Archived: Kingsdown House

Updated 16 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection, which took place on 02 October 2018 and was unannounced.

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of understanding of caring for people with learning disabilities.

Before the inspection, we reviewed information available to us about this service. The provider had completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports, information we had received and notifications about important events that had taken place in the service, which the provider is required to tell us by law. We used all this information to plan our inspection.

People had limited communication abilities. Two people were able to tell us about their experiences of living in the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also observed staff interactions with people and observed care and support in communal areas. We spoke with four people who used the service and two relatives.

We spoke with two support workers, deputy manager, the registered manager and the operations manager who was a representative of the provider. We also requested feedback from a range of healthcare professionals involved in the service. These included professionals from the community mental health team, local authority care managers, continuing healthcare professionals, NHS and the GP. We received feedback from two healthcare professionals.

We looked at the provider’s records. These included three people’s care plans, health records, risk assessments and daily care records. We looked at three staff files, a sample of audits, policies and procedures, satisfaction surveys and staff rotas. We reviewed duty rotas, complaints, compliments, quality assurance systems and processes.

We asked the registered manager to send additional training records information after the inspection visit. The information we requested was sent to us in a timely manner.

Updated 16 November 2018

The inspection was carried out on 2 October 2018, and was unannounced.

Kingsdown House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kingsdown House is registered to provide accommodation and personal care for up to nine people aged between 18 and 65 years, who have a learning disability. The service is situated in a residential area with shops and local amenities within walking distance. People who lived in the service had autism and different levels of communication difficulties.

Kingsdown House was designed, built and registered before registering the right support. Therefore, the service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance.

Although the service had not been originally set up and designed under the Registering the Right Support guidance, they were continuing to develop their practice to meet this guidance and used other best practice to support people. They have applied the values under Registering the Right Support. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last Care Quality Commission (CQC) inspection on 19 April 2016, the service was rated Good. At this inspection, the rating remains Good.

There was a manager at the service. 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 and associated Regulations about how the service is run.

Without exception, relatives and people who lived in the service told us staff were consistently very caring and kind towards them. Staff recognised people as individuals and went the extra mile to include them in the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people who mattered to them. Relatives and visitors were welcomed at the service at any reasonable time.

People received an effective care based on current best practice for people living with autism. Staff knew the people they worked with very well and involved them in decisions about their care and support throughout their interactions, greatly enhancing their quality of life.

Medicines practice was safe. Medicines records were accurately signed with no gaps in recording. Staff had detailed knowledge of the system in place. The environment was well maintained and infection control procedures were adhered to. All required safety checks were completed.

Staff received regular training and were provided with appropriate support and supervision as is necessary to enable them to carry out their duties.

People were protected from the risk of abuse at Kingsdown House. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for.

There were enough staff to keep people safe. The registered manager had appropriate arrangements in place to ensure there were always enough staff on shift.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider and staff understood their responsibilities under the Mental Capacity Act 2005.

People received the support they needed to access healthcare services. Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. People were supported to eat and drink enough to meet their needs.

The registered manager ensured the complaints procedure was made available in an accessible format if people wished to make a complaint.

There was a positive leadership in the service. The service was well led by a registered manager who led by example and had embedded an open and honest culture.

Effective governance systems to monitor performance had been fully embedded into the service.