Background to this inspection
Updated
22 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector carried out this inspection.
Service and service type
Kilvie House 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced. The inspection was completed on the 2 and 3 October 2019.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.
During the inspection-
We spoke with a person who used the service and spent time with others to gain their views about their experience of the care provided. We spoke with six members of staff including the registered manager. We also spoke with a visiting health professional.
We reviewed a range of records. This included three people’s care records and medication records. We also looked at a variety of records relating to the management of the service, including policies and procedures.
Updated
22 October 2019
About the service
Kilvie House is a residential care home providing personal and nursing care for eight people. People who live at the home have learning and physical disabilities. At the time of the inspection, there were eight people living at Kilvie House.
The home met the characteristics that underpin the Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Some of the people living in Kilvie House had a profound learning and physical disability and therefore did not communicate verbally. In order to understand their experiences, we observed staff interactions with people over the course of the inspection.
Staff were caring and attentive to people. People and staff were comfortable in each other's company. People were at the centre of the service and everything that they do.
People received safe care. Staff understood safeguarding procedures. Risk assessments were in place to reduce and manage risks within people’s lives. Staff recruitment procedures ensured that appropriate pre-employment checks were carried out. People had access to other health and social professionals. Safe systems were in place to ensure that people received their medicines as prescribed.
Staff were trained to support people effectively. Good communication was in place in the form of daily handovers, team meetings and one to one supervision.
Staff continued to provide people with daily choices on what they wanted to eat, wear and choice in respect of activities. Staff knew people really well and were responsive to changes in body language, gestures and their nonverbal communication.
Staff were very caring and provided people with care tailored to their needs promoting their rights to an ordinary life. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider had quality assurance systems in place to monitor the running of the home and the quality of the care being delivered.
There was an open and transparent culture within the service. Complaints, accidents and incidents were analysed, action was taken to reduce the risk of them happening again.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
Good (report published April 2017)
Why we inspected
This was a planned inspection based on the previous rating.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.