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Keswick House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 December 2019

About the service

Keswick House is a residential care home that was providing personal and nursing care. The service supports people who have a learning disability.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people. 13 people were using the service at the time of the inspection. This is larger than current best practice guidance detailed in Registering the Right Support. The provider had started to work towards meeting best practice guidance and people were encouraged to increase their independence. The staff culture was changing, and they understood the importance of supporting people when they needed it, whilst prompting people to make their own choices. Further improvements were needed to mitigate the impact of the environment on people.

People’s experience of using this service and what we found

The provider’s legal entity was registered with us as a partnership and remained inappropriate at this inspection due to concerns that had been raised about the partnership. Action still needed to be followed to ensure the new company registration continued. Improvements were needed to ensure all systems to monitor the service were effective in identifying and mitigating risks.

Improvements to the environment were ongoing to ensure infection control risk were mitigated and the design reflected the needs of people. Staff knowledge and skills still required further development to ensure people received effective care.

We made a recommendation for the provider to seek guidance on the advance planning of people’s end of life wishes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Improvements were still needed to ensure the policies and systems in the service supported this practice.

Risks to people’s health and wellbeing were identified and managed to keep people safe. There were enough staff available to provide support in an unrushed way and to meet people’s needs. People were supported with their medicines as prescribed.

People were involved in the planning and preparation of their meals and their nutritional needs were monitored and managed. People were supported to access health professionals and advice received was followed by staff.

People were supported by caring staff who respected people’s choices. People were encouraged to make choices and to increase their independence. People’s privacy was upheld.

The service had started to apply the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service had started to reflect the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People received support in line with their preferences and they were involved in the planning and review of their care. Goals were set by people with support from staff to help them achieve a greater independence. People accessed the community and were involved in activities which they enjoyed.

People, relatives and staff were able to approach the registered manager if they had concerns and the registered manager worked in partnership with other agencies.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 July 2019) and there were multiple breaches of regulation. At this inspection the service had made some improvements and there was one remaining breach of regulation. The service remains rated requires improvement.

This service has been in Special Measures since 06 November 2018. During this inspection the provider demonstrated that impro

Inspection areas

Safe

Good

Updated 10 December 2019

The service was safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 10 December 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 10 December 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 10 December 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 10 December 2019

The service was not always well-led.

Details are in our well-Led findings below.