Kemble House

People's experience of using this service: People told us they liked living at the service and most people said they felt safe there. Two people mentioned that had they felt uncomfortable about the occasional behaviour of people who had recently moved out.

Most people told us staff were kind and caring and people, families and health and social care professionals confirmed this.

The service was not always meeting the underpinning principles of Right support, right care, right culture due to issues highlighted in the Right support section below.

Right support: Despite the service being larger than best practice guidelines, the service provided care that was personalised, and the service was working to maximise people's choices. People were involved in a range of community activities of their choice, but people told us they would like the opportunity to go out to additional community activities.

Long-standing staff understood people's needs. New staff were in the process of getting to understand the needs of the individual people living at the house. But we were made aware from some relatives and health professionals that the service was not always able to understand the challenges of supporting people with dual mental health needs and a learning disability or autism. The registered manager was working with the staff team to develop their skills, knowledge and experience.

Right care: Care documentation was up to date, person-centred and promoted people's dignity, privacy and human rights. Care documents outlined people's needs, preferences and routines. Risk assessments were in place to address known risks. The management team were working with family members and health professionals, to understand how best to support people living at the home, and showed commitment to further improve this partnership working. Appropriate documentation was in place where people's liberty was restricted.

Right culture: The registered manager promoted good quality care, and was supporting staff to further develop and improve their skills through supervision, training and effective team communication. People and relatives told us that the registered manager communicated with them when issues arose. Following the inspection, the service introduced regular meetings with family members, had asked for their views through a survey, and was planning to undertake a survey of the views of health professionals.

Safe recruitment took place at the service, and people were safeguarded against the risks of abuse and harm by the systems and by the staff. There were enough staff to meet people's needs.

Medicines were managed safely, and there were infection control processes in place.

The provider and registered manager had systems in place to monitor the quality of the service through audits and checks. However, we became aware of some issues through feedback with relatives and health professionals, as part of the inspection that the registered manager and provider should have known.

The building utilities and fire equipment were safely maintained, but we saw that there was outstanding maintenance to the building required. At the time of writing this report we were shown a plan to address these building improvements.

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