Kingsley House

Updated 21 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by an inspector, a member of the medicines team and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Kingsley House is a ‘care home’. People in care homes receive accommodation and nursing or 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave 24 hours’ notice of the inspection as this is a servcie for people with Autism who may find people coming into their home difficult and need some time to process our role.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection-

We spoke with the registered manager, deputy and six staff. We observed people in their own environment and spoke briefly with a few of those. We sat in on one person’s annual review meeting. We looked at medicine records, three care plans and risk assessments, three staff recruitment records and a number of audits relating to records and safety audits.

After the inspection –

We sought feedback from people’s relatives and most people were unable or unwilling to give their views. We received feedback from three and had phone calls from two. We sought feedback from seven professionals and received feedback from five.

Updated 21 January 2020

About the service

Kingsley House is a residential care home providing personal care and support for up to 19 younger adults who have autism and a learning disability. At the time of the inspection there were 11 people living at the service with no plans to expand this number.

Kingsley House was formerly a special needs school. It is a large site with a number of buildings which allows people to have their own self contained house or flat as well as communal space and large grounds.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 19 people. Ten people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design meaning people had their own self-contained flats or houses. 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

People experienced exceptionally responsive care and support from staff who were dedicated to ensuring people had fulfilling and engaging lives. Some of the people living at Kingsley House had experienced a number of unsuccessful placements before living here.

Without exception relatives and professionals agreed that Kingsley House offered people a high standard of care which was truly personalised and ensured people were afforded a person-centred approach which met their needs and wishes.

Staff were skilled and experienced at understanding people’s complex behaviours, rituals and ways of communicating. They spoke passionately about people’s achievements and progress to be independent. This was key to providing a successful and fulfilling lives for people.

The management team and staff genuinely cared for the people they were supporting. They advocated for them at every opportunity. They were there for them and their families at point of admission, when needing to transfer to hospital or at the end of their lives. They had recently achieved a national accredited training in end of life care. They had been commended for the effort they had put into ensuring one person could receive hospital treatment which was not thought previously possible to achieve.

People were valued and placed at the centre of the service. Staff promoted their privacy and dignity, enabling them to make choices and have as much control and independence as possible. The service used a variety of methods to facilitate this including supporting people with communication, assistive technology, providing information in an accessible format and a consistent staff team who knew people extremely well.

People’s holistic needs were very well met by a staff team who were well-trained and understood the ethos of ensuring person centred care. The provider ensured the staffing ratios remained high so the best possible care and support could be provided. Each person had their own core team of staff which ensured a consistent approach.

People received their medicines in a safe and timely way. Staff worked in the least restrictive way with people and this included ensuring any calming medicines were used only when needed, and once other avenues had been explored.

Staff understood about abuse and robust recruitment processes ensured only staff who were suitable to work with people who may be vulnerable were recruited.

The management team demonstrated an open and transparent management style and were fully engaged with people and staff at the service. Robust quality assurance systems ensured the continued quality and safety of the service and continued to drive improvement. This ultimately improved the outcomes for people living at Kingsley House.

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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 (published 9 June 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.