Kirtling House

Kirtling House is a residential care home without nursing that provides support to up to eight people with mental health needs, accommodated in one adapted building. The service aims to support people to reach their potential, moving towards independent living and social inclusion. At the time of our inspection there were eight people using the service.

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

People spoke positively about their experience of using the service. For example, a person told us, “Best place I’ve ever been in. Staff show that they care. They’re always asking how you are. They show an interest.” Another person said, “Staff have a good understanding of mental illness; what happens and how to handle it.” Another person told us, “Staff are very supportive and non-judgemental, which is very important with mental health.”

There were systems and processes in place to protect people from harm. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns. Risk assessments were in place to support people to be as independent as possible. There were sufficient numbers of experienced staff to meet people’s needs. Safe recruitment practices were followed to make sure only suitable staff were employed to care for people in the home. People’s medicines were stored and well managed to ensure their safe and proper use. The service had effective systems for preventing and controlling infection. Staff took appropriate action following accidents and incidents to ensure people’s safety and this was appropriately recorded and reported.

The provider and registered manager were promoting an open, empowering and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support. The service worked in partnership with other agencies to support people’s needs and promote good practice.

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 10 April 2019).

Why we inspected

At the last inspection the service had been without a registered manager for over a year, which meant that the rating for the well led key question could not be rated better than requires improvement.

While a manager had subsequently been registered, we wanted to see if the provider had maintained a consistent level of service, so we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The rating for the well-led key question has changed from requires improvement to good based on the findings of this inspection. The overall rating of good for the service has not changed.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• The provider worked closely with external professionals to ensure that people were able to be safely admitted to the home whilst meeting their mental health needs. This demonstrated good partnership working.

• Staff carried out a thorough cleaning procedure twice daily. This involved a clean through with hot soapy water followed by a disinfecting procedure.

• Policies and procedures in relation to infection control and COVID-19 were thorough and up to date.

• There were arrangements in place to allow visitors to safely visit the home.

• Staff received the relevant infection control and prevention training and adhered to good practice around using personal protective equipment.

We were assured the provider ensured this service met good infection prevention and control.

Kirtling House is a residential care home without nursing that provides support to up to eight people with mental health needs. The service aims to support people to reach their potential, moving towards independent living and social inclusion. At the time of our inspection there were seven people living at the home.

People’s experience of using this service:

People told us they were well supported by the staff and managers.

Staff were friendly and caring and treated people with respect. There was an open, inclusive culture and ethos within the service, which empowered people and promoted positive outcomes. The managers and staff engaged well with people using the service, their relatives, and external stakeholders.

Staff demonstrated a good knowledge of people’s individual needs and preferences regarding their support. People were empowered to be involved in making decisions about their care and support and how the service was run. Any concerns were listened to and followed up appropriately.

There were systems and processes in place to protect people from harm. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

People’s medicines were stored and well managed to ensure their safe and proper use. People were supported to manage their own medicines within a framework of individual risk assessment.

Safe recruitment practices were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people in the home. There were sufficient numbers of experienced staff to meet people’s needs.

Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were assessed and care and support plans were person-centred and reviewed.

People were supported to maintain their mental and physical health and the service had good relationships with external professionals.

There were flexible approaches to supporting people to budget, shop, and to eat and drink well.

The service was responsive to people’s needs and staff listened to what they said. People were confident that any concerns or complaints they raised would be dealt with.

There were a range of systems in place to assess and monitor the quality and safety of the service and to ensure people were receiving appropriate support.

The service had been without a registered manager for over a year which has meant that the rating for the well led key question cannot be rated better than requires improvement.

More information is in the full report.

Rating at last inspection:

Kirtling House were rated Good at their last inspection (Report published 13 October 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will follow up on this inspection as per our re-inspection programme, and through ongoing monitoring of information received about the service.

Kirtling House is a care home without nursing that provides support to up to eight people with mental health needs. On their website the service states their aim is to support people to reach their potential, moving towards independent living and social inclusion. At the time of our inspection there were seven people living at the home.

The service had a registered manager who registered with the Care Quality Commission (CQC) on 4 April 2016. A registered manager is a person who has registered with the CQC 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 2008 and associated regulations about how the service is run. The registered manager was present and assisted us during this inspection.

Staff were professional and skilful when working with people. Staff knew how individuals liked things done and people were treated with care and kindness. Staff were aware of people's abilities and encouraged them to be as independent as possible.

People received support that was designed to help them meet their personal goals. Support was person centred and incorporated their personal preferences and needs. People said staff knew what they were working on and what they were able to do for themselves. People confirmed staff helped them to work towards their individual goals for recovery and increasing independence.

People received appropriate health care support. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were stored and administered safely.

People were protected from the risks of abuse and from risks associated with their support provision. They were protected by recruitment processes and people could be confident that staff were checked for suitability before being allowed to work with them.

There were sufficient numbers of staff on each shift to make sure people's needs were met. People benefitted from staff who received training to ensure they could carry out their work safely and effectively

People's rights to make their own decisions were protected. The manager and staff had a good understanding of people's rights to make their own decisions and ensured that decisions were not made on behalf of people unlawfully.

People knew how to raise concerns and felt they were listened to and taken seriously if they did. Staff were clear on what actions they should take should anyone raise concerns with them.

People benefitted from staying at a service that had an open and friendly culture. People felt staff were happy working at the service. People's wellbeing was protected and all interactions observed between staff and people at the service were caring, friendly and respectful. People's rights to confidentiality were upheld and staff treated them with respect and dignity.

Risks related to the premises were assessed and monitored. Checks were in place and action was usually taken to address any identified risks. However, on occasions we found some actions, although identified as needed, were not always monitored to ensure they had been completed. We have made a recommendation about the management of issues and remedial work identified during routine audits, servicing visits and risk assessments of the premises.

People told us they were happy living at the home. One person told us, 'They [staff] are brilliant'really supportive'. People told us that they were involved in making decisions about their care and treatment. One person said, 'They [staff] respect my decisions".

We saw that the home had information from referring agencies and that this was incorporated into people's care and support plans which were detailed and provided information about key risks. Staff we spoke with were able to tell us about people's support needs and we observed positive interactions between staff and people who used the service.

The home supported people to take their medication and where possible, staff encouraged people to develop independence in managing their own medication.

The home was adequately staffed, however the service was reviewing its arrangements for determining staffing levels to ensure that these provided the best possible service to people who lived at the home.

Systems were in place to monitor the quality of the service and to seek the views of people about the support they received.

In this report the name of a registered manager (James Gillespie) appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. His name appears because he was still a registered manager on our register at the time. At the time of our inspection the provider had an acting manager in post whilst recruitment to the role of registered manager was undertaken.

Regular meetings were held where staff and people were together discussing the same subject. People said these meetings gave them a sense of belonging. They told us that they were very happy with the service.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. People told us if they had any concerns they would report them to the manager of senior person on duty.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor and assess the quality of the service.