We inspected this service on 9 April 2018. The inspection was unannounced.

Kingsbury House Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Kingsbury House Limited accommodates up to 19 people living with mental health needs. On the day of our inspection, 17 people were living at the service.

The service had a registered manager at the time of our inspection. 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 a 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 home’s previous inspection in April 2017, we rated the service ‘Requires Improvement’ and identified one breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. This was in relation to Regulation 17 Good Governance. Systems in place to check on quality and safety were not as effective as they should have been. Following this inspection the registered provider was required to send us an action plan to inform us of the action they would take to make the required improvements.

During this inspection we checked to see whether improvements had been made, we found the breach in regulation had been met and all areas of the service had improved resulting in positive outcomes for people.

People told us they felt staff provided safe care and support. When safeguarding incidents or concerns were identified, the registered manager took appropriate action to protect people. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm or if they needed to report concerns.

There were systems in place to identify, manage and monitor risks associated with people’s needs including the environment. Accidents and incidents were minimal but recorded and reported by staff. The registered manager analysed these to ensure appropriate action had been taken to protect people, and to consider if there were any themes or patterns that required further action. Contingency plans were in place to support staff to provide a safe service in the event of an untoward incident affecting the service.

There were sufficient staff to keep people safe and meet their needs. Safe recruitment procedures were in place and followed. People’s prescribed medicines were managed and stored safely following best practice guidance.

Improvements had been made to infection control practice and some areas of the service had been refurbished.

People were supported by staff that had received an induction, ongoing training and support. The provider ensured practice was in line with current legislation and best practice guidance.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. Opportunities of healthy eating needed to be promoted; the registered manager took action to address this.

People had choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. The principles of the Mental Capacity Act (2005) were followed when decisions were made about people's care. Deprivation of Liberty Safeguards were in place for people where required.

The service worked with external healthcare professionals when required to ensure they provided effective care and support. When concerns were identified about people’s healthcare needs, appropriate action was taken to support people’s health and well-being.

Staff were kind and caring, they knew people well, and they supported people in a dignified and respectful way. Staff acknowledged and promoted

We carried out an unannounced inspection of the service on 10 April 2017.

Kingsbury House provides accommodation and personal care for up to 19 people living with mental health needs. On the day of our inspection there were 19 people living at the service.

Kingsbury House is required to have 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. At the time of the inspection a registered manager was in post.

Staff were aware of the safeguarding adult procedures to protect people from abuse and avoidable harm. Risks associated to people’s needs had been assessed and planned for. However, there was no risk assessment completed for contractors that were on site during our inspection visit. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. Some concerns were identified with the arrangements of night time staffing that meant people were not always fully protected from avoidable harm. Safe staff recruitment processes were in place and followed. Some health and safety issues regarding the environment were identified. Action was required to improve how medicines were managed.

Staff training requirements had not been monitored appropriately. Staff had received an induction and opportunities to discuss and review their work. People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People’s choice of supper time had been restricted.

People's healthcare needs had been assessed and staff offered support to people to maintain their health. Staff worked with healthcare professionals to support people.

Staff were kind and respectful towards the people they supported. Staff had an understanding of people's individual needs, routines and what was important to them. People’s diverse needs were known and understood by staff. People received opportunities to discuss their support needs. People had information to inform them of independent advocacy services.

People accessed the community independently and chose how to spend their time. Some group and social activities were provided by staff that people enjoyed. Staff promoted people’s independence such as encouraging people to participate in some domestic tasks. A complaints policy and procedure was available and people knew how to make a complaint if required.

The provider enabled people who used the service and their relatives to share their experience about the service provided. The provider had checks in place that monitored the quality and safety of the service. However, these were not as effective as they should have been; shortfalls identified at this inspection had not been identified.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.