Kingsbridge Road

Updated 12 November 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.

The service was selected to take part in this thematic review which is seeking to identify examples of good practice in infection prevention and control.

This inspection took place on 29 October 2020 and was announced.

Updated 12 November 2020

This inspection took place on 27 and 28 September 2017 and was unannounced on the first day. Kingsbridge Road provides a respite service for up to 11 people with learning disabilities or autistic spectrum conditions across three ground floor flats with a shared garden. Each flat contains a shared lounge, bathroom and shower and kitchen. Two of these flats provide an unplanned respite service, and one flat provides a planned respite service. At the time of our inspection there were 10 people using the service.

We last carried out a comprehensive inspection in May 2016 where we found breaches of regulations relating to the safety of the premises and consent to care and rated the service “Requires Improvement”. We carried out a focussed inspection in November 2016 where we found the provider was now meeting these regulations and changed their rating to “Good”. At this inspection we found the service remained “Good”.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

Since our last inspection visit, we found that the service was supporting more people with complex, mental health needs. We saw that the provider had suitable measures in place to manage this, including working with other professionals to plan people’s support and managing risks in a way which protected and promoted people’s rights. There were measures in place to manage times when people’s behaviour could challenge. Incidents and accidents were monitored and measures put in place in response to these. Staffing levels varied in order to meet the needs of who was using the service at the time. The provider maintained safer recruitment measures and included people who used the service in interviewing and assessing a candidate. There were suitable systems in place to safeguard people from abuse.

We brought this planned inspection forward as the provider had reported a number of medicines incidents. We saw that an action plan was in place to address this, however some of the checks carried out on medicines were not always being applied effectively in a way which would detect mistakes. We have made a recommendation about this. We found that people’s medicines were checked in and out of the system and there were clear medicines support plans, including medicines which were given as needed.

The service was able to respond to people’s changing needs, through support planning and review. Circle of Support meetings took place as needed, and were used to review people’s support and ensure that decisions were made in people’s best interests when necessary. The provider had assessed people’s capacity to make decisions and worked to promote people’s rights.

People were supported to speak up through keyworking and everyday interactions and the provider maintained communication passports and other tools to promote this. People continued to have personalised programmes of activities. Managers had clear tools in place to ensure that people’s needs were met throughout the day, including shift plans and regular handovers between shifts.

The building remained in a poor condition in places and had not been designed for its current purpose, which the provider worked with the building’s owners to address. Although the condition was poor, the building was not unsafe and the provider had worked to promote a more homely environment. We found that sometimes health and safety checks were not overseen in a way which meant that issues of concern could be addressed promptly, however these were audited by managers. There were measures in place to promote fire safety, including tests of fire equipment and personal evacuation plans.

Managers were visible in the service and people’s relatives were positive about the way the service was led. Managers had checks in place to ensure that staff received training in line with the provider’s requirements, and staff received regular supervisions with their line managers. People were confident they could speak to managers if they had a concern, and there were measures in place to monitor and investigate complaints. A new system of audit had been introduced which identified clear areas for improvements, but it was too early to judge its effectiveness.

We have made one recommendation about how the provider monitors people’s medicines.