Kirkgate House - Care Home

Kirkgate House - Care Home is a residential care home providing accommodation and personal care to people with a learning disability and/or autism. At the time of the inspection 28 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 ensured 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.

The provider recognised the service does not meet best practice guidelines in relation to the size of the service. They had adapted the environment to try to overcome this challenge, to enable people to have their own smaller self-contained areas. There were five areas to the property, one which included two bedsits for people. Each area had its own lounge, kitchenette and front door, which people had their own key fobs to access. Downstairs there were communal areas where people could choose to spend time if they wished. This included a lounge, dining area and the registered manager’s office. The size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Staff provided extremely person-centred support which helped people to achieve many positive outcomes. A wide variety of activities were organised based on people’s interests and hobbies, as well as encouraging socialisation amongst people, their relatives and the local community.

Staff used an innovative approach to technology which had a highly positive impact and promoted people’s independence. Technology was also used in the service to enable people to have experiences they may not otherwise be able to participate in, such as going on a simulated roller coaster and swimming with sharks.

The provider used individually tailored ways to ensure people’s communication needs were fully met. The registered manager put great emphasis on all members of the staff team being able to communicate effectively with people, irrelevant of their job role. Aids and adaptations were used to ensure people’s privacy was maintained.

The management team demonstrated a commitment to providing very person-centred, high quality care. We received consistently positive feedback from people, their relatives and staff about the registered manager. The staff team were fully supported which motivated them in their role. Health professionals were consistently positive about the service and their working relationship with staff.

The staff fully supported people to live healthier lives. They had recently started a ‘Healthy Initiative’ which included healthy eating and exercise. This had a positive impact on people’s wellbeing. The staff worked in partnership with healthcare professionals to ensure people’s health care needs were met. Staff were knowledgeable; all members of the staff team were empowered by participating in training outside of their specific job roles. People’s end of life wishes had been explored with them, and staff provided highly sensitive and emotional support to people regarding death and bereavement.

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.

People were involved in the recruitment of their staff and safe recruitment practices were followed. Staff were competent in ensuring people received their medication as prescribed. The service was clean and tidy, and staff supported people to be fully involved in the upkeep of the service.

Staff were kind and caring. There was a consistent staff team that knew people well. They ensured people’s independence was encouraged.

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.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 6 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.

Kirkgate House – Care Home is situated on the edge of the town of Bridlington in East Yorkshire with easy access to the town centre and transport links to other towns and cities in the county. It is a purpose built premises, which can accommodate up to 28 people all in single bedrooms. The premises have been modelled to house people in units and each unit has its own kitchen, lounge, activity area and bathroom. There are also two self-contained flats. The service specialises in care for people with a learning disability. At the time of the inspection there were 28 people using the service, most of whom had lived at Kirkgate House – Care Home for many years.

The registered provider is required to have a registered manager in post. On the day of the inspection there was a registered manager that had been in post for the last six years. 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.

People had excellent opportunities to engage in occupation, pastimes and activities if they wished to in order to lead fulfilling lifestyles and to develop their potential. They were empowered to engage in the local community as citizens and to take part in innovative ways of having their needs met.

People’s relationships were extremely well supported and encouraged so that people had very good family connections and support networks. All of this meant that people had an enhanced sense of wellbeing and an exceptional quality of life.

We saw that people were supported according to their detailed and person-centred support plans, which reflected their needs well and were regularly reviewed.

There was an effective complaint procedure in place and people had their complaints investigated quickly and without bias.

We saw that the service was well-led and both the culture and the management style of the service were positive, progressive, approachable, inclusive, open and honest. The management team and staff were powerful role models for people with regard to learning and developing life skills and engaging and being active in the community. This had been the case for many years.

There was a 'bespoke' and effective system in place for checking the quality of the service provided using audits, satisfaction surveys, meetings and a pledge to provide a high-quality service via the organisation's SHINE initiative, which underpinned the visions and values and put people at the heart of the service.

Recording systems used in the service and practices in handling information protected people's privacy and confidentiality. Records were well maintained and held securely on the premises.

People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns.

Risks were managed and reduced on an individual and group basis so that people avoided injury or harm wherever possible.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this.

Staffing numbers were sufficient to meet people’s need. Recruitment policies, procedures and practices were carefully followed to ensure staff were suitable to support vulnerable people.

We found that the management of medicines was safely carried out.

People were cared for and supported by qualified and competent staff that were regularly supervised and had their personal performance annually appraised by an equally qualified and competent management team. Communication was effective and people’s mental capacity was appropriately assessed and their rights were protected.

Employees of the service had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves.

The registered manager was able to explain how the service worked with other health and social care professionals and family members to ensure a decision was made in a person’s best interests where they lacked capacity to make their own decisions.

People were provided with the nutrition and hydration they needed to maintain their health and wellbeing. The premises were suitable for providing care and support to people with a learning or physical disability and action was being taken to ensure the environment was appropriately adapted to meet the needs of those people that had been diagnosed as living with dementia.

People were compassionately supported by staff that were kind and knew about people’s needs and preferences. People were involved in all aspects of their care and were always asked for their consent before staff undertook care and support tasks.

People’s wellbeing, privacy, dignity and independence were monitored. This ensured people were respected and enabled to take control of their lives.

People were supported and encouraged to maintain a healthy diet. People we spoke with were complimentary about the food provided at the service. One person told us 'The food is good.'

Each person's medicines were stored in a locked, wall mounted cabinet in their own rooms. This helped to promote a person centred approach to supporting people with their medication. We checked the arrangements for the ordering, storage, handling, administration, recording and disposal of medicines and found appropriate arrangements were in place.

Appropriate recruitment policies were in place to check that people working at the service did not present a risk to people who lived at the service.

The provider had effective systems in place to check on the quality and safety of the service people received at Kirkgate House.

Records were accurate, fit for purpose and were stored securely.

People's consent to care was gained and we saw evidence that people received the care they needed. Staff had training in the Mental Capacity Act (2005) and Deprivation of Liberty safeguards (DoLS) to ensure people's rights were protected.

We saw up to date plans of care which considered individual physical, emotional and mental health care needs. We saw risk assessments and that all documentation was kept up to date to ensure people had their changing needs met. We saw that the home consulted with specialists to make sure people had the benefit of expert advice.

People were protected from harm and the risk of harm through staff training and risk assessments. The service also referred safeguarding incidents to the local authority and to the Care Quality Commission as required.

We saw that the home had an effective system to assess and monitor the quality of service.