Karibu Place

Updated 25 December 2021

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. As this was a focused inspection we looked at the domains of Safe, Effective and Well-led, rating these accordingly. Where changes to the overall rating were affected due to the three-domain rating, we provided an overall rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by two inspectors, with a site visit taking place on 15 November 2021.

Service and service type

Karibu Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service, including notifications that the provider is legally required to send in ahead of the inspection. In addition, we spoke with health professionals, social services and attempted contact with relatives. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We engaged with three people who used the service and completed observations of three people’s interaction with staff. We spoke with four members of staff including the registered manager, positive support co-ordinator and two agency workers.

We reviewed a range of records. This included two people’s care records, behaviour plans, risk assessments, initial assessments and medicine records. We reviewed the induction of agency staff, staff training records, supervision protocols, team meetings, communication methods, incident analysis amongst other documents. In addition, a variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data analysis and quality assurance records. We spoke with five relatives and a further three staff.

Updated 25 December 2021

About the service

Karibu Place is a residential care home providing personal care to 6 people aged 18 and over at the time of the inspection. The service can support a maximum of 6 people. Each person has their own flat, that consists of a kitchen, living room, bathroom and bedroom. In addition, Karibu Place offers one large communal dining facility, a large garden and an multi-use room that is utilised as a sensory room as well as an activities room. Staffing is based upon the needs of people, with a minimum of 1:1 staffing provided to people in addition to surplus staff on site. Offices are located in one wing of the complex.

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

People were not always protected from the risk of harm by staff ensuring sufficient quantities of medication were on site and administered at the correct times. We made a recommendation about using best practice guidance on medicine management. People were not always protected from the risk of infection as the premises were not always kept clean. We made a recommendation that the provider work with external agencies specifically to manage this issue. The provider did have a re-decoration plan in place that they were working towards implementing. Risk assessments were robust and least restrictive. They encouraged and empowered people to access activities and daily living skills. Incidents were analysed and lessons were learnt to manage similar occurrences. Staff were trained in positive behaviour support as well as all relevant training associated with the social care. Agency staff were not trained in physical interventions training until they had worked at Karibu Place for three months. Although it was unclear if this impacted on people and safety, we did make a recommendation about training.

All aspects of people’s physical, emotional and social needs were assessed, and plans were in place to achieve good outcomes for them. Staff were effectively supported to acquire the required skills and knowledge to support people. All agency staff were given a comprehensive induction that included working in the ethos of the service. We saw evidence of people being supported to eat and drink frequently. Management worked with external health professionals and families to try and ensure people’s care and treatment was in line to their changing needs.

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 management team promoted a caring, person-centred culture where people were at the centre of care delivery. Staff felt supported. The registered manager understood their responsibilities to inform the necessary agencies and people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent reoccurrences. Audits were in place to monitor the service, and focus on how to develop the service on a continuous premise.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

• The model of care focused on using positive behaviour support to ensure people were supported in the least restrictive way and enabled to retain choice. The flats were designed to promote people’s independence and control of the environment.

Right care:

• We saw evidence of documentation that was person centred care, that promoted people’s dignity and human rights. We observed that some areas of care were reflective of promoting right care. The management were seeking assistance from external health providers to support them in this area.

Right culture:

• People were encouraged to engage with the community, and access services and provisions that empowered their lives and promoted inclusivity.

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 08 March 2019).

Why we inspected

The inspection was prompted in part due to concerns received about areas of concern in relation to poor care and treatment, that placed people at risk. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.