This inspection took place on 14 November 2018 and was unannounced. This meant the staff and the provider did not know we would be visiting. Kensington Hall was last inspected by CQC on 1 and 2 June 2016 and was rated Good.

At this inspection we found the evidence continued to support the rating of 'Good' and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risk or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Kensington Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Kensington Hall provides accommodation and personal care for up to 13 older people living with a learning disability and/or autistic spectrum disorder.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. On the day of our inspection there were 13 people using the service.

The home had a registered manager in place. A registered manager is a person who has registered with CQC 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.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty to meet the needs of people who used the service.

The provider had effective procedures in place for managing the maintenance of the premises and appropriate health and safety checks were carried out. The home was clean, spacious and suitable for the people who used the service.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe management and administration of medicines.

Staff were supported to provide care to people who used the service through a range of training, supervision and appraisal.

People who used the service and their relatives were complimentary about the standard of care at Kensington Hall. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves, where possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Care records showed people’s needs were assessed before they started using the service and care plans were written in a person-centred way and were reviewed regularly. Person-centred is about ensuring the person is at the centre of any care or support and their individual wishes, needs and choices are taken into account.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. People had access to healthcare services and received ongoing healthcare support. Care plans were in place that recorded people’s plans and wishes for their end of life care.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs, in the home and within the local community.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of

The inspection took place on 1 and 2 June 2016 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Kensington Hall on 30 September 2014, at which time the service was compliant with all regulatory standards.

Kensington Hall is a residential home in South Hetton, County Durham, providing accommodation and personal care for up to 13 people living with a range of learning disabilities. There were 11 people using the service at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like directors, 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 found that there were sufficient numbers of staff on duty in order to meet the needs of people using the service, as well as to ensure premises were clean and well maintained.

People who used the service, their relatives and a range of external professionals all expressed confidence in the ability of staff to protect people from harm.

Staff we spoke with displayed a good knowledge of safeguarding principles and how to look out for signs of abuse. They were clear about their responsibilities should they have any concerns.

We saw there were effective pre-employment checks of staff in place, including Disclosure and Barring Service checks, references and identity checks, to reduce the risk of unsuitable people working with people who may be vulnerable.

The storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Clinical Excellence (NICE).

All areas of the building including people’s rooms, bathrooms and communal areas were clean, with infection control risks well managed and appropriately resourced.

Individualised risk assessments were in place to manage the risks people faced. These assessments and associated care plans were reviewed regularly and included advice from healthcare professionals to keep people safe.

Visiting professionals had confidence in the experience and knowledge of staff, citing a range of examples where they ensured people’s healthcare needs were met. There was prompt and regular liaison with GPs, nurses and specialists to ensure people received the treatment they needed.

Staff were trained in areas specific to meeting people’s changing needs, for example dementia awareness and communication training, and were also trained in areas the provider considered mandatory, such as safeguarding, health and safety, moving and handling and dignity.

Staff were supported through well-planned regular supervision and appraisal processes as well as ‘hands-on’ from management when required.

We saw people had choices at each meal and were involved in planning the menu. We saw people who required help to eat were supported patiently and people with specialised diets had their needs met.

Each room had an en suite shower room, whilst the rest of the building was well maintained, with bright spacious corridors and ample communal and outdoor space.

Group activities were varied and well planned, coordinated by a new member of staff with relevant experience. Improvements were planned to ensure people who could not choose to engage in group activities had alternative, meaningful options.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

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The inspection team was carried out by a single inspector. We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People told us that they felt their rights and dignity were respected.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. People said that their care plans were up to date and reflected their current needs.

One person had a part time out reach support worker and told us that the service had helped them to find them. Other people we spoke with were also supported by outreach worker's.

Is the service caring?

We spoke with ten people being supported by the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example; “the staff are brilliant they should all be given a pay rise”, “Sometimes I help to write my care plan”, “I feel safe here."

When speaking with staff it was clear that they genuinely cared for the people they supported.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were taken on board and dealt with.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. One person said that they had made a complaint and were satisfied with the outcome.

The service worked well with other agencies and services to make sure people received care in a coherent way.

Is the service well-led?

The service has a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We observed how staff asked people for consent. For example, before entering someone’s bedroom, staff asked the person if it was OK to go in. We saw another member of staff asking someone what they wanted for their lunch and when they wanted to go shopping.

We spoke with several people who lived at the home and some of their relatives. People were very happy with the care provided. Comments included “I like the staff very much, everything’s fine and I’m doing very well” and “They are like my best friends.”

We spoke with some staff, people who lived at the home and their relatives about staffing levels. They all said they thought there was enough staff on duty to meet everyone's needs.

People said they knew they could speak to a member of staff if they had any concerns. One person said "I would speak to them or the manager: they would sort it out for me.” Another said “I haven’t had to complain but I know what to do.”

During our inspection we spoke with four people who used the service, and two visiting relatives. People and their relatives told us they were happy with the care which was provided. People told us they were encouraged to be independent, one person said, "Staff help me to do the things I can't do. But I do most things myself. I decide on my own clothes for the day and get myself dressed. But staff do help me with other bits." One relative told us, "My brother has never been happier since he's been here. He is in a happy steady place. Staff know people well. There is a lot of interaction with people and it really feels like people's own home." During our visit we saw people were treated with consideration and respect.

We reviewed three care records and saw that people's preferences and care needs had been well documented. We spoke with four members of staff. Staff were knowledgeable about the people's care needs and what they should do to support them.

People told us they enjoyed the food. One person said, "Lunch was very nice, it always is."

Staff training was kept up to date so that staff could care for people safely and to an appropriate standard.

We found that the provider had made suitable arrangements to protect vulnerable people from the risk of abuse.

There was an effective system in place to monitor and assess the quality of the service.

We were able to talk to three people who used the service and they commented that they ‘like living here’, that ‘staff work hard’ and that ‘staff are fantastic to us here’. They also said that they ‘love the food’ and that they ‘get enough’.