We carried out a review of the data available to us about Kirkside House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Kirkside House, you can give feedback on this service.
People's experience of using this service and what we found
People were supported safely and protected from harm. There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to people. The management of medicines was safe. Risk assessments were individualised and detailed to ensure staff knew how to support people. Incidents and accidents were managed effectively; lessons were learned to prevent future risks.
There were enough skilled and experienced staff to meet the needs of people who used the service. Staff completed training relevant to their role. Staff acknowledged people’s rights and quality characteristics were considered and respected.
The provider had embedded quality assurance systems to monitor the quality and safety of the care provided. People knew how to complain and felt listened to. Regular meetings were held with people living in the home, staff and health professionals to ensure any changes were effectively communicated. Surveys were used to gather feedback from people to improve care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The care and setting maximised people’s choice, control and Independence.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 4 March 2020). We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
We received intelligence in relation to feedback about the home, safeguarding enquiries and whistleblowing which suggested a possible closed culture within the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
Kirkside House is registered to provide accommodation and personal care for up to seven people with a learning disability and or autistic spectrum disorder. At the time of our inspection there were
seven people using the service. Kirkside House accommodates people across three separate units, each of which has separate facilities.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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 receive planned and co-ordinated person-centred support that was appropriate and inclusive for them.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People’s experience of using this service and what we found
People received safe care and the service made sure risks to people’s health and safety were managed well. People and their relatives or advocates said the service was safe and people received the support they needed. Staff showed a good understanding of how to protect people from harm or abuse. There were enough staff available to provide a timely response to people and provide safe care. Staff worked flexibly, to meet the diverse and individual needs of people. Staff were recruited safely. Medicines were managed so people received their medicines as prescribed.
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. People gave their consent to care in line with current legislation. The service respected people’s human rights. Staff understood the variety of ways people communicated their wishes and preferences. People received a balanced diet and the staff monitored people’s nutritional health. Staff received training and support to ensure they had the skills and knowledge to meet people’s needs.
People told us they were happy at the service and enjoyed a fulfilled life. Staff were caring and supportive. They knew how people preferred their care and support. Staff respected people’s privacy and dignity and promoted equality and diversity. People and their relatives or advocate spoke positively about the staff. Comments included; “It is so good here; the best team ever” and “The staff are all wonderful.”
People had up to date support plans, which clearly set out how staff should meet how their care and support needs. People and their relatives had been involved in their development and review. The registered manager and staff team placed high emphasis on making sure people had meaningful lives, with plenty to do. The provider had a complaints procedure in place and systems in place to deal with complaints effectively.
The service was well led by a management team who led by example and had embedded an open, positive and honest culture. Staff were happy in their work and felt well managed and supported. They were enthusiastic and said they would recommend the service as a good place to work. The management team carried out effective audits and checks to monitor the quality and safety of care delivered and actions were taken to continuously improve the service. The registered manager was aware of their responsibility to report events that occurred within the service to the Care Quality Commission (CQC) and external agencies.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update) The last rating for this service was requires improvement (published 7 November 2019) where the provider was found to be in breach of regulation 18 of the CQC (Registration) regulation 2009. At this inspection we found the provider had made improvements and was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
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.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. 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.
People’s experience of using this service: Medicines were managed safely. Risks to people were assessed and records contained clear guidance for staff to follow. Staff knew how to respond to possible harm and how to reduce risks to people.
People were safe and protected from avoidable harm as staff knew how to recognise and respond to concerns of ill-treatment and abuse. Lessons were learnt about accidents and incidents and these were shared with staff members to reduce the risk of further occurrences.
The provider followed effective infection prevention and control guidance when supporting people. Any equipment that people used was maintained and kept in safe working order and the provider undertook regular safety checks.
People were observed to have good relationships with staff. People told us they felt well cared for by staff who treated them with respect and dignity. People also told us they were listened to and were involved in their care and what they did on a day to day basis.
Detailed care plans described the support people needed. This included best practice guidance and support from external healthcare professionals where required. People's health was well managed and the positive links with professionals promoted people’s wellbeing.
People participated in a range of activities that met their individual choices and preferences. Staff understood the importance of this for people and provided the structured support people required. This enabled people to achieve positive outcomes and promoted a good quality of life.
People's right to privacy was maintained by the actions and care given by staff members. Staff understood their responsibilities in relation to the Mental Capacity Act 2005. People told us they were involved in making every day decisions and choices about how they wanted to live their lives.
Staff were recruited using safe recruitment procedures and processes. There were enough skilled and experienced staff to meet the needs of people who used the service. Staff told us that they were supported by the management and found them to be approachable.
Staff received a comprehensive induction when they commenced employment and completed annual refresher training. Staff told us the training was detailed and gave them the skills they needed to meet people's needs. People, their relatives and staff all felt confident raising concerns and ideas. All feedback was used to continuously improve the service.
A complaints system was in place and there was information so people knew who to speak with if they had concerns. Checks and audits were completed by the registered manager and the provider to monitor the quality and safety of the service.
Full details of our findings can be found in the main sections of the report.
Rating at last inspection: Good. (published 8 July 2016)
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Enforcement: We found the provider failed to notify us of five incidents which had occurred at the service across a 22 month period which the provider is legally required to inform us of. More information is in detailed findings below.
Follow up: We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated requires improvement. If any concerning information is received we may inspect sooner.
Kirkside House provides care for up to seven people who have a learning disability. The service had a one bed, two bed and four bed unit. A communal room and gardens were shared by all. The service had a registered manager. 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 2008 and associated Regulations about how the service is run.
People were well cared for. People who used the service told us the staff were caring and they liked the registered manager. During the inspection we observed staff spending time with people and it was clear they knew the people they were supporting. Staff were able to tell us about people’s history, likes and preferences.
People who used the service and their family were involved in the care planning process and helped identify how their care should be delivered. Care plans described what staff needed to do to make sure people’s needs were met and covered areas that were important to the person. They were clear and easy to understand. A range of other professionals were involved to help make sure people stayed healthy.
There was enough staff deployed to keep people safe. Some people were allocated additional staffing to enable them to participate in agreed activities but it was not clear from the rotas or care records these were being allocated appropriately. The provider had started to improve this system.
Staff were skilled and experienced to meet people’s needs because they received appropriate training and support.
The provider had systems in place to protect people from the risk of harm and staff understood how to keep people safe. People who used the service and staff discussed health and safety to help increase awareness and keep everyone safe. There were appropriate arrangements for the safe handling of medicines.
The service had good management and leadership. Staff told us the service was well managed and described the registered manager as ‘approachable’. The provider supported the management team at Kirkside House and carried out checks to make sure people were receiving safe and effective care. People who used the service and staff were encouraged to put forward suggestions and ideas. Any concerns or complaints were responded to and resolved where possible to the satisfaction of the person.
This was an unannounced inspection carried out on the 9 February 2015. At the last inspection in April 2014 we found the provider was meeting the regulations we looked at.
Kirkside House is registered to provide accommodation and personal care for up to seven people with a learning disability. The service is divided into two units.
At the time of this inspection the home did not have a registered manager. 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. A manager had been recently appointed; they told us they had started the registration manager’s application process and would be submitting this shortly to CQC.
At this inspection people we spoke with told us they were supported by staff who were caring.
Their care and support was personalised although some gaps in how care was assessed and monitored meant people’s health and care needs could be overlooked. People enjoyed activities within the home and the community; their daily routines were planned and personalised.
People told us they always had plenty to eat and drink. People were supported to make decisions about their care and support. Where people did not have the capacity to make decisions about different aspects of their care this was assessed and recorded in their individual care plan. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).
People were not always protected against the risks associated with medicines because the arrangements in place to manage medicines were not always appropriate. People were protected from abuse and felt safe although the behaviours of others they lived with impacted on their everyday life. People’s safety had been assessed and risks were managed and monitored.
There were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people’s needs because they received appropriate training, supervision and appraisal.
Staff felt well supported by the management team. The provider had a system to monitor and assess the quality of service provision. Safety checks were carried out around the service and any safety issues were reported and dealt with promptly. The home’s statement of purpose contained the aims and objectives of the service but it had not been updated when service provision had changed.
You can see what action we told the provider to take at the back of the full version of the report.
Below is a summary of what we found. The summary is based on speaking with people using the service and their relatives, the staff supporting them and from looking at records.
The detailed evidence supporting our summary can be read in our full report.
Is the service safe?
Staff had received safeguarding training and could identify types of abuse and knew what to do if they needed to report any incidents. Staff said they were confident that people who used the service were protected from abuse. They said any untoward practices would not be tolerated and would be dealt with promptly.
Care records contained some good information and showed why and how decisions were made. They showed when it was appropriate other professionals had been involved. People had 'My Life, My Goals' documents which identified short term achievements people were working towards. However, we noted in some care records it was not always clear why and how some decisions were made and when these would be reviewed. The provider had identified through their auditing processes they could improve some aspects of involving people in the care planning process.
Is the service effective?
The provider supported staff to deliver care to an appropriate standard. Training records showed that appropriate training was being delivered. We looked at a training plan which showed individual training needs were taken into consideration when training was planned. Staff we spoke with told us everyone worked well together and they felt well supported.
Is the service caring?
We spoke with five people who used the service. Four people said they were happy with the care and support they received. One person said, 'The staff all know what to do; they are all good.' Another person talked to us about developing skills and increasing their level of independence and said, "I know how to get up the ladder and talk to (name of staff) about it." Another person told us they enjoyed going out and doing 'lots of different things.' One person told us their care was not always appropriate to meet their needs.
We spoke with one relative. They told us the service was excellent and the standard of care was very high. They said, 'Staff understand (name of person)'s needs. They know her so well.'
We observed staff supporting people who used the service. Staff knew the people they were supporting very well. People who used the service seemed comfortable with the members of staff who were supporting them.
Is the service responsive?
People were supported in promoting their independence and community involvement. People told us they went out frequently and were involved in daily living tasks within the home. Everyone had an activity planner that identified what people did each day. These showed people went out frequently and visited the local and wider community.
We asked for and received details of complaints people had made and the provider's response. The evidence we reviewed indicated the provider had considered complaints and responded appropriately.
Is the service well led?
The provider had an effective system to regularly assess and monitor the quality of the service that people received. We looked at a selection of reports which showed the provider had assessed and monitored the quality of service provision.
During our visit, we saw staff interacting with people in a positive, respectful and caring manner. Staff we spoke with told us they encouraged people to be as independent as possible and make their own decisions where possible. We observed staff respecting people's rights and promoting their independence. People appeared relaxed and comfortable in the presence of staff.
One relative we spoke with told us, 'The staff are marvellous, when my son first came here, he wouldn't go out, now he goes for walks and out on the bus.' Another relative said, 'My daughter is happy here, she went on holiday to Spain last year, she would let me know if she was not happy here.'
The service was clean, tidy and free from bad odours.
We saw that appropriate checks were undertaken before staff began work to make sure they had the relevant experience and skills for the role.
The service had good systems in place for monitoring the quality of the service provided. Results from the service user satisfaction questionnaire, showed people had high levels of satisfaction with the care which the home provided.
People who used the service told us they were happy living at the home and they were well looked after. One person told us, 'It's alright living here' and 'It feels like it is my own home.' One person said, 'Its alright living here but I don't like the noise.' Another person told us, 'I am happy living here, I quite like it.' Staff were described as, 'Alright and they understood.'
The three people we spoke with told us that they felt safe at the home and they would tell staff or the manager if they were worried about anything.
People we spoke with said that the staff gave them their medication and that they received it on time and when they needed it. One person told us, 'I get my tablets on a morning and evening, I never miss.' Another person told us, 'I get my medication when I ask for it.'
People who use services told us they were happy with the care they received. One person said, 'I like it here. It's better than being at home. Staff talk about what I'm doing and arrange for me to do different things.'
People who use the service told us that they would talk to the staff or manager if they had any concerns. They said their keyworker asked if they felt safe. One person who uses the service said, 'They help you to manage your anxiety and behaviour. They manage behaviours really well.'
Three people who use the service discussed safeguarding and raised some concerns about recent incidents at the home although they said the manager and staff had supported them well. The manager and area manager discussed the related incidents and explained what action they had taken to protect people.
People who use the service were complimentary about the staff and everyone we asked said there was enough staff. One person said, 'It's a pretty good staff team. All the staff are nice.' Another person said, 'I go out all the time with staff, we go to lots of places, they spend time with me at home helping me do different things.'
One visitor was very complimentary about the care their relative received. They said, 'Since (name of person) moved here they have blossomed and thrived and done things I never thought they would do. It's the best place they have ever been.'