We carried out a review of the data available to us about Kingly Croft 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 Kingly Croft, you can give feedback on this service.
Kingly Croft provides accommodation and personal care for up to six adults with acquired brain injuries and neurological conditions. The staff team includes a dedicated team of occupational therapists, a speech and language therapist and a physiotherapist to assist people with their support and rehabilitation. There were four people using the service at the time of our visit.
People’s experience of using this service and what we found
People received personalised safe care. All the people and relatives we spoke with told us they received support that was tailored to their needs and preferences and were complimentary of the care they received. Staff knew people well and our observations confirmed they were kind and considerate when they supported people.
People’s consent to care was obtained. People were supported to have maximum 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.
There were enough experienced and qualified staff to safely meet people’s needs. Staff knew people well and were kind and considerate when delivering care. Where we identified an issue with overnight staffing this was immediately resolved.
Processes were in place to safely manage risks associated with people’s care. Care plans and risk assessments were reflective of people’s needs. Where people’s needs changed prompt action was taken to ensure their health and well-being were maintained.
Staff were safely recruited, and people were involved in the providers recruitment process.
People were provided with a safe and homely place to live. Improvements to the environment had been made and a refurbishment plan was in place.
They were provided with a balanced diet and support from healthcare professionals was sought when required.
People were protected from the risk of infectious diseases as far as practicably possible. A robust infection control policy was in place and staff followed guidance in relation to COVID-19.
People’s medicines were managed safely. Staff had received training in medicines management and their competency had been checked.
The registered manager and provider were open and transparent, and systems and processes were in place to ensure people received quality care. Where any shortfall was identified action was taken to bring about the required improvement.
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 requires improvement (published 25 September 2019).
Why we inspected
This was a planned inspection based on the previous rating.
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 COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kingly Croft on our website at www.cqc.org.uk.
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.
People’s experience of using this service and what we found
The use of agency staff who didn’t always know people well, placed them at potential risk. People were at risk of not getting the care and support they needed, when they needed it, or in a timely manner. This was because the staff at times, were required to support the staff at Kingly Croft’s sister service, Kingly House.
The service was without a registered manager therefore the providers operations manager was acting as manager. Whilst some monitoring of the service took place, this was neither fully formalised or robust.
Comprehensive care plans were in place however, documentation within them didn’t always correspond, providing inaccurate information to the reader. This compromised the support provided by agency staff.
People felt safe living at Kingly Croft and staff were aware of their responsibility to keep people safe from avoidable harm. People’s medicines were managed safely and in line with manufacturer’s instructions. Staff had received training in medicines management and their competency had been checked.
Risks associated with people’s care and support had been assessed and managed and the providers infection control policy was followed. Lessons were learned when things went wrong to improve the service provided.
Staff were provided with relevant training and felt supported in their role. They were kind and caring and treated people with respect. They supported people to make decisions about their care on a daily basis.
People were provided with a comfortable and homely place to live. They were provided with a balanced diet and support from healthcare professionals was sought when required.
People’s consent to their care was sought. They were supported to have maximum 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.
When people had concerns or complaints, these were handled appropriately. Staff meetings and meetings for the people using the service had been held, though records of these were not always available. The management team worked in partnership with others for the benefit of the people using the service.
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 outstanding (published 2 August 2017) Since this rating was awarded the provider has changed its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected: The inspection was prompted in part due to concerns received around staffing levels and the overall management of the service. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led section of this full report.
The overall rating for the service has changed from outstanding to requires improvement. This is based on the findings at this inspection.
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.
Kingly Croft provides accommodation and personal care for up to six people who require support because they have suffered brain injuries or have neurological disabilities. It, and three other services run by Kingly Partnership, are a centre of excellence used by organisations who support people with similar needs. Kingly Croft is a 1920s detached property that has been extensively modernised and adapted for people who use wheelchairs and other specialist equipment. Accommodation is on two floors. People have access to an enclosed landscaped garden.
The service has 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 and associated Regulations about how the service is run.
People consistently experienced care that met their unique needs. People’s lives had been enhanced as a result, often with outstanding outcomes which transformed their lives.
The registered manager, the senior managers and the staff had a strong and visible person centred culture that was at the core of the service. Staff were motivated because they felt supported by a management team they felt inspired them. People using the service felt the benefit of this through their experience of consistently outstanding care.
The provider was an active participant of three regional and national forums, all specialising in raising awareness of brain injury and neurological disabilities. This helped the provider to ensure that care practice was in keeping with the latest research and a ‘flagship’ provider. They had been shortlisted for awards for best service in three different categories in three consecutive years, 2014, 2015 and 2016. The service provided preceptorships for newly qualified NHS occupational therapists.
People using the service felt safe and were protected by effective safeguarding procedures that staff were fully conversant with. Staff also helped people to make choices about how they wanted to be supported and how they spent their time. People were supported to participate in activities that developed and increased their independence. Where those activities included risks these were managed to protect people from injury.
People were supported by sufficient numbers of experienced and professionally qualified staff who understood their needs. The provider had effective procedures for the safe management of medicines.
Staff were well trained and supported by the management team and the directors of Kingly Partnership, all of whom were professionally qualified and specialists in neurological disability who participated in research in that area. People were supported by rehabilitation support workers (RSW) and professional occupational therapists that had extensive professional training about neurological disabilities. People were therefore supported by highly skilled and knowledgeable staff that consistently provided outstanding care.
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 support this practice. The registered manager’s contribution to a complex court case involving the Mental Capacity Act 2005 had been acknowledged in a court’s decision.
People were supported with their dietary and nutritional needs. Staff made special efforts to ensure people had meals they enjoyed. Staff supported people to access health services when they needed them.
Staff were caring and compassionate. They understood people’s needs and developed caring professional relationships with people. They supported people to express their views and took account of what they said. People and their relatives consistently reported that staff were kind and compassionate.
Staff respected people’s privacy and dignity. The provider had policies and procedures that supported this practice.
People received care and support that was focused on their individual needs. The support they received had made a significant difference to the quality of their lives. People had developed skills which dramatically increased their independence as a direct result of the care and support they received.
People knew how to raise concerns and express their views. Their views were acted upon.
People using the service knew what the aims of the service were and they were involved in developing the service. The service was exceptionally well led by the registered manager and senior team of qualified professionals. There were effective procedures for monitoring and assessing the quality of service and there was a commitment to continually improving the service. Feedback we received from a local authority that was that Kingly Croft was a ‘high performing and well led service.’ People’s and relative’s feedback from a recent satisfaction survey rated the service as outstanding.
We inspected the service on 6 January 2015. The inspection was announced because we wanted to be sure that people would be at the service when we visited.
Kingly Croft provides accommodation and personal care for up to six people who require support because they have suffered brain injuries or have neurological disabilities. Kingly Croft is a 1920s detached property that has been extensively modernised.
The service has 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 and associated Regulations about how the service is run.
People using the service felt safe and were protected by effective safeguarding procedures that staff were fully conversant with. Staff also helped people to make choices about how they wanted to be supported and how they spent their time. People were protected from harm but were encouraged to take risks that increased their independence.
People were supported by sufficient numbers of experienced and well-qualified staff who understood their needs. The provider had effective procedures for the safe management of medicines.
Staff were well trained and supported by the management team and the directors of Kingly Partnership. The provider had links with nationally and internationally recognised organisations that were experts in the field of brain injury and neurological disabilities. This helped the provider to ensure that care practice was in keeping with the latest research.
Staff understood the relevance to their roles and responsibilities of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff sought people’s consent before providing care and support and did not practice any form of constraint.
People were supported with their dietary and nutritional needs; and were able to access health services when they needed them.
Staff were caring and compassionate. They understood people’s needs and developed caring professional relationships with people. They supported people to express their views and took account of what they said.
People’s privacy and dignity were promoted because staff had a good understanding of `dignity in care’ and put that into practice.
People received care and support that was focused on their individual needs. People had developed skills and increased their independence as a direct result of the care and support they received. People knew how to raise concerns and express their views. Their views were acted upon.
People using the service knew what the aims of the service were and they were involved in developing the service. The service was well led and organised. The provider took an active interest in the service. There were effective procedures for monitoring and assessing the quality of service. A high quality service was provided.