CQC report explained · a residential care home
What the CQC found at Kingsley House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust safeguarding procedures, clear risk assessments, suitable staffing and safe medicines systems. They noted that handwritten medicines changes were not always double signed, although action was promised.
- Effective?
- Good
- Assessments were detailed and staff had specialist training in autism and positive support. People were supported with health care, food, exercise, communication and least restrictive care.
- Caring?
- Good
- Relatives and professionals said people were treated as individuals with dignity and respect. Staff used communication aids and other methods to involve people in decisions.
- Responsive?
- Good
- Care plans were highly personalised and activities were tailored to people's interests and abilities. The rating changed from Outstanding at the previous inspection to Good.
- Well-led?
- Good
- Inspectors found open management, regular audits, staff involvement and learning from incidents. Relatives and professionals spoke positively about the home's person-centred approach.
What inspectors found, January 2020
Rated Good; inspectors found highly personalised care, with a small medicines-record issue and Responsive falling from Outstanding to Good.
This was a planned inspection on 10 December 2019. The inspector, a medicines specialist and an Expert by Experience spoke with staff, observed people, reviewed a care meeting and checked medicines, care plans, risk assessments, recruitment records and audits. Feedback was also sought from relatives and professionals.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found staff understood people's complex needs, supported choice and independence, and provided activities and communication support suited to each person.
Inspectors noted that medicines records were not always double signed after handwritten changes, although the home said this would be put right. The home is larger than current best practice guidance suggests, but the report says its design and separate living spaces reduced the effect of this.
Personalised support
Staff understood people's complex needs, routines and ways of communicating. Care plans were adapted to help people make choices and take part in their own reviews.
“People received care and support in a way that was highly responsive to their needs.” from the report
Choice and independence
People had their own living spaces and were supported to make choices, learn skills and take positive risks. Staff worked to avoid unnecessary restrictions.
“Staff worked in the least restrictive way to ensure people were kept safe but also had opportunities to lead fulfilling lives” from the report
Skilled staff
Staff received specialist training and knew how to support autism, communication needs and behaviours that could place people or others at risk.
“Staff were skilled and experienced at understanding people's complex behaviours, rituals and ways of communicating.” from the report
Meaningful activities
Activities and timetables were tailored to people's interests. Staff helped people access the community, try new experiences and develop skills.
“Every effort was made to ensure people living at Kingsley House had active and fulfilling lives.” from the report
Learning from incidents
The home reviewed incidents and upgraded its alarm system after a serious incident involving staff injury. It also monitored response times and shared learning.
“Where incidents had occurred, action had been taken to minimise the risks of reoccurrence, and any learning was shared” from the report
Medicines records
needs fixingHandwritten changes to medicines records were signed and dated, but not all had a second signature to show they had been checked. The home said this would be implemented straight away.
“However they were not all double signed to show they had been checked by a second member of staff, which is good practice.” from the report
Size and design
minorThe home is larger than current best practice guidance for this type of service, and its design does not fully match that guidance. Inspectors said separate flats and houses helped reduce the impact.
“The design and layout is not within keeping of registering for the right support” from the report
Lower Responsive rating
minorResponsive was rated Good at this inspection, compared with Outstanding at the previous inspection. The report still found care to be highly responsive to people's needs.
“At the last inspection this key question was rated as outstanding. At this inspection this key question has changed to good.” from the report
- 01How were the medicines records changed so that handwritten amendments are now double checked?
- 02How will my relative's separate flat or house be made homely and suitable for their sensory and communication needs?
- 03How will you make sure my relative has a consistent core staff team?
- 04How will you support my relative to take positive risks while managing triggers and behaviours that could cause harm?
- 05How will my relative and family be involved in care-plan reviews and decisions about activities and support?
This was a planned comprehensive inspection covering all five key questions, with the previous rating from June 2017 used as a comparison. This explanation was written from the published report of 21 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, June 2017
Rated Good overall, with Outstanding responsiveness and inspectors finding highly personalised, safe and caring support.
Inspectors visited on 29 March and 6 April 2017. The first visit was unannounced and the second was agreed so people and staff were available to talk to. They observed care, spoke with people, staff, relatives and health professionals, and checked care plans, medicines, recruitment, staffing and quality records.
The home supported younger adults with autism and learning disabilities in small flats and houses on one site. Inspectors found that people were safe, medicines were managed well, staffing was sufficient and staff were properly recruited and trained. Care was kind, respectful and based on each person's needs, communication style and wishes.
The home was rated Good overall. It was rated Good for Safe, Effective, Caring and Well-led. Responsive was rated Outstanding because people were helped to communicate, make choices, develop independence and take part in activities that mattered to them. The previous concern about the environment being too school-like had been addressed.
Safe medicines
Medicines were given at the prescribed times and records matched the stock checked by inspectors. Staff received training and their competence was checked regularly.
“People received their medicines on time and in a safe way.” from the report
Skilled communication support
Staff used symbols, pictures, photographs, communication books, tablets and social stories to help people understand information and express choices.
“The service was exceptional in enabling people to communicate their needs and preferences.” from the report
Personalised support
Plans focused on each person's strengths, interests, routines and goals. People were supported to build independence and try activities that had previously caused anxiety.
“People received person centred care from staff who knew each person, about their life and what mattered to them.” from the report
Kind relationships
Inspectors saw positive relationships between people and staff. Staff respected privacy, dignity, personal choices and important family relationships.
“People received care from staff who developed positive, caring and compassionate relationships with them.” from the report
Improved environment
The previous inspection found some areas were too school-like. Inspectors found that communal areas, bedrooms and flats had since been personalised and made more suitable for adults.
“Improvements had been made.” from the report
Strong improvement culture
Managers and staff reviewed incidents, sought advice from specialists and looked for ways to improve people's wellbeing, activities and independence.
“There was a strong commitment to continuous improvement, both through investment in staff learning and support and in developing a specialised service which met the needs of people with autism.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure staffing levels remain safe when regular staff are off sick or on leave, and how often are agency workers used?
- 02How will you involve my relative in choosing their support staff, activities and personal goals?
- 03Which communication aids, pictures or social stories would you use for my relative, and how would you review whether they are helping?
- 04What restrictions or Deprivation of Liberty Safeguards would apply to my relative, and how would these be reviewed?
- 05How would you meet my relative's healthcare needs, given that the home does not provide nursing care?
This was a comprehensive inspection covering Safe, Effective, Caring, Responsive and Well-led, with observations, discussions and checks of care, medicines, staffing and quality records. This explanation was written from the published report of 9 June 2017 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 Kingsley House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- April 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2014
Registered with the Care Quality Commission on 29 December 2014.
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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17 live-in carers within about an hour of Devon
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 £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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