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Inspection carried out on 7 November 2017

During a routine inspection

Kilkenny House is a sheltered housing with care scheme, registered to provide personal care support for older people. At the time of our inspection there were 29 people receiving care and support.

At the last inspection, on 14 October 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff understood their responsibilities to keep people safe from harm. Safeguarding procedures were in place and staff understood their duty to report potential risks to people’s safety.

People received their medicines as prescribed and risk assessments were in place to manage risks within people’s lives. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

Staffing levels ensured that people's care and support needs were safely met and safe recruitment processes were in place.

Staff induction training and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to perform their roles. Staff were well supported by the registered manager and senior team and had regular one to one supervisions.

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 supported people to access support from healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure people received coordinated and person-centred care and support.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

The provider had systems in place to monitor the quality of the service as and when it developed and had a process in place which ensured people could raise any complaints or concerns.

During the inspection we were made aware of on going environmental fire safety concerns at the service. People using the service were receiving a personal care service and had separate tenancy agreements for their accommodation. Therefore, the accommodation provided to people is not regulated by the Care Quality Commission. We contacted the local fire authority, who was already aware of the concerns. Temporary measures had been implemented to mitigate the current risk to people and the provider was working with the housing provider and the fire authority to develop a long term solution.

Inspection carried out on 14 October 2015

During a routine inspection

Kilkenny House is registered to provide support for older people who require personal care and support in their own homes to enable them to retain their independence. The service is provided within an extra sheltered housing scheme and people receive domiciliary care support from care assistants based at the service. It is registered for up to 49 people. On the day of our visit, there were 34 people receiving care and support.

The inspection was announced and took place on 14 October 2015.

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 felt safe and were protected from abuse by staff that had a good understanding of how to identify abuse, and knew how to respond appropriately to any concerns to keep people safe.

Specific and general risks to people’s safety had been assessed and were detailed clearly within their care plans. Staff used these to assist people to remain as independent as possible.

There were sufficient staff members on duty to support people with their required care needs. Staff had been recruited using a robust recruitment process.

Safe systems and processes were in place to ensure that medicines were handled, administered and disposed of safely.

New staff received a robust induction to the service to help them prepare for their role and responsibilities. Staff were also provided with a variety of training, based upon people’s needs, to help them to carry out their roles effectively. They had regular supervision meetings with their manager and annual appraisals to support them to meet people’s needs.

Policies and procedures were in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that people who could not make decisions for themselves were protected.

People’s dietary requirements had been assessed. They were supported to make menu choices and encouraged to be independent in meal preparation if this was appropriate.

Prompt action was taken in response to illness or changes in people’s physical and mental health. When required, staff supported people to attend healthcare appointments, if they could not be supported by relatives.

Staff treated people courteously, with kindness and compassion. They provided care and support based upon assessed needs. Staff had a good awareness of people’s preferences and worked with them to ensure that effective care was provided.

People were supported to take part in meaningful activities within the sheltered housing scheme. Staff undertook baking and arts and crafts and also provided an on-site shop for people to use.

People knew how to make a complaint if they needed to, and were confident that the service would listen to them. The registered manager investigated and responded to people’s complaints in accordance with the provider’s complaints procedure.

The registered manager, operational manager and senior staff consistently monitored and reviewed the quality of care people received. The service encouraged feedback from people and their representatives. This was then used to identify, plan and make improvements to the service.

Inspection carried out on 16 June 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service had risk assessments in place to enable them to be as independent as possible. Generic risk assessments were also available to protect staff. These included use of kitchen equipment and general health and safety.

People who used the service told us staff always knocked on their doors and asked for consent to carry out any activity.

Is the service effective?

People had been involved in the planning and reviewing of their care plans and had signed to consent to this.

Staff had received appropriate training to enable them to carry out their roles effectively.

Is the service caring?

People were supported by staff who were knowledgeable of, and responsive to, their needs.

We observed positive interactions between staff and people who used the service.

One person we spoke with told us, �I could not be anywhere better.�

Is the service responsive?

People�s care plans were reviewed regularly, and updated when required.

Customer satisfaction surveys had been sent out to people who used the service. Results were recorded and any actions needed followed through in order to drive improvement.

People we spoke with told us that if they pressed their alarm button, staff arrived immediately. This was observed during our inspection.

Is the service well led?

There was a registered manager in post, who was supernumerary to the staff rota. They were supported by a staff team.

There were robust quality monitoring processes in place.

People, who used the service, and staff, were asked for their opinions and we saw that these had been acted on where appropriate.

Inspection carried out on 14 August 2013

During a routine inspection

We spoke with approximately 20% of the 32 tenants who received domiciliary care support at Kilkenny House at the time of inspection. With their prior agreement we met and spoke with seven tenants in six flats within the sheltered housing complex and we asked them to tell us about their experience of receiving a service.

All the tenants we spoke with told us they received a very good standard of care and support from the care assistants. They all said that without the domiciliary support they received they would not have been able to enjoy the independence of remaining in their own flat.

One tenant commented, �The help I receive is marvellous.� Another tenant said, �Without their help I would never manage. Having my own flat is so important to me. I can rely upon them.�

We found that the domiciliary support provided to tenants living in the flats at �Kilkenny House� was effective, safe, and was provided by a team of conscientious and competent staff.

Inspection carried out on 19 February 2013

During a routine inspection

We spoke with five people that used the service. They were all happy with the service. One person told us "It's lovely, I can't speak highly enough of it". Another person told us "There a smashing lot of carers".

We spoke with two staff members who enjoyed their roles and felt well supported.

We saw that people's needs had been assessed and a care plan put in place to ensure that they were met. We saw that people were involved in decisions about their care plan. We found that where risks had been identified that risk assessments had been carried out.

We saw that there were staff based at Kilkenny House throughout the 24 hour period and that people were able to call them if they needed to. We found that the provider calculated the total care hours required and ensured that staffing hours were adequate to met them.

We had concerns about the medication disposal records kept by the service especially those relating to controlled drugs.

Inspection carried out on 20 January 2012

During a routine inspection

People told us that someone from the service had visited and assessed their needs before they received a package of care and support.

People we spoke with confirmed that they were treated with respect and their dignity was maintained. They said that they were satisfied with the standard of care provided and were of the opinion that staff understood their needs. They told us that the staff treated them as individuals and respected their views and choices. They said that they were consulted with about any changes to their care and support and were able to make decisions and contribute to the care planning process.

Systems were in place to offer protection to the people who use the service from abuse. The people we spoke with confirmed that they felt safe and had no concerns regarding the

care provided.