Kilkenny House

Kilkenny House is an extra care housing scheme. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant's own home. At the time of our visit there were 37 people using the service.

People’s experience of using this service and what we found

Risks associated with people’s care were assessed but these assessments required more detail. Medicines were managed safely, however ‘protocols for ‘as and when required’ (PRN) medicines were not in place to help guide staff when to administer these. Governance systems were not always effective. There was a lack of oversight at provider level, however the registered manager had developed their own internal audits to monitor the quality of the service and take actions as needed.

People felt safe and were protected from the risk of harm and abuse. Risks to people were assessed and plans were in place to mitigate these risks. Staff received appropriate training and were supported with regular supervisions. There were enough staff to meet people’s needs and staff were recruited safely.

People were asked to give their consent for support and the principles of the Mental Capacity Act were followed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to eat and drink and maintain healthy lives. People were supported to access healthcare services where needed.

Staff treated people with kindness, dignity and respect. People were complementary about the staff and the service they received. People were involved in decisions about their care and received regular reviews where they could provide feedback.

People and relatives were complementary about the activities and engagement opportunities provided by the service. People were given opportunities to maintain their social relationships and to maintain their independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 01 January 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kilkenny House on our website at www.cqc.org.uk.

Recommendations

We have made recommendations in relation to medicines’ management and provider oversight.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

older people. At the time of our inspection there were 32 people receiving personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

We found the following examples of good practice.

The registered manager had taken steps to ensure staffing was sufficient to fully meet people’s needs. Staff had worked flexibly, often taking on new responsibilities to ensure people continued to receive safe care and support.

The provider supported people to engage with the vaccination programme. They made reasonable efforts to help people to understand vaccination, including using the most appropriate communication for each person.

The provider followed relevant COVID-19 testing guidance. This included staff testing requirements as well guidance on testing for people using the service and visitors.

Isolation, cohorting and zoning was used to manage the spread of infection. This meant people self-isolated in their flats when necessary.

Staff received Infection Prevention and Control (IPC) training and followed the providers IPC procedures. This included wearing Personal Protective Equipment (PPE) and washing and sanitising hands regularly. PPE stations were available throughout the service and there were sufficient stocks of PPE available.

At the last inspection, on 14 October 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff understood their responsibilities to keep people safe from harm. Safeguarding procedures were in place and staff understood their duty to report potential risks to people’s safety.

People received their medicines as prescribed and risk assessments were in place to manage risks within people’s lives. 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.

Staffing levels ensured that people's care and support needs were safely met and safe recruitment processes were in place.

Staff induction training and on-going training was provided to ensure that staff had the skills, knowledge and support they needed to perform their roles. Staff were well supported by the registered manager and senior team and had regular one to one supervisions.

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.

Staff supported people to access support from healthcare professionals, and supported them to maintain a healthy lifestyle. The service worked with other organisations to ensure people received coordinated and person-centred care and support.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

The provider had systems in place to monitor the quality of the service as and when it developed and had a process in place which ensured people could raise any complaints or concerns.

During the inspection we were made aware of on going environmental fire safety concerns at the service. People using the service were receiving a personal care service and had separate tenancy agreements for their accommodation. Therefore, the accommodation provided to people is not regulated by the Care Quality Commission. We contacted the local fire authority, who was already aware of the concerns. Temporary measures had been implemented to mitigate the current risk to people and the provider was working with the housing provider and the fire authority to develop a long term solution.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service had risk assessments in place to enable them to be as independent as possible. Generic risk assessments were also available to protect staff. These included use of kitchen equipment and general health and safety.

People who used the service told us staff always knocked on their doors and asked for consent to carry out any activity.

Is the service effective?

People had been involved in the planning and reviewing of their care plans and had signed to consent to this.

Staff had received appropriate training to enable them to carry out their roles effectively.

Is the service caring?

People were supported by staff who were knowledgeable of, and responsive to, their needs.

We observed positive interactions between staff and people who used the service.

One person we spoke with told us, 'I could not be anywhere better.'

Is the service responsive?

People's care plans were reviewed regularly, and updated when required.

Customer satisfaction surveys had been sent out to people who used the service. Results were recorded and any actions needed followed through in order to drive improvement.

People we spoke with told us that if they pressed their alarm button, staff arrived immediately. This was observed during our inspection.

Is the service well led?

There was a registered manager in post, who was supernumerary to the staff rota. They were supported by a staff team.

There were robust quality monitoring processes in place.

People, who used the service, and staff, were asked for their opinions and we saw that these had been acted on where appropriate.

All the tenants we spoke with told us they received a very good standard of care and support from the care assistants. They all said that without the domiciliary support they received they would not have been able to enjoy the independence of remaining in their own flat.

One tenant commented, 'The help I receive is marvellous.' Another tenant said, 'Without their help I would never manage. Having my own flat is so important to me. I can rely upon them.'

We found that the domiciliary support provided to tenants living in the flats at 'Kilkenny House' was effective, safe, and was provided by a team of conscientious and competent staff.

We spoke with two staff members who enjoyed their roles and felt well supported.

We saw that people's needs had been assessed and a care plan put in place to ensure that they were met. We saw that people were involved in decisions about their care plan. We found that where risks had been identified that risk assessments had been carried out.

We saw that there were staff based at Kilkenny House throughout the 24 hour period and that people were able to call them if they needed to. We found that the provider calculated the total care hours required and ensured that staffing hours were adequate to met them.

We had concerns about the medication disposal records kept by the service especially those relating to controlled drugs.