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We are carrying out a review of quality at Katherine House. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 17 August 2020

During an inspection looking at part of the service

About the service

Katherine House is a care home providing personal care and accommodates nine people in one adapted building. On the day of the inspection, the service was providing care and support for eight people who have a learning disability and behaviours that challenge others.

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

Care and treatment was not always provided in a safe way. The providers systems failed to identify risks to people or if risks were identified they were not managed effectively.

Systems in place failed to safeguard people from the risk of abuse. Support for staff to carry out their role was not effective.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes. Systems in place to manage the control of infection were not robust and did not always follow current government guidance in relation to COVID19.

People received their medicines when needed.

There was a lack of provider oversight which meant risks to people’s safety had not been responded to appropriately. Systems to monitor the quality and safety of the service were ineffective and placed people at the risk of harm. The systems in place failed to identify the areas for improvement found at this inspection.

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 Good (Published February 2018 ).

Why we inspected

The inspection was prompted due to whistleblowing concerns raised with us. These concerns related to people's care and their safety. A decision was made for us to inspect and examine those risks.

We reviewed the information we held about the service. We only looked at safe and well led during this inspection. We did not look at the key questions of effective, caring and responsive. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Inadequate. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Katherine House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified three breaches in relation to safe care and treatment, safeguarding and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our en

Inspection carried out on 5 January 2018

During a routine inspection

This inspection took place on 5 and 8 January 2018 and was unannounced. At our last inspection of the service on 6 October 2015, the service was rated as ‘Good’ in all questions asked.

Katherine House is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Katherine House accommodates nine people in one adapted building. On the day of the inspection, the service was providing care and support for nine people who have a learning disability and behaviours that challenge others.

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.

There was 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 supported by staff who had received training in how to recognise signs of abuse and were aware of what actions they should take should they suspect someone was a risk of harm. Staff were aware of the individual risks to people and how to best to support them and manage those risks.

Staff were safely recruited and systems were in place to ensure the skill mix on each shift was able to meet the needs of the people being supported. Systems were in place to ensure people received their medicines as prescribed by their GP and staff competencies in this area were checked.

Systems were in place to protect people from the spread of infection. Where accidents and incidents took place, they were investigated and where appropriate lessons were learnt and actions taken.

People’s care, health and social well-being were part of a pre-assessment process that provided staff with the information required to meet their needs effectively. Staff were provided with an induction and regular training to ensure they had the skills and knowledge to support people. Systems were in place to monitor staff learning and to ensure that training provided, was put into practice.

People were supported to maintain good health and access a variety of healthcare services. Choices were routinely available at mealtimes and picture cards were in place to assist people in making those choices.

Staff routinely obtained people’s consent prior to offering support. 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 were described as kind and caring and were respectful in their dealings with people. People communicated with staff in a variety of ways and systems were in place to ensure information was available to people in a format that they understood.

People were supported and encouraged to regain and maintain their independence and do as much for themselves as possible.

People contributed to the planning of their care, providing staff with the information required to help meet their needs. Care plans identified people’s strengths and aspirations and how people were to be supported to achieve their goals.

Where complaints were raised, they were investigated and responded to accordingly and where appropriate, lessons were learned. People were confident that if they did raise concerns they would be listened to and action would be taken.

People considered the service to be well led. The registered manager and project manager were well thought of by peo

Inspection carried out on 06 October 2015

During a routine inspection

This inspection took place on 6 October 2015 and was unannounced. It was undertaken by two inspectors.

Katherine House is a residential care home registered to provide personal care to people who have a learning disability and behaviours that challenge others. On the day of the inspection, the home was providing care for nine people. The home has three floors which are only accessible by stairs. Each room is single occupancy.

Katherine House is required to have 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 2008 and associated Regulations about how the service is run.

On the day of the inspection that there were adequate numbers of staff on duty.

People told us that they could speak with the staff if they had any concerns or did not feel safe. Family and professionals also stated they felt the staff looked after the safety of the people who used the service.

People were protected from abuse and avoidable harm because the provider had effective systems in place. There were risk assessments in place to identify any potential risks associated with peoples care. Staff had the skills and knowledge to manage these risks and made sure people were kept safe.

Staff were recruited using robust procedures and only after appropriate checks were completed.

Systems were in place to make sure people received their medicines safely.

Staff ensured that consent was obtained and people were involved in their day to day care. Appropriate actions were taken to ensure any restrictions in place on people’s movements were done in their best interests.

Staff received the training and support they needed to carry out their role effectively.

People were encouraged and supported by staff to maintain a healthy diet. People were supported to attend their appointments with health care professionals.

We observed positive interactions between the staff and people who used the service. Staff worked with people in a respectful, caring and informal way.

Staff knew people well and responded to people’s needs. People were supported to participate in their hobbies, individual and group activities as well as work placements.

A complaints procedure was in place and available for people in a number of different media formats including in pictures and audio tape so that it was accessible to people.

We saw that there were systems in place to monitor the quality of the service, and quality audits were undertaken by the manager and senior manager of the service.

Inspection carried out on 16 January 2014

During a routine inspection

At the time of our visit there were eight people living in the home. Due to the complex needs of the people living at the home they were not all able to give their views about the service provided. We were able to speak with two people in some depth and briefly to another two. We also spoke with the manager and four staff and observed how people were being cared for.

We saw that people were able to make choices and decisions about their care and treatment. People were asked to consent to what was happening in their lives and before any care was given.

Staff were aware of people's needs and plans were in place to deliver care in a personalised way. People's health care needs were met through community health services. There were systems in place to identify and manage risks to keep people safe.

People were supported to take part in a variety of activities in the home and the local community which meant that they led fulfilled lives. One person told us, ‘‘I am going to bingo tonight.’’ Another person told us they were going to watch some television and do some internet shopping.

Systems were in place to ensure only the appropriate people were employed to work at the home.

There were systems in place to ensure people’s views were listened to and acted on. Systems were in place to monitor the quality of the service.

Inspection carried out on 23 November 2012

During a routine inspection

People told us that they were able to make choices about their daily living. We saw that people living at the home were able to maintain their independence and were involved in community activities.

Everyone living at the home that we spoke with said that they liked living there. We saw that people received the care and support they needed to help them live full and independent lives. One person told us,” I like living here.”

People told us that if they were worried about anything they would tell the staff. One person told us, “If I was worried about anything I would tell X, she is pretty good.” We saw that systems were in place to ensure that people were safeguarded from abuse.

People told us that they liked the staff that supported them. We found that staff were trained and supported to deliver care and treatment safely and to an appropriate standard.

People said that they were able to raise any concerns they had with staff. We found that there were systems in place to investigate and respond to people's complaints.

Inspection carried out on 24 May 2011

During a routine inspection

People who live in this home told us that they like living there. People told us they take part in a range of activities. They said, �, �I like the food���I say what I want���I can choose�� �I like it here���I go to bingo��I like my art classes�. People looked happy and comfortable.

Relatives of people who live in this home told us that they feel their relatives are well cared for and the staff communicate well with them.

Social workers who placed people at this home told us, �They communicate well���they have managed x well���communication with the unit is effective���at a recent review (parents) informed they were pleased with the placement and the support provided for X�.

Reports under our old system of regulation (including those from before CQC was created)