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Inspection Summary


Overall summary & rating

Good

Updated 21 February 2017

Keb House is registered to provide accommodation for up to 18 older people, some of whom may be living with dementia. The service is a Victorian style house with the addition of a newer single storey extension. The service is accessible for people with mobility difficulties and comprises various communal rooms, en suite bedrooms, a laundry, and kitchen and activity room. There is outdoor garden space with areas of seating. On the day of the inspection there were 13 people using the service.

We undertook this unannounced inspection on the 4 January 2017. At the last inspection on the 7 January 2016 we found a breach in regulation. The registered provider had not always ensured the service was well maintained and in a good state of repair. The overall rating for the service was, “Requires improvement”. Following the inspection we received an action plan from the registered provider in August 2015 detailing how improvements would be made.

The service had a registered manager in post who was also the registered provider. A registered manager is a person who has registered with the 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.

During this inspection we found the cleanliness of the premises was satisfactory. The registered provider had made improvements to the general environment, which included redecoration to some areas of the older part of the building, such as a bathroom and the hall, stairs and landing. Two window frames in the main lounge had been re-painted and cracked glass replaced. The lights we checked during the inspection were all in working order, with the exception of one sensor light on an upstairs corridor where two bedrooms were located. We saw there was adequate ceiling lighting to compensate for this and the registered manager told us they would address this issue.

In the extension we saw nine bedrooms, the dining area and corridors had been re-painted. In one bathroom we found a bath support leg which was very rusty and in one bedroom we saw the person’s bed sheet had a rip in it. The registered manager addressed these issues immediately during this inspection.

It was recommended at the last inspection that the registered provider obtained information and direction from the local authority in respect of DoLS applications to ensure they are working within the principles of the Mental Capacity Act 2005 (MCA). At this inspection we found improvements had been made. The registered manager was following the principles of the MCA and seven applications had been submitted to the authorising body in respect of people being deprived of their liberty. The MCA legislation is designed to ensure that when an individual does not have capacity, any decisions are made in the person's best interest.

At the last inspection we made a recommendation for the registered provider to refer to good practice guidance with regard to making the environment more suitable for those people who may be living with dementia. At this inspection we saw there was pictorial signage as prompts to locate toilets, bathrooms, the kitchen and people’s bedrooms had signs on the door with their names on.

We also recommended at the last inspection that the registered provider reviewed the action plans produced following in house audits and ensured they were more detailed and robust in the recording. During this inspection we found improvements had been made to the maintenance recording and checks were more in depth and made on a weekly basis.

We found that people’s medicines were stored and administered appropriately. We saw medicine audits had not been completed since September 2016, but were completed regularly prior to that.

People living at Keb House said they felt safe and that staff were kind and caring. There were risk assessments in

Inspection areas

Safe

Good

Updated 21 February 2017

The service was safe.

People felt safe and risk assessments were in place.

There was an adequate number of staff available to support people.

People received their medicines safely.

Effective

Good

Updated 21 February 2017

The service was effective.

Staff were provided with an induction before working for the service, on-going supervision and support.

Staff knew how to support people in line with the Mental Capacity Act and gained their consent before assisting or supporting them.

A variety of food and drink was available at the service and specialist diets were supported.

Caring

Good

Updated 21 February 2017

The service was caring.

Staff maintained people's dignity and provided respectful care. From our observations and from speaking with staff, we could see they knew people well.

People felt that staff were kind and caring towards them.

People were involved in making decisions about their care and how it was to be delivered.

Responsive

Good

Updated 21 February 2017

The service was responsive.

People who used the service had assessments of their needs and care plans were produced which provided staff with information about how to care for them in ways they preferred.

We observed people received care that was individualised and person-centred.

There was a complaints procedure in place staff told us they would support people to make a complaint if they had difficulty in doing so.

Well-led

Good

Updated 21 February 2017

The service was well led.

Quality assurance processes were in place. People were consulted and asked for their views to help the service to improve and develop.

We found the registered manager had an open and honest approach.

Staff told us they enjoyed working at the service and felt supported by the registered manager.