Archived: Kathleen House Flat

• Kathleen House Flat is a residential care home that was providing personal to two people with a range of needs including learning disabilities and challenging behaviour at the time of the inspection.

• 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.

People’s experience of using this service:

• The provider was not working within the principles of the Mental Capacity Act and Deprivation of Liberty Safeguards when service users lacked capacity to make specific decisions. The provider’s governance and oversight systems had failed to identify this and meant service users rights were not always upheld and protected.

• The provider’s systems, processes and records in place for decisions taken in relation to care and treatment of people were not always effective.

• The registered manager understood their legal requirements within the law to notify us of all incidents of concern, deaths and safeguarding alerts. The registered manager was open and honest.

• People were safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had enough staff to support people safely. People received their medicines as prescribed. Staff followed infection control guidance and had access to personal protective equipment.

• People’s nutritional needs were met and they received enough to eat and drink to ensure they had a healthy diet. People accessed health care when needed.

• People received care from staff who were kind and caring and knew them well. Staff were patient and empathetic and had built good relationships with people. People's privacy, dignity and independence were respected by staff.

• People continued to receive care that met their needs. People's support needs were assessed regularly and planned to ensure they received the assistance they needed. People's support was individualised. People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaints process to share any concerns.

Rating at last inspection:

• Rated Good overall (report published 21/05/2016)

Why we inspected:

• This was a planned inspection based on the rating at the last inspection.

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Kathleen house flat is registered to provide accommodation for persons who require personal care for up two people on a ‘respite basis’. Respite means that people are supported in a care environment rather than by family or friends for short periods of time. People use the service for varied amounts of time. Some people use it a few times a year; others regularly for evening and overnight support, and some people use the service whilst their main carer went on holiday. The remainder of the time people live with their families in the community. The service is provided in a ground floor flat which has two bedrooms. People who use the service have a range of needs which include learning disabilities, physical disabilities and autistic spectrum disorder. The provider has another residential care home that provides respite and the staff work at both locations.

At the time of our inspection there was one person due to use the flat at the weekend. However this person then cancelled their visit. We were told that the flat would not be used for several weeks. Therefore we were unable to meet people using the service, but we did speak to family members of people who had used the service recently in order to gain feedback about their experiences.

There was a registered manager in post and she was present during 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.

Staff had an understanding of potential abuse and knew how to protect people from the risk of harm. Risk assessments were in place to maintain the safety of the people who used the service.

Staff had been trained to administer medication and systems were in place to assist people to have their medication as prescribed.

Recruitment procedures were in place to ensure suitable staff were employed. We found that gaps in staff members’ employment were being addressed.

Staff had a good knowledge of people’s needs and preferences. Relatives described the staff as kind and caring.

The staff had received the training they required to equip them with the skills they needed to support the people who used the service.

The registered manager understood the requirements of the Mental Capacity Act (MCA) and was currently completing the required documentation to ensure people received care in line with their best interests.

People were encouraged to make decisions about their care. If they were unable to, their relatives were involved in how their care was planned and delivered.

The staff supported people with their nutrition and dietary needs to maintain their health.

People were offered and enabled to engage in recreational activities that they enjoyed and met their preferred needs.

Complaints systems were in place for people and their relatives to raise their concerns or complaints.

Relatives were satisfied with the service provided. Feedback was being sought from relatives about the service provided to their family member.

Improvements were required to ensure audits were undertaken to monitor the service provided and to see if any changes or improvements were needed.

We found that the provider had a system in place to identify the support needs of people. We observed how staff communicated and supported people. One relative said, "I was involved in the care planning process and I get invited to the reviews".

The provider had a policy in place to ensure people were supported appropriately and kept safe from harm. One relative said, "I do feel X is safe".

The provider had systems in place to monitor the quality of the service people received.

We spoke with relatives who said that they had been involved in planning people's care. One said, 'There is constant communication between us and the service'.

We saw care and support being given in a friendly and professional manner. We were told by relatives that staff provided care whilst promoting the independence of people. A staff member said, 'I wouldn't do it for them if they can do it themselves'.

Kathleen House Flat was a modern ground floor two bedroomed property that had a suitable design and layout for the people using it. We saw that it was secure and well maintained.

Kathleen House Flat usually provided a service to people with complex needs on a one to one staff member to person basis. Staff were selected for work at the location only if they had received specific training relevant to the person using the service.

People knew how to make a complaint should the need arise. The provider maintained a log of complaints and the actions taken to resolve them.