CQC report explained · a residential care home
What the CQC found at Kilkhampton Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable staffing, safeguarding training, safe medicine systems and a clean environment. They also noted that some risk assessments lacked detail and that arrangements for one person's monitoring had previously not matched their assessed needs, but this had been rectified.
- Effective?
- Good
- People's needs were assessed and staff supported eating, healthcare, communication and independence. Not all staff had received recent supervision, although plans were in place to provide supervision and annual appraisals.
- Caring?
- Good
- Staff knew people well, respected their preferences and used communication tools to support choice. Inspectors saw trusting relationships and received highly positive feedback from relatives and professionals.
- Responsive?
- Good
- Care plans covered people's needs, preferences and daily lives. People were supported with activities, relationships, communication, complaints and end-of-life wishes.
- Well-led?
- Good
- The management structure and responsibilities were clear. Audits, staff meetings, incident reviews and feedback from families were used to monitor and improve the service.
What inspectors found, January 2020
Kilkhampton Lodge was rated Good in all five areas; inspectors found person-centred care, with some restrictions and staff supervision needing attention.
This was an unannounced inspection on 07 January 2020. Inspectors met five people and six staff, observed people with staff, reviewed care, medicine, recruitment and management records, and spoke with professionals and relatives.
The home supported nine people with complex needs linked to learning disability, autism and mental health conditions. Inspectors found people were treated kindly, supported to make choices, and helped to develop independence. Staff knew people well and relatives were very positive about the care.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The inspection was brought forward because of concerns about staff deployment and hygiene practices. The report says the specific issues identified had been rectified, although it noted that some risk assessments lacked detail and not all staff had recent supervision.
Support for independence
People were encouraged to gain skills, make choices and become more independent. Staff adapted support to people's abilities and goals.
“People's support focused on them having as many opportunities as possible to gain new skills and become more independent.” from the report
Staff knew people well
Staff understood people's needs, preferences and communication styles. This helped them build trusting relationships and support people in a personalised way.
“Staff knew people well and had an understanding of their needs and preferences.” from the report
Detailed care planning
Care plans covered health, preferences, cultural needs, communication and daily life. Daily records were checked against incidents and plans were updated when needed.
“Care plans were detailed and covered all areas of people's lives.” from the report
Good management oversight
There were clear management roles, regular audits and reviews of accidents and incidents. Staff said they were listened to and supported.
“Regular checks and audits were completed to help identify any areas for improvement.” from the report
Restrictions on daily life
needs fixingTwo people lived separately from the rest of the house and could not independently access shared areas or leave their accommodation. The report says this was to keep people safe, and other high-level restrictions had legal authorisation, but families should understand how this would affect their relative.
“Two people were living in segregated accommodation. This meant they lived entirely separately from others and were unable to access shared lounges and kitchens or leave their accommodation independently.” from the report
Some risk assessments lacked detail
needs fixingRisk assessments explained how staff should respond when people became distressed, but inspectors found that some did not contain enough detail. Ask how these assessments have been strengthened since the inspection.
“This information was recorded in risk assessments although these sometimes lacked detail.” from the report
Staff supervision was not up to date
minorNot all staff had received recent supervision. The home had plans to provide supervision and annual appraisals for the whole team.
“Not all staff had received recent supervisions. There were plans in place to provide these, and annual appraisals, for the whole staff team.” from the report
- 01How do you decide whether restrictions or segregated accommodation are still necessary for a person?
- 02What extra detail has been added to risk assessments since this inspection?
- 03Have all staff now received regular supervision and annual appraisals?
- 04How would you support my relative's communication, choices, activities and independence?
- 05What changes were made after the concerns about staff deployment and hygiene that led to this inspection being brought forward?
This was an unannounced inspection covering all five CQC questions, including care and the premises, with findings based on observations, records and feedback from professionals and relatives. This explanation was written from the published report of 28 January 2020 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, July 2018
Kilkhampton Lodge is rated Good; inspectors found kind, personalised care and improvements since the previous inspection, with some records still needing more detail.
Inspectors made an unannounced comprehensive visit on 3 July 2018. They spoke with people, a relative, staff, managers and healthcare professionals. They observed care, looked around the home and checked care records, staff files, training records and other documents.
The home supports up to eight people with learning disabilities and/or mental health conditions. Inspectors found people felt safe, staff knew them well and activities reflected their interests. Medicines, staffing, staff training and support were judged good.
The home had improved the problems found at the previous inspection in June 2017. Risk assessments and best-interest decisions were now being used more appropriately. All five areas were rated Good, meaning the inspectors found the service met the relevant standards at this inspection.
Inspectors did identify some weaknesses. One person's changing risky behaviour did not yet have a specific risk assessment. Some monitoring records, including records of food portions, were not detailed or consistently completed. The service was given a recommendation about monitoring records.
Personalised support
Care plans described people's routines, abilities, communication needs and preferences. Staff used this knowledge to reduce anxiety and support people in ways that suited them.
“Care plans were detailed and informative.” from the report
Kind relationships
Staff spent time talking with people, understood what could distress them and supported choices about daily life. People appeared comfortable and at ease.
“People were comfortable and at ease with staff and within their environment.” from the report
Activities and independence
People could take part in planned activities or spontaneous trips. The home supported individual interests, including walks, swimming, horse riding and art activities.
“Activities provided were varied and met people's individual preferences and interests.” from the report
Improved decision-making
Since the previous inspection, best-interest processes and reviews of restrictive practices had improved. Relevant professionals and family members were involved where needed.
“Decisions to introduce restrictive practices were taken in line with the best interest process and involved relevant professionals and family members.” from the report
Stable, organised team
Inspectors found clear responsibilities, low staff turnover, regular supervision and effective communication about changes in people's needs.
“There was a stable staff team in place and staff retention was very good.” from the report
A changing risk was not yet documented
needs fixingOne person's risky behaviour had recently increased, but there was no specific risk assessment for staff to follow. Managers said they were taking action and seeking further professional advice.
“There was no risk assessment in place for staff to refer to in respect of this.” from the report
Monitoring records lacked detail
needs fixingSome records about people's care and wellbeing were incomplete or too general to show clearly whether needs were being met. For example, a food record did not state how much had been eaten.
“Not all of the records were detailed enough to be meaningful.” from the report
- 01How quickly would you create or update a risk assessment if my relative's behaviour or needs changed?
- 02How do you record the amount of food and drink someone has had, rather than only the type of food?
- 03How do you check that monitoring records are completed consistently and acted on?
- 04How are restrictive practices reviewed, and how are families and relevant professionals involved in those decisions?
- 05How would my relative's preferred activities and trips be included in their care plan?
This was an unannounced comprehensive inspection covering all five questions; it also checked improvements following the previous inspection on 22 June 2017. This explanation was written from the published report of 27 July 2018 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 Kilkhampton Lodge
4 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 15 March 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
10 live-in carers within about two hours of Cornwall
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.