Archived: Kenilworth

Kenilworth is a care home providing accommodation and personal care for up to six people with a learning disability or autism. At the time of our inspection six people were living at the service.

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 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Records within the service were not always contemporaneous. We found people’s activities had not been recorded robustly, a person’s needs had not been reflected in their support plan and some staff rotas were blank. We have issued a recommendation to the registered provider in this respect.

People lived in an environment which was in need of redecoration and we observed poor moving and handling practices. The registered provider responded to our feedback in relation to these identified concerns.

People received the medicines they were prescribed and staff supported people to access healthcare professional support and treatment when needed. People’s rooms were individualised and suitable for their needs and people could have privacy when they wanted it.

People had food and drink sufficient for their needs and staff adhered to any specific guidance in place for people with regard to their diet. People were encouraged to be independent and carry out daily living tasks. Staff treated people with respect and care.

People attended activities of their liking and were encouraged to maintain relationships important to them. Relatives were happy with the care their family member received at Kenilworth. People were cared for by staff who underwent training and felt supported in their role.

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.

The service worked with eternal agencies to meet the changing needs of people and staff and relatives felt involved in 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 Good (report published 5 July 2017).

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 inspection took place on 2 June 2017 and was unannounced.

There was a registered manager in post. 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. The registered manager assisted us with our inspection.

We last inspected Kenilworth in May 2016 where we found the registered provider was in breach of two regulations. These related to assessing people’s capacity to make decisions and the submission of statutory notifications to CQC. Following this inspection the registered provider sent us an action plan outlining how they planned to address these areas. We carried out this inspection to check whether appropriate action had been taken and we found it had.

The registered manager understood their legal requirements and submitted statutory notifications to CQC when necessary. Staff understood the need to assess people’s mental capacity to make decisions and they followed the requirements of the Mental Capacity Act (2005) in this respect.

People lived in an environment that staff helped ensure was safe for them. People’s individual risks had been identified and information and guidance was available for staff. Staff had a good knowledge of their responsibilities in relation to safeguarding and the registered provider carried out appropriate checks on prospective staff to help ensure they were suitable to work in the home.

People were supported by staff that had the skills and experience they needed to provide effective care. Staff had an induction when they started work and access to ongoing training, supervision and support. Staff had medicines training and we found medicines were stored appropriately and people received the medicines they required. Accidents and incidents were recorded. We found very few incidents had taken place.

People were involved in choosing the food they ate and the menu we saw demonstrated staff endeavoured to ensure people ate a wide range of foods. People were supported and encouraged to participate in the cooking or the preparation of their own drinks.

People’s healthcare needs were monitored effectively and people were supported to obtain treatment if they needed it. Referrals were made to healthcare professionals if staff identified concerns about people’s health or well-being.

Staff were kind and caring, treated people with respect and they were attentive to people’s needs People had developed positive relationships with the staff who supported them and they enjoyed their company. There was sufficient staff employed in the home to help ensure people did not have to wait for support.

Support plans had been developed which detailed the support people required and how they preferred their care to be provided. These were reviewed regularly to help ensure they contained the most up to date information about people.

The range of activities available to people had increased since our last inspection. People had opportunities to take part in in-house activities and outings to places of interest. More individualised activities had been arranged for people and staff continued to think of different ways to keep people occupied.

There was an opportunity for people to complain should they feel they need to and the registered manager had instigated a compliments book which visitors could contribute to. We found no complaints had been received, but there were several compliments. Relatives felt involved in the running of the home and although regular house meetings were not held with people, they had the opportunity to give feedback in their own individual way through their keyworker meetings.

Staff told us the registered manager was approachable and supportive. Staff told us the registered manager was always willing to listen to ideas and put them into practice if they could be shown to improve people’s care. Staff enjoyed working at Kenilworth and felt they offered a personalised, caring service for people.

The provider had effective systems of quality monitoring and improvement. Key areas of the service, such as infection control, health and safety and medicines management, were audited regularly to ensure appropriate standards were maintained. The provider’s regional manager carried out monitoring visits and produced reports of their findings. Where shortfalls were identified through the quality monitoring process, there was evidence that action had been taken to address them. In the event of an emergency staff had undertaken fire safety training so would know how to evacuate people safely.

This inspection took place on 4 May 2016 and was unannounced.

There was a registered manager in post at the time of our inspection. 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. The registered manager helped us with the inspection.

Although the registered manager was able to describe to us the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) some decisions had been made for people without following the legal requirements. DoLS authorisations had been submitted where restrictions were imposed to keep people safe. For example, in relation to the locked front door.

The registered manager was not aware of their statutory requirements in relation to notifying CQC of important events. People were not always supported to be involved in the running of the home as regular house meetings did not take place and although the registered manager told us there was a meeting in December 2015 they were unable to locate the minutes. The registered manager provided us with evidence following our inspection that a meeting had taken place.There was a complaints procedure in place for people.

Although people had their own individual activities planner, we found that they did not always attend the activities they should do. More individualised activities were needed to help ensure people spent their leisure time in a meaningful way.

People were kept safe because staff understood their responsibilities should they suspect abuse was taking place. Risks to people’s safety had been assessed and measures had been put in place to mitigate these risks. People received the medicines they had been prescribed and medicines administration and management was carried out in a safe way. There were enough staff on duty to meet people’s needs. The provider’s recruitment procedures helped ensure that only suitable staff were employed.

People received their care from staff who were supported through supervision and had access to relevant, on-going training. Staff felt the home was well-managed and said the registered manager was approachable and listened to them.

People’s nutritional needs were assessed and any dietary needs were identified and people provided with appropriate foods. Staff enabled people to make choices about what they ate and people were encouraged to get involved in making their own meals. People were supported to maintain good health and to access healthcare professionals when they needed to.

Staff were kind and caring. They treated people with respect and supported them in a way that maintained their privacy and dignity. People were supported to maintain relationships with their friends and families.

People’s needs were assessed before they moved into the home and their care plans reflected their individual needs, preferences, likes and dislikes. People received care from staff who had access to guidance and person-centred information about the person.

The provider had a system of quality monitoring, which helped ensure that all areas of the service were working well. Relatives were invited to give their feedback on the care their family members received and staff had regular staff meetings so they could participate in the running of the home.

During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. We also made a recommendation to the provider. You can see what action we told the provider to take at the back of the full version of the report.

People who used the service had limited capacity and very little or no verbal communication so were not directly involved in this inspection visit. They were whoever welcomed by staff to join the inspection at any time they wanted to or felt comfortable with.

We saw that everyone receiving a care from the service had an assessment of their needs undertaken before a care was offered. This was to ensure that people's assessed needs could be met and that the service had the staff with the relevant skills and qualifications to meet these needs.

Care plans were based on the needs assessment that had been undertaken prior to admission and were reviewed regularly.

We saw the service had adult protection policies and procedures in place known as safeguarding. These demonstrated how the provider identified potential abuse and prevented abuse from happening for the people who used the service.

There were sufficient numbers of bathrooms and toilets for the people to use. We found that some of these had been adapted to provide assistance for people that had been assessed with mobility needs. Where areas of concern were identified regarding the environment the registered manager and the staff team acted in a responsive manner and ensured that the provider was aware and maintaince planned accordingly.

The provider had an established quality assurance (QA) program in place. We looked at the provider's QA system and found that there was a range of monitoring processes in place that enabled the provider to respond to issues of quality and risk.

We conducted a random telephone survey of three family members of the people who lived at the service. The relatives told us that their relative was "fully supported by the staff at Kenilworth" and that the staff always try to "get people to do things for themselves and because they know them so well they understand people abilities" and that everyone was treated with "respect, encouraged and supported to participate in the home".

People have their needs appropriately assessed and their care and treatment was planned and delivered in line with their individual care plan.

One family member to us told us that their relative received an "exceptional service at Kenilworth and they are supported in a safe and appropriate way".

A relative of one person who lived at the service told us that they have "great faith in the staff, they are very competent at looking after the people who live their" and they understand the "complexities" in dealing with safeguarding the individuals at Kenilworth.