Background to this inspection
Updated
19 July 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector 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. The Expert by Experience contacted people's relatives by telephone to request their feedback.
Service and service type
Kismet House is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Kismet House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this to plan our inspection.
During the inspection
We spoke with 5 people who used the service and 2 relatives. We spoke with 6 members of staff including the registered manager who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 2 people's care records and 6 people's medicines records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service and quality assurance were reviewed including accident and incident records and audits. We sought feedback from professionals who work with the service.
Updated
19 July 2023
About the service
Kismet House is a residential service providing personal care and accommodation for up to 9 people with mental health support needs. The service consists of an adapted building, which includes individual bedrooms and communal spaces and an accessible outdoor space. At the time of our inspection there were 7 people using the service.
People’s experience of using this service and what we found
People and their relatives told us people were safe with the care and support they received from the service. However, despite positive feedback we found we found shortfalls with environmental risks, medicines management, infection prevention and control and quality assurance systems which placed people at increased risk of harm.
Systems in place to monitor the quality and safety of the service were not fully effective in ensuring shortfalls were addressed.
Medicines were not managed safely in line with national guidance. Infection control measures were not fully effective in minimising risks to people.
The provider had systems in place to assess risks to people before undertaking their care and support. However environmental risks including fire safety were not always safely managed.
Appropriate staff recruitment procedures were in place; however, recruitment records were not always well documented. There was enough staff to keep people safe, people spoke positively of the support they received.
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 had a positive culture, staff told us they felt supported and morale within the staff team was good. People and their relatives told us they were satisfied with the service.
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 October 2017). There was a targeted inspection since this inspection, published February 2021. This did not change the rating.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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 continue to monitor information we receive about the service, which will help inform when we next inspect.