CQC report explained · a residential care home
What the CQC found at Kemble House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were generally safe, risks were assessed, recruitment checks were completed and there were enough staff. Some building repairs were still outstanding, including a broken air conditioning system in the living room.
- Effective?
- Requires improvement
- Support for people with dual mental health needs and autism or a learning disability was not always consistent. Inspectors found gaps in staff experience and concerns about whether behaviour plans were followed by all staff.
- Caring?
- Good
- People, relatives and professionals described staff as kind, caring, polite and respectful. People were involved in decisions and supported to maintain their privacy, dignity and independence.
- Responsive?
- Good
- This key question was not covered by this report, so no current rating is given.
- Well-led?
- Good
- The registered manager supported staff and responded openly when issues were raised. However, relatives' and professionals' views had not been gathered in a structured way for some time, although this was addressed after the inspection.
What inspectors found, October 2022
Rated Good overall, but inspectors found that support for complex mental health needs was not always effective.
This was an unannounced planned inspection. One inspector and an Expert by Experience visited the home on 10 August 2022, with inspection activity continuing until 20 September 2022. They spoke with people living there, staff and managers, reviewed care and medicine records, and received feedback from families and health professionals.
The home was rated Good overall. Inspectors found people were generally safe, staff were kind and caring, medicines were managed safely, and there were enough staff. Care records were up to date and people were supported with health appointments, daily activities and maintaining their independence.
The Effective rating fell from Good to Requires Improvement. Inspectors found that staff did not always have the skills and experience to support people with both mental health needs and autism or a learning disability. There were also building repairs outstanding, limited detail in some as-needed medicine guidance, and some checks of medicine competencies had not been completed on time.
The Caring and Well-led ratings were Good. The home had acted on some previous issues, including training staff about inclusive care. After the inspection, it introduced regular family meetings, sent a survey to relatives, reviewed medicine guidance and checks, and made plans for building improvements.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors found that staff respected people's dignity, privacy, diversity and independence.
“Staff treated people with dignity and respected their diversity.” from the report
Safe staffing and recruitment
The home had enough staff to meet people's needs and completed the required recruitment checks before staff started work.
“Staff were recruited safely, and there were enough staff to meet people's needs.” from the report
Personalised care records
Care documents recorded people's needs, preferences and routines. Risks were assessed and people had health action plans and hospital passports where needed.
“Care documentation was up to date, person-centred and promoted people's dignity, privacy and human rights.” from the report
Support for independence
People were helped with cooking, cleaning, appointments and activities while being encouraged to do as much as possible for themselves.
“People were supported to do as much as they could for themselves.” from the report
Open management
The manager was described as available and responsive. The service acted on several issues raised during the inspection.
“We found the management team immediately addressed any issues raised at this inspection.” from the report
Outstanding building repairs
needs fixingSeveral areas of the building needed repair and maintenance. The living room was very hot because its air conditioning did not work.
“The building was in need of repair and maintenance in a number of areas.” from the report
Medicine guidance and checks
needs fixingSome guidance for as-needed medicines did not explain clearly enough when staff should give them. Yearly medicine competency checks had not always been completed on time, although the manager took action after the inspection.
“They lacked some detail in guidance for staff as to when to give them.” from the report
Family feedback
minorThe home had not formally gathered relatives' and other stakeholders' views for some time. Regular family meetings and a relatives' survey were introduced after the inspection.
“The views of relatives and other stakeholders had not been sought in a structured way for some time.” from the report
- 01How do you make sure all new staff understand my relative's mental health needs as well as their autism or learning disability?
- 02How do you check that every member of staff follows the agreed behaviour and mental health support plans?
- 03What building repairs are still outstanding, and when will the air conditioning and other works be completed?
- 04What extra detail is now included in the guidance for as-needed medicines, and how often are staff's medicine skills checked?
- 05How will relatives' views be gathered and acted on through the new meetings and surveys?
This planned inspection covered Safe, Effective, Caring and Well-led; Responsive was not covered, and the report does not give a current rating for it. This explanation was written from the published report of 20 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2022
Kemble House was inspected but not rated; inspectors were assured about infection control, visiting arrangements and COVID-19 safety measures.
This was an announced, targeted inspection on 13 January 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements and whether COVID-19 staffing pressures affected the service.
Inspectors found that people were supported to leave the home safely, visitors were tested and the home had enough protective equipment. They also found clean premises, good ventilation and trained staff.
The home had plans for safe admissions and for managing an outbreak. It was meeting the requirement for non-exempt staff and visiting professionals to be vaccinated against COVID-19.
The service was inspected but not rated. This was not a full inspection of the home's overall quality, so the report does not give ratings for most areas of care.
Infection control
The premises were clean and hygienic, with cleaning stations and good ventilation. Staff had protective equipment and training in how to use it safely.
“The premises looked clean and hygienic throughout. There were cleaning stations in place and adequate ventilation.” from the report
Safe visiting
Visitors were tested before visits and the home provided protective equipment information. Video calls were available for people who were not named visitors.
“The home had alternative methods to support social contact for visitors who were not named. For example, video calling.” from the report
Outbreak planning
The home could separate its two floors if there was an outbreak, with staff assigned to each floor to reduce the risk of infection spreading.
“If there was an outbreak on a floor, the home could be run as two separate homes with staff assigned to each floor to ensure infections did not spread.” from the report
Safe admissions
New people were tested before admission, isolated in their room and tested again. Staff also carried out welfare and mental health checks during isolation.
“People were tested before being admitted then a period of isolation in their room before a further test at the end of the isolation period.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, and when were they last reviewed?
- 02How would the home separate residents and staff if there were an infection outbreak on one floor?
- 03How are visits managed now, including testing, protective equipment and visits from people who are not named visitors?
- 04How does the home cover staffing pressures when staff are absent because of COVID-19?
- 05How are new residents tested, supported during isolation and monitored for their wellbeing?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19 staffing pressures; it did not rate the other areas of care. This explanation was written from the published report of 15 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Kemble House
3 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2022Inspected but not ratedSafe: Inspected but not rated
- July 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: Requires improvementWell-led: Good
- October 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 10 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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