Kenton House

Updated 6 September 2019

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.

Inspection team

The first day of inspection was completed by one inspector and the second day by two inspectors.

Service and service type

Kenton House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 on day one.

What we did before the inspection

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

Some people at Kenton House were not able to fully share with us their experiences of using the service. Therefore, we spent time observing interactions between people and the staff supporting them in in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with six members of staff including the provider, registered manager, team Leader, registered nurse, senior care worker, and the chef.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at five 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 spoke with five relatives about their experience of the care provided. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted 12 professionals who are involved with, and visit, the service and had contact back from three of them.

Updated 6 September 2019

About the service

Kenton House is a residential care home providing personal and nursing care to 17 people with learning disabilities or autistic spectrum disorder at the time of the inspection. Kenton House can support up to 17 people in one adapted building.

Kenton House has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 17 people. 17 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.

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

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.

Safe recruitment practices were not always followed. However, the registered manager was taking action to address this.

Most of the care plans and risk assessments were up-to-date, person centred, and goal orientated with a focus on achieving outcomes. However, care plans and risk assessments relating specifically to health did not always contain sufficient clarity of detail to enable staff to carry out the support safely. However, the risk was mitigated by staff demonstrating clear knowledge and understanding of how to support people safely.

Regular checks were undertaken in relation to the maintenance and safety of equipment and concerns identified. However, actions and outcomes were not always recorded for concerns identified from these checks. We have made a recommendation about evidencing response to safety checks.

The environment was accessible and met the needs of the people living at Kenton House. There was some required maintenance that once completed would enhance the environment.

Staff were caring. Everyone we spoke with was very complimentary about the service and said they would recommend the home.

Activities were available to keep people occupied both on a group and individual basis. Activities were organised in line with people's preferences.

A system was in place to ensure medicines were managed in a safe way for people. Staff were trained and supported to ensure they were competent to administer medicines.

People received support with meals and drinks and there was an emphasis on identifying and monitoring likes and dislikes for people using their preferred communication methods.

Staff knew how to access relevant healthcare professionals if their input was required. The service worked in partnership with other organisations and healthcare professionals to improve people's outcomes.

There were sufficient numbers of staff deployed to keep people safe and to meet their care needs. Staff were received appropriate training which was relevant to their role. Staff were supported by the registered manager and were receiving formal supervision where they could discuss their on-going development needs.

Individual needs were assessed and met through the development of detailed personalised care plans, which considered people's equality and diversity needs and preferences. Care plans were up to date and most detailed the care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to mitigate most risks which had been identified. Appropriate referrals were being made to healthcare professionals when necessary.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. Systems were in place to ensure complaints were encouraged, explored and responded to.

The service had links with other resources and organisations in the community to support people's preferences and meet their needs.

Kenton House met the characteristics of Good in some areas and of Requires Improvement in others. Overall, we have rated the service as Required Improvement.

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 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

We identified one breach of regulations. You can see what action we have told the provider to take at the back of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kenton House 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 re-inspection programme. If we receive any concerning information we may inspect sooner.