Kaydar Residential

We found the following examples of good practice during our inspection:

• Systems were in place to prevent people, staff and visitors from catching and spreading infections.

• People and their relatives were supported to keep in contact using a range of technology.

• Additional cleaning of all areas and frequent touch surfaces was being carried out regularly.

• People were supported to understand the pandemic and the need for infection prevention and control (IPC) measures, such as staff wearing face masks.

• People and staff participated in a regular testing programme.

• Appropriate vaccination status checks were in place.

• Staff wore appropriate PPE and the service had ample PPE supplies.

• Staff had an excellent understanding about the impact of the pandemic on the people they supported. They recognised the particular difficulties they faced and did all they could to make reasonable and safe adjustments to support people's emotional wellbeing.

Kaydar Residential 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.

This service provides personal care for up to eight people 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 days of our inspection there were seven people using the service.

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 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 the service in April 2017 and rated the service as 'Good' overall. At this inspection we found the service remained Good.

Staff knew how to keep people safe and prevent harm from occurring. Staff had completed training in safeguarding vulnerable adults and understood their responsibilities to report any concerns. Thorough recruitment and selection procedures ensured suitable staff were employed. Risk assessments relating to people's individual care needs and the environment were reviewed regularly. Medicines were managed safely and administered by staff trained for this role.

Staff received appropriate training 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 supported this practice. People were supported to have enough to eat and drink and attend appointments with healthcare professionals.

Staff provided care and support with kindness and compassion. There were positive interactions between people and staff. People could make choices about how they wanted to be supported and staff listened to what they had to say. People's independence was promoted and encouraged. There was a welcoming and homely atmosphere at the service.

People received support which was person-centred and responsive to their needs. Detailed support plans were in place which guided staff how people wished and needed to be supported with daily living. People who received support, or where appropriate their relatives, were involved in decisions about their care.

People spoke positively about the registered manager and the providers, who visited the service often. There was a positive ethos and culture which was led by the management team. There was an effective quality assurance system in place to ensure the quality of the service and drive improvement.

Further information is in the detailed findings below.

Kaydar Residential is registered to provide accommodation for people who need personal care. The home is a large terraced house with eight bedrooms, two lounges, a kitchen / dining room. It is located in a residential village, near to public transport routes and local shops.

The service had a registered manager in place and they have been registered with the Care Quality Commission since January 2011. 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. The registered manager also owned the service.

The registered manager had knowledge of the Mental Capacity Act [MCA] 2005 and Deprivation of Liberty Safeguards [DoLS]. 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. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The registered manager understood when an application should be made, and how to submit one. At the time of our visit no one living at the service were subject to a DoLS authorisation.

Risks to people’s health or well-being had been assessed and plans put in place to protect people. People had access to medicines and these were stored and administered safely.

Staff we spoke with understood the principles and processes of safeguarding. Staff knew how to identify abuse and act to report it to the appropriate authority. Staff said they would be confident to whistle blow [raise concerns about the service, staff practices or provider] if the need ever arose. The registered provider followed safe processes to help ensure staff were suitable to work with people living in the service.

Staff had completed a range of training which was updated yearly and felt supported by the registered manager.

There were sufficient staff to provide the support needed and staff knew people’s needs well. Staff had regular supervisions and appraisals to monitor their performance.

Staff provided individualised care for people. They showed respect to people and spoke with them in a kind and caring manner. The registered provider supported people to be as independent as they could be and to remain a part of the community. People’s privacy was respected and people said they felt safe and cared for.

People felt involved in the way their care was planned and delivered. They were able to provide feedback on the service they received and their concerns were addressed.

People were supported to access healthcare professionals and services.

People who used the service had freedom to come and go as they pleased and all enjoyed their own hobbies such as baking, shopping and listening to music.

People’s care records were person centred. Person centred planning (PCP) provides a way of helping a person plan all aspects of their life and support, focusing on what’s important to the person. The care plans were found to be detailed outlining the person’s needs and risks. Risk assessments were in place. Care plans provided evidence of access to healthcare professionals and services.

Accidents and incidents were monitored each month to see if any trends were identified. Where trends were identified actions were put in place to prevent or minimise the risk of the same accident or incident happening again.

We saw that the service was clean and tidy and there was plenty of personal protection equipment [PPE] available.

We observed a lunchtime meal. People were provided with choice and enjoyed the food on offer.

Staff were supported by the registered manager and were able to raise any concerns with them. Lessons were learnt from incidents that occurred at the service and improvements were made if and when required. The service had a system in place for the management of complaints.

We saw certificates for safety checks and maintenance which had taken place within the last twelve months such as fire equipment and electrical safety.

The registered provider had developed a quality assurance system and gathered information about the quality of their service from a variety of sources.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they were happy at Kaydar and they felt safe and secure.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Although no DoLS applications had been made, staff were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they had been fully involved in what was written in their plans and had been able to make decisions about what was important to them which was respected by the provider and staff.

People had access to a range of health care professionals and they were supported by staff to attend healthcare appointments if this was needed.

This meant that people were sure that their individual care needs and wishes were known and planned for.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people.

There was an advocacy service available if people needed help or support to speak for themselves.

Staff were aware of people's preferences, interests, aspirations and diverse needs. We observed that people's individual wishes for care and support were taken into account and respected and we saw these were regularly discussed with them and recorded in their care plans.

Is the service responsive?

People told us, that they were able to participate in a range of activities both in the home and in the local community. One person told us 'I'm never in.' The activities people took part in included those where people could enjoy as a group and others that met their individual interests, for example shopping, going out for meals and visiting interesting places, events and performances.

People told us they were involved in reviewing their plans of care when their needs changed.

People knew how to make a complaint if they were unhappy and were supported by staff or advocates if they were needed. People said they would have no hesitation in raising any concerns with the staff or manager. One person said 'I can talk to the staff at any time and ring (the provider) if there is anything I'm not happy about.'

Is the service well-led?

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

The home had a system to assure the quality service they provided. We found people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. The way the service was run had been regularly reviewed and prompt action was taken to improve the service or put right any shortfalls that were found.

We found care and treatment was planned and delivered in a way which ensured peoples' safety and welfare. We spoke with people about how they felt about the home. They said things like, 'I have lived here for many years and I am very happy with the service and support I get from (staff and the provider),' 'They're all canny and I'm happy' and 'So far I am very impressed.'

The provider had made suitable arrangements to protect vulnerable people and responded appropriately to any allegation of abuse.

We found people were cared for by staff who were trained and supported by the provider to deliver care and treatment safely and to an appropriate standard.

We found people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We spoke with some relatives of people who lived at the home. They said things like, 'I'm so pleased there are places like Kaydar. My (relative) is so much happier here and it really does feel like the staff look out for her' and 'An excellent home couldn't fault it.'

We found care and treatment at the home was planned and delivered in a way which ensured people's safety and welfare. One person said, 'I like it here because I get what I want ' no pressure.'

We looked at the way medication was handled at the home. We found people were protected against the risks of unsafe use or management of medicines because the provider had appropriate arrangements in place.

We found staff received appropriate professional development. People told us they were happy with the support they received from staff. One person said 'Staff are all good together.'

People who used the service, their representatives and staff were asked for their views about the care and treatment offered. We saw their responses were acknowledged and acted on. When we spoke to people they said 'everything's fine in my life' and, 'I like it here, I don't want to be anywhere else.'