we want them to be safe."

Where people were unable to make decisions for themselves, Mental Capacity Assessments (MCA) had been completed. Where necessary, decisions were made on behalf of people, in consultation with appropriate others, in their best interests. Staff had received training about the MCA and Deprivation of Liberty Safeguards (DoLS). People's choices and preferences were included in their care plans. These were regularly reviewed and updated as people's needs changed.

The provider had appropriate procedures in place to manage safeguarding concerns. They had their own company investigators who led on safeguarding concerns, and this was overseen by regional staff. Records showed staff had completed relevant safeguarding training.

Risks to people had been assessed and planned for.

Staff knew people very well and supported people with their individual needs. One staff member said, "When it comes to care plans and risk assessments, I had to read them when I started but also, they are always being updated. I must be familiar with people’s needs before I care for them. Whenever changes are made, we are told. The deputy manager is really good at this and does briefings so we can talk about people’s care." The registered manager told us, “You need to mitigate the risk, allow people to be safe but give them choice and support. We need to see where things could go wrong and pre-empt the risk”. We observed staff supporting people to transfer from a chair to a wheelchair using a hoist. The person was transferred safely and appeared comfortable and relaxed during the process.

We observed staff supporting one person who was becoming distressed and responding negatively to staff input. Staff worked very well as a team, with the first member of staff withdrawing to give the person space and a few moments later another member of staff offering the person support. This was done calmly and respectfully, and the person became more relaxed and able to accept the support they needed Through our observations, it was clear people were supported by staff who understood their individual risks and took the necessary action to keep them safe. For example, we observed one staff helping someone to stand up, they took their time and provided lots of reassurance to the person.

Behaviour monitoring records for one person showed several recent occasions where the person had experienced distress and had reacted either verbally or physically. The records were completed using respectful language that demonstrated staff had an awareness of how to reduce their distress. Records also showed this information was shared with the GP to seek support about how to support them effectively.

The premises were well maintained and decorated to a high standard. The environment had been designed to provide a comfortable and stimulating setting. Consideration had been made for people living with dementia to help them find their way around the home, such as walls painted in different colours and discrete signage to help people know which room they were entering. There were sensory wall displays and many different floral arrangements throughout. People had access to well-maintained outside areas. There were sufficient facilities to meet people’s needs. Bedrooms were all en-suite and there were additional showering and bathing facilities as well as toilets. Some of the communal bathrooms had sensory equipment to help reduce anxiety and tension.

The provider had robust systems for monitoring the safety of the environment and equipment, including fire safety. Equipment was well maintained and serviced regularly. Staff understood how to report maintenance concerns, and the maintenance team addressed issues when they arose. People had personal emergency evacuation plans [PEEPs] in place to provide guidance on what support they would require in the event of a fire. The provider completed regular health and safety and environmental audits of the service to identify any concerns.

People and their relatives told us there was enough staff to care for and meet people’s needs, one person told us, " I seldom call staff, they pop into my room to check on me, I feel very safe and there is always someone there to help you".

Staff told us there was enough staff to care for people and we observed this during our site visits, care was not rushed, and call bells were responded to in a timely way. When people need reassurance, we observed staff sitting with people and giving them the support they needed.

During our site visits we found there were enough staff on duty to meet people’s needs safely. Staff demonstrated a strong commitment to providing good quality, safe care. They knew people’s needs well and had the skills necessary to support them safely. They prioritised positive engagement with people and supported each other to provide timely, flexible care to meet the individual needs and preferences of each person.

The provider had carried out the required pre-employment checks to ensure staff were recruited safely. However, we found gaps in the employment history in the three records we reviewed, we brought this to the providers attention, and they took prompt action to address this.

There were effective systems for managing infection prevention and control. The home was clean and free from malodour. One professional told us " The home is clean and well maintained, I don’t see dirt, it is impressive. People also confirmed this, one person said, "Cleaning is good, the home is cleaned perfectly."

The registered manager told us, "Infection control is about keeping the environment clean, and I want to have a clean home, and it is important to keep it that way. The training manager does spot checks, and we have a keen eye, we are hot on infection control."

The registered manager told us, "Infection control is about keeping the environment clean, and I want to have a clean home, and it is important to keep it that way. The training manager does spot checks, and we have a keen eye, we are hot on infection control."

The home had a dedicated team, who were responsible for cleaning, and managing the laundry, we observed staff used appropriate personal protective equipment when providing support to people.

The provider carried out an infection prevention audit report which considered all aspects of infection control. There were suitable systems for managing laundry, waste and cleaning.

Staff administering medicines had received training; however, we identified concerns with medicines. Staff told us they felt supported with medicines. They said they could raise any problems and knew how to report any errors or issues.

We identified two people were at risk of seizures but within their medicine risk assessment and care plan there was no information recorded for staff. This meant staff may not have the correct information to guide staff on how to support them if they had a seizure putting them at risk of harm. We brought this to the attention of the registered manager who stated that these people had not had seizures since moving into the home but changes to the care plans were made to reflect this.

There was no information recorded in people’s care plans on how to manage and monitor side effects of high-risk medicines such as anticoagulants. The staff did not always monitor the medicines refrigerator appropriately. Medicines were stored within the required range; however, the staff were recording temperatures below 2*c and over 8*c but no action was being taken. Following our feedback staff receiving training.

Regular medicines audits were carried out; however, the audits did not identify the concerns we found during the assessment. We brought this to the attention of the registered manager, and they took prompt action to address the concerns raised.