Kingly Terrace

We found the following examples of good practice.

Safe arrangements were in place for visitors to the service including relatives and friends, professionals and others. This included a booking system, rapid LFD testing, showing evidence of vaccination, temperature checks and sign in process.

Isolation, co-horting and zoning were used to manage the risk of infection spread. This meant people self-isolated in their rooms when necessary and staff would be allocated to work in certain areas of the service should anyone test positive for COVID-19.

Enhanced cleaning and disinfection of all areas of the service continued to take place to reduce the risk of cross contamination. The manager planned to update cleaning schedules to reflect the sanitisation of high touch areas, such as door handles and hand rails, at least twice a day.

There was plenty of personal protective equipment (PPE) including masks, gloves, aprons and hand sanitiser available. PPE stations were located around the service. Used PPE was disposed of safely in clinical bins.

A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. This meant swift action could be taken if anyone received a positive test result.

Options for a staff changing area and the introduction of a staff uniform were being looked into. This would further reduce the risk of cross contamination.

Building works were ongoing to create an extension. Included in the building programme were planned improvements to the kitchen and laundry areas, which would improve infection prevention and control measures.

The manager started in November 2021 and was in the process of reviewing and updating documentation and records. They had good oversight of infection prevention and control processes. Regular quality assurance checks were undertaken, and identified improvements were being addressed.

Kingly Terrace provides accommodation and personal care for up to eight people that require support with varied and complex needs primarily arising from an acquired brain injury and, or, neurological disability. The home is a detached property that has been adapted for people that use wheelchairs and need other specialist equipment to manage their disability. There were eight people in residence when we inspected the service on 27 November and 1 December 2017.

There was a registered manager in post at the time of our inspection. 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.

People benefitted from receiving support from a motivated staff that were enabled to work creatively to achieve outstanding outcomes. Staff had insight into people’s capabilities and aspirations. People were encouraged and enabled to do things for themselves. They were encouraged to set goals and evaluate their progress in attaining these goals. People were enabled as much as possible to relearn skills they had lost as a consequence of their injury or condition. Their individual preferences for the way they liked to receive their care and support were respected. The emphasis was on rehabilitation and enhancing people’s ability to realise their potential for managing their disability and attaining increasing levels of independence in their daily lives. The staff team demonstrated a commitment to providing outstanding care and support and they achieved this by working with each person individually and involving them in all aspects of their care and support.

The provider and registered manager had a rigorous quality assurance system that encouraged reflective practice within the team and ensured that people consistently received care and support that was reflective of best practice. The provider actively participated in national forums for raising awareness in the care of people with acquired brain injury and neurological disabilities. This enabled the provider to be at the forefront of best practice and research into caring for and supporting people living with such disabilities. The provider's vision and values were understood and shared across the staff team and they led with a proactive approach that focused on evaluating ways of making improvements to the service. People and their relatives were encouraged to be involved in making improvements to the home and their feedback was acted upon.

People received care and support from staff that knew what was expected of them. Staff were friendly, kind and compassionate and the team were well-led and evaluated their practice on a day-to-day basis. They were well trained and had the support of the management team and the provider. The registered manager and senior staff inspired and supported their team to aim for and consistently achieve high standards when providing people with care and support. There was an ethos of care that was person centred and valued people as unique individuals, each with their own identity, aspirations and potential to be empowered.

People were safe. People were protected by rigorous recruitment procedures that made sure people did not receive unsafe care from staff that were unsuited to work at the service.

People were cared for by sufficient numbers of staff. They were supported by rehabilitation support workers (RSWs) and professional occupational therapists that had extensive professional training and experience of working with people with neurological disabilities. There was a policy of avoiding using temporary agency staff and this ensured that people had continuity of care from staff they knew and had formed positive relationships with. They received care from staff that had received training and support they needed to do their job well.

People's needs had been rigorously assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. Risks to people’s safety were regularly reviewed as their needs and dependencies changed. The premises and equipment used to provide people with the specialist care they needed were appropriately maintained throughout to ensure their safety and that of the staff.

People were supported and safeguarded from avoidable harm and poor practice by staff that understood how to keep people safe. Safeguarding procedures were in place to help protect people from harm and staff understood their responsibilities to do so and to report any concerns. All safeguarding issues were investigated and appropriate action was taken.

Staff responded to people in a timely way whenever they needed assistance. Care plans were personalised. The care plans reflected each person’s individual needs and provided staff with the information and guidance they needed to support people. Care planning involved people and supported their diverse needs. Staff had a good understanding of people’s preferences and supported people to participate in activities they enjoyed.

People’s capacity to make informed choices had been assessed and regularly reviewed. The provider and staff were mindful of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support. People were supported to have maximum 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 healthcare needs were monitored. They had access to community based healthcare professionals, such as GP’s and nurses, and had regular check-ups. They received timely medical attention when needed. Medicines were safely managed. They were securely stored and suitable arrangements were in place for their timely administration by staff that had received training.

People had enough to eat and drink. They enjoyed their meals and participated in creating menus that catered for their tastes and appetites. Individuals that needed encouragement and support with eating a healthy diet received the help they required. People were supported to have a balanced diet and to have their nutritional needs met.

Systems were in place to ensure the premises was kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.

People were enabled to keep in touch with family and friends. The provider made use of computers with internet access for people to communicate with family and friends using, for example, ‘Skype’ and online interactive phone calls tailored to the individual needs and capabilities of the person.

Comprehensive information about the provider and the services provided was readily accessible on their website. As this was the first comprehensive inspection of this location a previous inspection rating was not yet on display.