Archived: Kesgrave Bungalow

Kesgrave Bungalow is a short break respite care service that provides support for people with a learning disability. The service has four beds and the length of stay can vary depending on the needs and choices of the people who use the service. At the time of our inspection there were two people using the service.

The service has 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.

The team leader is the person who manages the service on a day-to-day basis, supported by the registered manager.

There were systems in place, which provided guidance for staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe. There were processes in place to ensure the safety of the people who used the service. These included risk assessments, which identified how the risks to people were minimised. There were sufficient numbers of trained and supported staff to keep people safe and to meet their needs. Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

The registered manager, the team leader and the staff understood their obligations under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager knew how to make a referral if required. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff were supported in their role and received regular supervision and underwent training , which enabled them to better support the people they worked with.

People were supported to eat and drink enough to maintain a balanced diet, people were given a choice of meals and were encouraged to help preparing the vegetables. They were also supported to maintain good health and access healthcare services.

We saw examples of positive and caring interactions between the staff and people living in the service. The people who were using the service on the evening of our inspection were not able to communicate easily, but they were able to express their views through facial expressions, signs and smiles. The staff knew the people well enough to be able to understand their individual communication methods, understood what they wanted and took action to ensure their decisions were acted on. Staff protected people’s privacy and dignity.

People received care that was personalised and responsive to their needs. The service listened to people’s experiences, concerns and complaints. Staff took steps to investigate complaints and to make any changes needed.

Staff told us that the registered manager and team leader were open, supportive and had good management skills. There were systems in place to monitor the quality of service the organisation offered people.

Kesgrave Bungalow is a short break respite care service that provides support for up to 27 people with a learning disability. The service has four beds and the length of stay can vary depending on the needs and choices of the people who use the service. At the time of our inspection there was one person using the service.

The service has 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.

The service was not always safe because the provider’s pre-employment checks that were carried out as part of their recruitment process was not always robust. There was however enough staff to meet people needs, and staff had received the required training to fulfil their duties. They demonstrated a good understanding of their roles and responsibilities to safeguard people and to provide care that was both appropriate and personalised.

People who used the service had care plans and risk assessments put into place to manage their care needs in a consistent and safe way. Whilst care plans were robust, we found that improvements were required in risk assessment because there were areas identified within people’s care plans as areas of risk but were not accompanied by a risk assessment. Also, people’s risk assessments were not in accordance with current health and safety guidance.

People were supported by staff that were friendly, kind and caring. They had their privacy, dignity and choices respected by staff who sought their consent before providing any care. The requirements of the Mental Capacity Act 2005 were met.

People’s medicines were managed and stored appropriately. Staff supported people to access healthcare services when required. We found that the relatively short stays for people which ranged from one night to two weeks combined with the infinite number of combinations of potential people to use the service at any one time limited the provider’s ability to fully personalise such things as bedrooms and menus. However, efforts were made to ensure that where possible individual tastes were catered for and that rooms did not have an ‘institutionalised’ feel to them.

Improvements were required in the provider’s quality assurance processes to ensure they fully captured and addressed all shortfalls in the service delivery. People, their relatives and staff commented positively about the service’s management team. We found the team leader who was responsible for the day to day operation of the service to be knowledgeable and clear in their role and responsibilities.

The provider had policies and procedures in place to effectively manage complaints and concerns in a timely manner. The team leader with support from the registered manager ensured the service ran appropriately providing visible leadership.

This is a summary of what we found

Is the service safe?

We found that the service was safe. When we arrived our identification was checked and we were asked to sign the visitor's book. This showed that the staff took the security of the building and the safety of the people who lived there seriously.

We looked around the property which we found was clean, homely and free from unpleasant odours. It was well maintained and ensured that there was a safe environment for the people who used the service.

Records showed that the health and safety checks were carried out in the service regularly and action was taken if equipment was found to be faulty or unsafe. This included regular visual checks and servicing of equipment such as hoists, the fire alarm panel and wheelchairs. Regular fire safety and other health and safety checks were carried out, which showed that people were protected from unsafe or poorly maintained equipment.

Medication was stored and handled safely. We saw that medication was stored and managed in accordance with the service's procedure and staff had undergone training in managing and dispensing the medication.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), which was updated every year. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

The staff records we looked at showed that safeguarding checks on criminal record, references and previous experience had been carried out on staff before they were recruited which ensured that staff were of good character and had the qualifications, skills and experience to work with this client group.

Is the service effective?

People told us that they liked using this respite service, those that were unable to communicate verbally with us showed by their expression and body language that they felt safe and relaxed. During our observations of the support staff gave to people we saw that the service was effective in meeting people's needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were met.

Is the service caring?

We saw that the staff interacted with people who used the service in a caring, respectful and professional manner. One person told us that, 'I really like staying here, the staff are good.' Another person said, 'They (the staff) are kind to me.' While talking to staff and observing the way they worked with people we saw that staff were committed to caring for the people they supported.

The service provided meaningful activities and pastimes that were suited to people's personality and interests. People were supported to go out when they requested it, to participate in a favourite pastime and to follow their interests during their stay at the service. One person's relative told us that they were very happy with the service their relative received, they told us, 'Where other providers had focused on the problems, Kesgrave Bungalow looked for the solution.' They went on to say, 'The staff are genuinely caring, I can actually relax when (my relative) is on respite.'

Is the service responsive?

We saw evidence that the service was flexible and made changes as required to ensure people were kept safe. For example staffing levels were based on the assessed needs of the people. If necessary, because of unforeseen circumstances, staffing levels would be increased to ensure people's needs were met. One person, who benefited from extra staff support, received that support.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that they communicate with their main carer so that people were provided with the support they needed.

We saw evidence that the service had responded quickly to address an incident that may have affected people's wellbeing. The service changed the hob to one that cooled quickly after a near miss.

The people who used the service, their relatives and other professionals involved with Kesgrave Bungalow were given the opportunity to complete annual satisfaction questionnaires. The manager said that the service responded to concerns raised with them and made changes to the service where they could.

The service responded to people's choices at meal times, the manager told us that people get together and plan the weeks menu at the beginning of their stay. One person told us, 'I choose sausage and mash for dinner, it was very good.'

When a health and safety audit discovered that the curtains were not fire proof, they were removed and replace with new curtains throughout the service. This showed us that the service's health and safety checks were effective and the service responded to any issues identified to ensure people's safety.

Is the service well led?

Annual surveys were given to the people who used the service and their relatives and the majority of people who completed the survey said they thought the service was good and listened to them. The service had an effective quality assurance system in place and the records we examined showed that identified shortfalls were addressed promptly. This ensured that the quality of the service was maintained.

The staff we spoke with told us that the manager was supportive, easy to approach and listened to what they had to say. The manager told us that they felt supported by the provider.

We observed that the staff were attentive to people's needs. Staff interacted with people in a friendly, respectful and professional manner. We saw that staff sought people's agreement before providing any support or assistance.

We found that the service took steps to protect the people who used the service from abuse. One person said, 'I always feel safe when I stay here.'

We spoke with three staff members, they told us they were supported through supervision and that they believed they were trained sufficiently to support people with learning disabilities in all aspects of their lives. We saw that the provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.