This inspection took place on 29 June and 5 July 2018. The first day of the inspection was unannounced.

Kemp Lodge provides support for people who have an acquired brain injury. It is owned by Voyage Care. The home Lodge can accommodate up to seven people in one adapted building, at the time of our inspection seven people were living at the home.

Kemp Lodge is a ‘care home’. 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.

The home had a registered manager. 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.

During our previous inspection in April 2017 there were breaches of Regulations 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The overall rating of the service was ‘requires improvement’. This is because people using the service and those lawfully acting on their behalf, had not always given consent before care or treatment was provided. The provider did not seek and act on feedback from people using the service, those acting on their behalf, staff and other stakeholders. And, the provider did not maintain accurate, complete and detailed records in respect of each person using the service.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions. Is the service safe? Is the service effective. Is the service responsive? and; Is the service well-led? To at least good.

At this inspection we found that the service was ‘good’ and was no longer in breach of regulations. This was because appropriate procedures had been followed to ensure that the administration of covert medication was appropriate, legal and in the person’s best interests. Also, the service was now working within the principles of the MCA and people’s consent to their care was sought.

At this inspection we looked at the care files for four people. The information contained was up to date, detailed and thorough. Important information to and for a person was clear and highlighted at the front of the care file. People told us that the support they received met their needs. One person said, “I wish to go home. These guys are helping me to get ready for this.”

We also saw that feedback from people, their relatives and staff had been obtained by a stakeholder questionnaire. There were also less formal plans to engage with people; we saw that there was an upcoming friends and family BBQ planned. We also saw that there had been regular ‘house meetings’ were feedback was sought from people living at Kemp Lodge.

People living at the home told us that they felt safe and secure. One person when referring to a member of staff said, “He’s a good friend of mine. He keeps his eye on us. I like it here, I wouldn’t; want to move.” Another person told us, “I feel quite safe here. I like the people here.” There were enough staff at the home to meet people’s needs safely. They had been safely recruited and appropriately trained in safeguarding vulnerable adults. Steps had been taken to ensure that the home’s environment was safe.

People living at the home praised the staff and how they cared for them. People told us that they had got on very well with the staff and had found them friendly. Staff told us that they enjoyed their roles and received appropriate training and support to be effective. People at the home were listened to and were treated with dignity and respect.

People’s needs and choices were assessed as part of the care planning process when arriving at the home. Their s

This inspection was carried out on 19 and 24 April 2017. Kemp Lodge is registered to provide accommodation and support for up to seven people and at the time of our inspection there were seven people living at the home. The home provides support for people who have an acquired brain injury. It is owned by Voyage Care, a national organisation.

The home had a registered manager, however at the time of the inspection the registered manager was not working in the home. 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.

We last inspected Kemp Lodge on 4 and 8 December 2015 when we found that the home was providing an overall good service but improvements were needed to the management of people’s medication. Since that inspection we have received information of concern about the service and so this inspection was brought forward.

During the inspection we found breaches of Regulations 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because: people using the service, and those lawfully acting on their behalf, had not always given consent before any care or treatment was provided and: the provider did not seek and act on feedback from people using the service, those acting on their behalf, staff and other stakeholders.

Most people told us that they thought Kemp Lodge was a safe place to live, however we heard some concerns about whether there were enough experienced staff to ensure that people were kept safe and that their support needs were met.

Improvements had been made to the arrangements for the storage of people’s medicines, however there was scope for further improvement.

People living at the home did not receive a varied and nutritious diet and the home’s kitchen had a poor food hygiene rating.

A system for staff supervision and appraisal was in place but had not been kept up to date.

People’s capacity to make decisions was assessed and appropriate Deprivation of Liberty Safeguards were in place, however we did not see evidence that people living at the home and/or their families had always been involved in making important decisions about their care and support and this was confirmed by a relative we spoke with. There were no records of complaints that had been made.

Care records were not always sufficiently detailed, accurate or up to date.

Systems were in place for checking the quality of the service provided but these had not always been effective.

The house was well maintained with systems in place for checking the safety of the building. Work was taking place to improve the environment.

Systems and training were in place to help staff identify and deal with any allegations of abuse and appropriate notifications had been made.

New staff were recruited safely and a programme of staff training was up to date.

People received support to access health professionals as and when needed.

Staff knew people’s individual needs, choices and communication methods and we saw that staff treated people with kindness and respect.

The provider had taken, and was continuing to take, positive action to address concerns raised during recent months.

This inspection was carried out on 04 and 08 of December 2015. We gave the registered manager short notice of our inspection to ensure people would be at home when we visited.

Kemp Lodge is registered to provide accommodation and support for up to seven people. At the time of our inspection there were seven people living at the home. The home provides support for people who have an acquired brain injury. It is owned by Voyage 1 Limited, a national organisation who provide support services to people across the UK.

The home had a registered manager. 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.

During the inspection we met six of the people living at Kemp Lodge and spoke with two of their relatives. We also looked around the premises and spoke with six members of staff. We examined a variety of records relating to people living at the home and the staff team. We also looked at systems for checking the quality and safety of the service.

At this inspection we found a breach of regulations. This was because medication had not always been safely and properly managed. We also found that risks had not always been properly assessed and balanced against people’s rights.

You

can see what action we told the provider to take at the back of the full version of the report.

People told us that they thought Kemp Lodge was a safe place to live. Systems and training were in place to help staff identify and deal with any allegations of abuse that arose.

The house was well maintained with systems in place for checking the safety of the building. Staff were aware of the actions they should take in the event of an emergency occurring.

The people living at Kemp Lodge liked and trusted the staff team. There were sufficient staff working at the home to meet the needs of the people living there. Suitable systems were in place for recruiting, training and supporting staff, this helped to ensure they were suitable to work with people who may be vulnerable.

People received the support they needed in all areas of their life. This included support to manage their health, access therapists and increase their everyday living and independence skills.

People’s legal rights were protected and people had received the support they needed to make decisions for themselves or with appropriate support as applicable.

Staff knew people’s individual needs, choices and communication methods well and worked with people to explain things in a way they understood.

The people living at Kemp Lodge and their relatives felt confident that any concerns they raised would be listened to and acted upon. Systems were in place for encouraging people to raise concerns and for dealing with any concerns raised.

Systems were in place for checking the quality of the service provided and obtaining people’s views. Any areas identified as needing improvements were addressed via a clear action plan that was monitored by the provider.