This focused KLOE inspection of 153 The Parade (Protea Care Homes (Kent) Ltd) found the service had improved to Good in both Safe and Well-led following previous breaches of Regulations 13 and 17. The provider had strengthened safeguarding, incident monitoring, medicines management, infection control and governance systems, with no remaining regulatory breaches identified.
Concerns (3)
minorRecord keeping — “Reviews of risk were completed when people's needs changed but not always documented comprehensively.”
minorGovernance — “The registered manager maintained a service wide improvement plan this was not shared with staff or team leaders for discussion.”
minor
Communication with families
— “Information from head office is adhoc as opposed to on a scheduled basis... it's not once a month or once a week it's adhoc.”
Strengths
· Safeguarding systems improved; provider no longer in breach of Regulation 13 following previous inspection.
· Medicines managed safely with completed administration records and staff competency assessments.
· Robust infection prevention and control processes throughout the pandemic.
· Sufficient staffing levels with consistent teams enabling meaningful relationships with people.
· Appropriate recruitment practices with all pre-employment checks in place.
Quality-Statement breakdown (9)
safe: Systems and processes to safeguard people from the risk of abuse, learning lessons when things go wrongGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
well-led: Managers and staff being clear about their roles, understanding quality performance, risks and regulatory requirements; continuous learningGood
well-led: Duty of candour — open and honest with people when something goes wrongGood
well-led: Promoting a positive, person-centred, open, inclusive and empowering cultureGood
153 The Parade, a supported living domiciliary care agency, was rated Requires Improvement overall at its first inspection in January 2020, with breaches of Regulation 13 (safeguarding) and Regulation 17 (good governance) identified due to an ongoing financial abuse investigation and ineffective audit systems. Caring, effective and responsive aspects were rated Good, with staff demonstrating kind, person-centred practice, though leadership stability and management oversight required significant improvement.
Concerns (5)
criticalSafeguarding — “At the time of our inspection there was an ongoing investigation in relation to safeguarding people from financial abuse.”
criticalGovernance — “The provider did not have adequate systems and audits in place to assess and monitor the overall quality and safety of the service.”
moderateGovernance — “Neither the nominated individual or the operations manager had been aware that the service was providing the regulated activity of personal care.”
moderateLeadership — “The previous 'registered Manager' for Protea homes had left the service six months prior to the inspection.”
moderateRecord keeping — “These were not always effective in identifying shortfalls in the quality of the service provided. There was a lack of management oversight at one of the supported living properties.”
Strengths
· Staff were aware of how to identify and report abuse and safeguarding concerns
· Robust recruitment process with designated staff member ensuring pre-employment checks
· Medicines safely managed, administered, stored and disposed of with regular audits
· Staff received regular training, supervision and team meetings and felt supported
· People's needs were fully assessed before the service commenced and care plans kept under review
Quality-Statement breakdown (23)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseRequires improvement
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffRequires improvement