Kirk House

At this assessment we did not assess all quality statements within this key question. We found 5 breaches of regulation which related to need for consent, dignity and respect, safe care and treatment, premises and equipment and safeguarding people from abuse. People were subject to restrictive practices that were not regularly reviewed to ensure they were justified. There was no evidence the provider had taken steps to reduce some restrictive practices or evidence that people had been supported appropriately to ensure they had not suffered emotional or psychological harm. Staff understood their responsibility in relation to safeguarding people from abuse, however when some concerns had been raised there was no evidence that appropriate actions had been taken to keep people safe. Additionally, we received a large number of anonymous concerns from staff. Decisions made in people’s best interests were not regularly reviewed. Additionally, people were not always supported to share their views and have them accepted. Staff were recruited through robust processes. Staff had completed training in line with their role which was up to date. However, training was not always effective. There were areas in the environment that were not safe or clean. Food was not always handled or stored safely, additionally there were areas in the home that were poorly maintained and required deep cleaning. Medicines were not always stored or managed safely.

At this assessment we did not assess all quality statements within this key question. We found 1 breach in regulation which related to person-centred care. People’s needs and risks were not always assessed appropriately or reviewed regularly. People were not supported to have maximum choice and control of their lives. Regular assessments of people who had been using the service long term, had not been carried out to ensure the provider continued to work in line with the Mental Capacity Act (MCA). Some staff we spoke with understood the principles of the MCA.

At this assessment we did not assess all quality statements within this key question. We found people were not always treated with dignity and respect. Systems were in place to promote independence and respond to individual needs, however it was unclear how they achieved good outcomes for people.

Staff ensured people had access to healthcare to maintain their wellbeing, however there was no evidence on how lessons were learnt or improvements identified. People were supported to attend specialist health appointments for continued monitoring and treatment. The service had developed good relationships with their GP practice.

At this assessment we did not assess all quality statements within this key question. We found 1 breach in regulation which related to the governance of the service. The provider’s audits failed to identify the concerns we found during the assessment in relation to the environment, medicines and infection, prevention and control. Concerns that had been found were not always actioned in a timely manner with some concerns being found again in later audits. The management team did not always promote positive cultures to ensure, where possible, immediate steps were taken to identify and reduce restrictive practices.