Kensington Hall

Updated 6 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector, a medicines inspector, and an Expert by Experience. The Expert by Experience made telephone calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Kensington Hall is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Kensington Hall is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 17 October 2023 and ended on 25 October 2023. We visited the service on 17 and 23 October 2023. The Expert by Experience made telephone calls on 25 October 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service. Some of the people who used the service had complex needs or limited verbal communication. This meant they could not always tell us their views of the service or did not wish to engage with us. We also spoke with 6 relatives; we spoke to 1 relative in the home and 5 by telephone. We received feedback from 3 professionals by telephone and e-mail.

We spoke with 6 staff including the registered manager, senior support worker, support workers and agency support worker.

We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at a variety of records relating to the safety and management of the service, including policies and procedures, staff recruitment, risk assessments and safety checks.

Updated 6 December 2023

About the service

Kensington Hall is a residential care home providing personal care to 10 people at the time of the inspection. The service can support up to 13 people.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. Based on our review of key questions of safe and well-led, the service was not able to demonstrate how they were consistently meeting some of the underpinning principles of Right support, right care, right culture.

Right Support:

Medicines were managed safely. However, improvements were needed in the records and guidance for topical and when required medicines. Care records were not always complete or accurate. Care plans and risk assessments had not always been completed with specific details required about people’s care and some included out of date information. Audits did not always identify the issues we found.

There were effective staff recruitment and selection processes. There were enough skilled and experienced staff who knew people well to safely meet people's health and physical needs. We received some mixed feedback about how the level of staff consistently supported independence and choice.

Infection control measures were in place, people were supported by staff to keep their home safe and clean. 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.

Right Care:

People received safe care in relation to their physical and health needs. Staff and people cooperated to assess risks people might face. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so.

Right Culture:

Governance systems were in place but the oversight of these was not always effective. There was a registered manager in post who is registered across 2 services. There had recently been additional support for the registered manager so they could spend dedicated time in the home making improvements. Longer-term a senior support worker was being upskilled to provide more management support. Both told us they felt supported by the wider organisation.

People did not always receive care that supported their needs and aspirations, was focused on their quality of life, and followed best practice. People's care plans did not always reflect clear goals and outcomes to support people’s independent living skills. There was limited evidence that activities were structured or planned to be as person centred as possible. Some people were active in the local community, but other people had limited access. The registered manager was already aware this was an area needing development and had started work to address this. We have made a recommendation about person centred support.

Most people and relatives told us there was a positive atmosphere in the home and staff were kind and caring. People and staff told us the registered manager was helpful, approachable and dealt with concerns if raised. Staff had close links with health professionals and met with them regularly to review people’s needs. Management and staff were working proactively on improvement plans from partner agencies. There were systems in place to gather feedback on the service. Most people, relatives and staff told us their feedback was valued and acted on.

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 14 January 2019).

Why we inspected

This was a planned focused inspection based on the length of time since the last inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to good governance at this inspection. We have made a recommendation about person-centred support.

Please see the action we have told the provider to take at the end of this report.

Follow up

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