Kingsdown House

Updated 10 May 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three inspectors, including a member of the CQC medicines team carried out the inspection.

Service and service type

Kingsdown House 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. When we visited on the first day of inspection 25 January 2022, we found the service had an outbreak of COVID-19. We inspected the area of infection prevention and control on the second day, 26 January 2022. A manager from one of the provider’s other services was present during this. We then paused the inspection until the COVID-19 outbreak had ended and we returned on 8 February 2022 to continue the inspection, ending on 10 February 2022. The registered manager was present for the rest of the inspection.

What we did before inspection

We asked for feedback about the service from local authority commissioners and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

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 reviewed the information the provider had sent us, such as notifications of significant events the provider is obliged to send without delay. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke/communicated with three people who used the service and two relatives about their experience of the care provided. We spent time with all the people living at Kingsdown House in the communal areas on each day of the inspection, observing their day and how they communicated and interacted with staff. This helped us to understand their body language and limited verbal/nonverbal communication when seeking feedback.

We spoke with seven members of staff including the registered manager, senior support staff and support workers.

We reviewed a range of records. This included six people’s care records. We reviewed nine medicine administration records. We looked at three staff files in relation to recruitment and staff supervision. 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 and quality assurance records.

Updated 10 May 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Kingsdown House provides accommodation and personal care for up to nine people aged between 18 and 65 years, who have a learning disability and autism. At the time of our inspection, there were nine people living at the service. The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However, the negative impact of the size of the service on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size nearby.

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

Right Support

Although staff knew people well and we saw good interaction between them, there were shortfalls in the running of the service. This meant people could not be assured they would always receive the right support which would help them to reach the best possible outcomes. Medicines were stored and managed safely within the service, however there were some issues with the prescribing of medicines which resulted in one person receiving an out of date medicine on multiple occasions.

Right Care

Staff were caring, knew people well, and were able to describe how they supported people to maintain their independence. We saw this in practice. However, the provider’s processes to learn lessons and continuously improve did not ensure that people would always receive the right care.

Right Culture

People told us they were happy living at Kingsdown House, and we saw from our time inspecting that people appeared happy and content. However, the provider did not promote a culture of person-centred support that focused on clear outcomes and putting people first. There were maintenance and furniture replacement concerns that had not been addressed in a timely manner.

There were insufficient staff, so people did not always get the support they needed, and staff told us they were tired. A process was not in place to monitor incidents and check for trends so improvements could be made to benefit people.

People were not always protected against risks associated with their care and support. The provider did not ensure there was robust auditing to review and improve the quality of care.

People received the right support to follow a healthy diet and to choose their meals and when they ate. Staff supported people to access the health care they needed to maintain and improve their health and well-being.

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

Why we inspected

This is the first inspection for this newly registered service. We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture.

The last rating for the service under the previous provider was good, published on 16 November 2018.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. 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.