Background to this inspection
Updated
26 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was prompted in part by concerns we had received about some of the practices at the service, which included restrictive practices which were not in line with the legislative framework of the Mental Capacity Act 2005. Concerns had also been raised about the activities that people were supported to do.
Prior to the inspection, we had raised a safeguarding alert with the local authority about the concerns we had received. The local authority undertook their own investigations into each of the allegations during the same time period as the inspection. Since the inspection, we have received outcomes from the local authority who have closed all the safeguarding concerns.
Similar concerns had also been raised by the same complainant about two other services owned by the same provider. The concerns about the other services were not addressed during this inspection, but have been considered separately in line with our inspection methodology.
This inspection was carried out by an Adult Social Care inspector and took place on 11 December 2018 and 9 January 2019. The inspection was unannounced on the first day. The second day was arranged with the registered manager.
Before the inspection we reviewed information held on our systems, this included notifications we had received from the service. A notification is information about important events, which the service is required by law to send us.
We had also sent the registered manager details of the concerns raised and asked for a response to the allegations. They had sent a written response which we reviewed prior to the inspection.
The provider had not been requested to send a Provider Information Return (PIR) since the previous inspection in April 2018. A PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we met three people, who lived at Kite House and spoke with two of them; Two people living in the service were out during the days of inspection undertaking activities in the community.
We talked with the registered manager, their deputy, an administrator and three care workers including an agency care worker. We also met and spoke with two directors from the provider’s organisation. After the inspection we spoke with one relative of people living at Kite House. We also had discussions and email exchanges with health and social care professionals in the local learning disability team during and after the inspection.
Updated
26 February 2019
This unannounced, focussed inspection took place on 11 December 2018 and 9 January 2019. We carried out the inspection as we had received concerns about some of the care at the service. This was in relation to:
• People being restricted in terms of their movement around the service.
• The care and support for two people, including what activities they were supported to do.
Similar concerns had also been raised by the same complainant about two other services owned by the same provider. The concerns about the other services were not addressed during this inspection, but have been considered separately in line with our inspection methodology.
Prior to the inspection, we had raised a safeguarding alert with the local authority about the concerns we had received. The local authority undertook their own investigations into each of the allegations during the same time period as the inspection. Since the inspection, we have received outcome information from the local authority, who have closed all the safeguarding concerns. The outcomes described how the service had worked with them and, where necessary, taken action to address the concerns.
We did not find evidence of unnecessary restrictions being placed upon people. We also did not find any evidence to support the allegation that people were not being supported to have fulfilled lives doing activities of their choice both within the service and in the local community.
At the last inspection in April 2018, we rated the service Good in all five domains and therefore the service was rated as Good overall.
At this inspection, we looked at the two key questions, “Is the service effective?” and “Is the service well-led?” and found that both domains continued to be rated as Good.
No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection
Kite House is a residential care home for people who live with a diagnosis of learning disability and/or autism. Some people living at Kite House also have physical disabilities. The service is registered to provide accommodation with personal care (without nursing) for up to six people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
At the service, there is a main building with six bedrooms and communal areas. There is another care home on the same site, called Burridge Farm which is owned by the same provider. Burridge Farm is managed by the same registered manager and most staff work in both care homes. A building located beside Burridge Farm provides office space for the registered manager, senior staff and administrative staff who work across both the services.
At the time of the inspection, there were five people living at the service.
The service had been designed in line with the values that underpin the Registering the Right Support (RRS) and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. During the inspection we observed that staff worked with people promoting their choice and independence. This included being involved in activities within the service and in the local community.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People were being supported within the requirements of the MCA.
There was a registered manager in post. 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 and their families were very positive about the care and support provided at Kite House. One person’s comments included, “Really like living here, staff are great.” A relative said they were, “Very happy” with the care they family member received.
People’s risks, needs and preferences were assessed when they first came to Kite House. Risk assessments and care plans were developed with the person, and where appropriate, their families. When there was a change in a person’s presentation, their risk assessments and care plans were reviewed to ensure they still met the person’s requirements. Staff were knowledgeable about each person, their history and family background. Staff worked to ensure that people’s rights in relation to the Equality Act (2010) were upheld.
People were provided opportunities to do activities of their choice. This included activities both in the service and the local community. People said they enjoyed the activities they did which included going to the gym and working in a local café. People were also supported to develop life skills including cooking and household chores.
People were involved in choosing and preparing meals they said they enjoyed. People’s dietary needs were understood by staff who encouraged people to eat healthily.
People were supported to maintain their health by attending appointments with health professionals such as GP and dentist. Where a person had to spend time in hospital, staff remained with them to ensure their needs were met.
Further information is in the detailed findings below.