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We are carrying out a review of quality at Keswick House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 July 2019

About the service:

Keswick House is a residential care home that was providing accommodation with personal care. Keswick House accommodates up to 15 people in one adapted building. At the time of the inspection 13 people who had a learning disability were using the service.

We inspected this service within the principles of Registering the Right Support and other best practice guidance. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. We found that people using the service did not always receive planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service:

People had been placed at risk of continuing harm because staff had not recognised and reported incident of suspected abuse. The provider did not have effective systems in place to learn when things went wrong, this meant areas of poor practice within the service continued.

There was a lack of clear governance within the service and the provider did not have effective systems to consistently assess, monitor and improve the quality of care. This meant that concerns were not identified and rectified by the provider.

The provider did not have a clear plan or system in place to monitor the changes to the culture within the home to ensure they were following the principles of Registering the Right Support.

People were not always supported to have maximum choice and control of their lives. The registered manager lacked knowledge to ensure they supported people in line with legislation. Training received by staff had not always been effective because this was not used to change practice.

People felt cared for and were involved in daily choices about their care. However, improvements were needed to ensure practices promoted a caring and respectful environment.

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

Rating at last inspection:

Inadequate (report published 18th May 2019)

Why we inspected:

This inspection was planned to follow up on the concerns at the last inspection in line with our ‘special measures’ procedures. We needed to check that people were supported safely and whether the provider was meeting the Regulations.

We found continued concerns during the inspection and there were breaches in regulations. We rated the key question of well led as Inadequate. The key questions Safe, Effective, Caring and Responsive were rated Requires Improvement. The overall rating is Requires Improvement.

Enforcement:

At this inspection, we have identified breaches in relation to safeguarding people from suspected abuse, leadership and governance and ensuring people's consent to care and treatment was in line with legal requirements.

Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.

Follow up:

The overall rating for this service is ‘Requires improvement’. However, the rating for well led continues to be ‘Inadequate’ and the service therefore remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the pr

Inspection areas

Safe

Requires improvement

Updated 12 July 2019

The service was not always safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 12 July 2019

The service was not always effective.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 12 July 2019

The service was not always caring.

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 12 July 2019

The service was not always responsive.

Details are in our Responsive findings below.

Well-led

Inadequate

Updated 12 July 2019

The service was not well-led.

Details are in our Well-Led findings below.