We carried out a review of the data available to us about Keo Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Keo Lodge, you can give feedback on this service.
We found the following examples of good practice.
There was a clear process in place to monitor vaccination status and testing for staff and people at the service.
Personal Protective Equipment (PPE) stations where staff could sanitise their hands, don and doff the appropriate PPE were placed throughout the building in key areas. Staff wore PPE in line with current government guidance when supporting people who were isolating.
The provider responded swiftly when people tested positive for COVID-19 and supported them to isolate immediately and ensure all areas of the home were sanitised and disinfected through a deep clean.
The provider regularly reviewed their risk assessments relating to COVID-19 to ensure they were up-to-date and accurate.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Keo 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the provider, registered manager, support manager, senior care workers, care workers and the chef.
We reviewed a range of records. This included two people’s care records and multiple medication records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We spoke with two health professionals and reviewed additional information the provider sent to us in relation to the inspection.
This inspection was carried out on 18 May 2017, was unannounced and carried out by one inspector. There were ten people living in the home at the time of our inspection.
At the last inspection in July 2014, the service was rated Good.
At this inspection we found the service remained Good.
People using the service felt safe. People were supported by staff that were able to recognise signs and symptoms of abuse and were able to raise their concerns. People were also safe because risks associated with their needs were identified and managed by staff in line with the management plans in place. There were sufficient numbers of safely recruited staff to meet people’s needs. People were supported to receive their medicines as prescribed.
People were supported by staff that had the skills and knowledge to provide effective care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to have food and drinks that met their needs and that fulfilled individual preferences. People were supported to have their health needs met by a variety of healthcare professionals.
People were supported by staff that were caring and kind and that knew people’s individual likes and dislikes. People were spoken with in a respectful and dignified way and their privacy was promoted as far as possible. People were supported to develop their independence to enable them to have greater control over their day to day lives.
People received a service that was responsive to their changing needs and wishes and that listened to the views of people so that the service could be adapted to meet their needs.
People received a good quality service that showed some elements of development towards an outstanding quality of service. The registered manager and provider provided good leadership so that people and staff were happy and were able to influence the direction of the service. The quality of the service was monitored regularly to ensure shortfalls were identified and addressed in a timely manner. There were good relationships with other professionals providing a service to the people living there.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This inspection was unannounced so no one at the home knew we were going to inspect..
The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Keo Lodge provides a service for up to ten men who have a learning disability and/or mental health diagnosis. There were ten people living in the home at the time of our inspection. They have been discharged from hospital with restrictions that relate to where they live, their medication regime and being available for treatment and assessment. Accommodation is provided over three floors. Bedroom doors are alarmed so that the movements of people are known by staff.
We last inspected this service on 6 November 2013 when we saw that people received a good service. At this inspection we saw that there were no breaches in the regulations we looked at.
All the people we spoke with told us that they were happy with the support they received. We saw that people were involved in planning their care and were able to comment on the day to day care provided by making comments in their daily diaries and one to one sessions with staff. We saw that people were safe from harm because they knew the restrictions on their placements and how to raise concerns if they were unhappy. We saw that when people raised concerns these were dealt with quickly. We saw that people were told what actions would be taken or not taken as a result of their comments and the reasons for this response. This showed that people were kept informed about the actions taken.
There were robust recruitment procedures in place and staff were supported and trained to ensure that they were able to provide safe and appropriate care and support to people according to their individual needs.
We saw that everyone living at Keo Lodge had the capacity to make decisions about their care and support. People were able to make decisions about their day to day lives. People were protected from abuse and unnecessary harm because there were sufficient staff available to support them. Staff had received training and support that ensured that they had the skills and knowledge to support people safely and in a personalised way. Healthcare professionals told us that they were happy that the care and support people received met their needs. The support people received enabled them to develop their daily living skills and progress towards independent living where appropriate.
Staff responded to people’s needs for reassurance and support as required. Staff were kind and caring and people knew what had been planned for the day and who was supporting them at different times of the day. We saw that sometimes physical interventions had been undertaken by staff to protect people. We saw that these incidents were monitored by the senior management team and other professionals to ensure that they were not occurring unnecessarily and putting people at risk of harm.
Staff respected people’s privacy and dignity by always knocking on bedroom doors and asking for permission before entering. Although people needed constant supervision people were able to have privacy in their bedroom because bedroom doors were alarmed so that staff were alerted to their movements around the home.
We saw that people were supported to have their physical, mental and social needs met by staff working in the home and healthcare professionals including GPs, dieticians, psychiatric community nurses and inpatient treatment. People were supported to carry out their own personal care and develop their daily living skills. People were supported to maintain contact with the local community and people important to them. Relatives told us that they were able to visit at times that suited them so that their relationships were maintained.
We saw that systems were in place to monitor and check the quality of care and to make sure the environment was safe and well maintained. There was evidence that learning from incidents and investigations took place and changes were put in place to improve the service. This meant that people were benefiting from a service that was continually looking how it could provide better care for people.
People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. We saw people being consulted about what they would like to do. People's preferences were documented to inform staff. One person told us: 'Staff treat me with respect and observe my dignity.'
People experienced care, treatment and support that met their needs. People were encouraged to remain as independent as possible and to participate in a range of activities and outings. People's changing needs were recognised and appropriate specialist intervention was sought. One relative told us: 'I am pleased with the care, the staff are good.' The provider ensured people's health and welfare needs were met.
People were kept safe from the risk of abuse. The service had made arrangements to ensure that both staff and people understood what abuse was and how to report. One person told us: 'I've been in here four years and I feel safe here'.
People experienced a service which was monitored to improve its quality. Complaints and comments were listened to and acted on to people's satisfaction. The provider sought the opinions of people, their representatives and staff to make improvements within the service.
The provider had been able to manage peoples care and welfare needs successfully, working in partnership with other healthcare professionals and peoples families. One visitor told us, 'They have my relative's best interest in mind and we work well together'. People had opportunities to be part of their local community and maintain strong family links.
Staff were trained and skilled to support people using the service. People within the service were aware of what abuse was and how to report it. Staff displayed a good understanding of how to protect people and attended regular training updates.
Staff received support to maintain and increase their skills and qualifications. Staff had mandatory training and other professional development. They were encouraged to undertake additional related training to support them in their roles. One staff member told us that support arrangements were good and that senior staff were always accessible.
The complaints arrangements met people's needs and were well used by people within the service. The provider had ensured that it was accessible and engendered a culture of no blame, being investigated in a timely and impartial manner.
People told us that staff involved them in their care, as 'I can go to my review meetings if I want to.' They were also supported to take part in activities in the local community and one person told us 'I get to go out when I want to.'
They said staff supported them to manage their health by 'remind(ing) me to take my tablets' and if they did not feel well, 'I go to the doctor.'