Kelly House

Kelly House is a service providing support with personal care to people with mental health needs living in supported living accommodation and in their own homes, as an outreach service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The provider told us that 92 people were receiving support with personal care, however this was largely limited to prompting of medicines and some personal care, rather than hands on care provided by staff.

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

People using the service were safe. Risks associated with their care were identified and guidance put in place to support staff in managing the risk. Staffing levels were sufficient to ensure people’s needs were met. There was a pool of bank staff able to cover shifts when required. People were supported to be as independent as possible with their medicines. If staff provided support, this was outlined in their care plan.

The service was well led. The service provided was person centred in nature and encouraged people to be as independent as possible. Staff were well supported and able to openly discuss any concerns they had. There were systems in place to monitor the service including audits and recording of any accidents and incidents.

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 outstanding (published 2 April 2019). At this inspection we rated the service good.

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of people's personal care. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from outstanding to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Kelly House provides support to people with mental health needs and people with learning disabilities. Some people live in a supported living accommodation, others receive support in their own homes in the community as part of an outreach service.

People’s experience of using this service:

People received an Outstanding service. Person centred values were embedded in to practice and delivered by a valued and motivated staff team. Staff were supported to develop in their careers and their ideas about the service were listened to.

Strong links had been established with the local community and the manager had ideas to develop this further. These links were of great value to people using the service and were being used to break down some misconceptions held about mental health.

People were included in planning their own goals and supported to achieve them. Care was reviewed regularly to ensue it continued to meet people’s needs. People were encouraged to, and had opportunity to give their views and opinions on how they wanted the service to run.

People told us they got on well with staff and felt safe with them. Staff understood and knew people’s needs very well.

There were sufficient numbers of staff available to deliver the support people needed. Safe recruitment practices were in place.

People received support as necessary to make and attend health appointments.

The service was very well led. The manager was passionate and enthusiastic about their role and the service they provided. Staff felt well supported and told us morale was good within the team.

Rating at last inspection: Good. Last report published on 29 July 2016

Why we inspected: This was a planned inspection based on previous rating.

The inspection took place on 5 July 2016 and was unannounced. The service was last inspected in February 2014 when it was compliant with the regulations at that time.

There was a registered manager for the service. 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.

People felt safe with the staff that supported them. Staff were knowledgeable in their understanding of the subject of abuse. Staff were able to tell us what to do if they were concerned about someone. They had attended training to help them understand what abuse was and knew who to report concerns if they had them.

People felt they were well supported with their mental health needs and they understood the aims of the service. They told us they were there to gain confidence and to recover from their mental health issues. They also said they were achieving these aims at the service. People’s right to privacy was maintained. Health and safety room checks were completed in agreement with people in advance.

There was enough staff to support people with their mental health needs as well as to provide a caring and effective service. People told us they were treated with care and kindness by the staff. The staff engaged people in social activities, household tasks and other activities of daily living. Staff had a caring and attentive approach. Staff knew people well and provided them with a service that met their needs.

There were systems in place to ensure that people’s rights were protected if they did not have the mental capacity. There was guidance in place for staff to follow about the Mental Capacity Act 2005.

People were supported by staff that had a good understanding of their needs and the care they required. The staff were trained and knew how to provide them with effective support.

People knew how to make their views known and there was an effective system in place to receive and address complaints and concerns. Care records showed how people wanted to be supported by the staff with their mental health needs and other support needs. Staff helped people to make choices in their daily life and encouraged them to be independent.

The provider’s visions and values around promoting independence and providing person centred care were understood by staff and the people who used the service. The staff put these values into practice when they assisted peoples with their needs.

Audits to check and monitor the care and service were completed on a regular basis. People were asked for their views of the service as part of this process.

People told us that they received the support they needed. Sometimes this was for practical things and sometimes it was for emotional support. People said they felt in control of their lives. One person said they had a good key worker. Another said 'staff support me, especially with my financial difficulties.'

We saw that care records were up to date and reviewed regularly. They showed clearly the goals and progress that individual people were making. People were also supported to have their long term health needs monitored.

The service had an effective recruitment process that reduced the likelihood of inappropriate people being appointed. The induction programme was comprehensive and followed-up with discussions with the manager to ensure that the learning was embedded in the daily practice of staff.

There were processes in place for assessing and monitoring the quality of service provided. These included auditing of systems and records but also included being sensitive to the feedback from people using the service on a daily basis.

A member of staff said that the provider was always willing listen and 'welcomed change.' Staff commented that the organisation invested in their staff team and that they felt properly equipped to undertake the job.

An independent trainer had commented on the senior staff and said 'They show enormous loyalty to the company and the users and have a great clarity as to what their job's about ' it's a pleasure to work with them.'

People told us about aspects of the service that they particularly appreciated, such as having a key worker and 'having staff around'. They said that they got on well with staff; the support staff for example were described as 'very approachable' and 'friendly'.

Staff told us that they felt supported in their work and had good opportunities for training. The provider had set up systems for gaining feedback from the people who used the service and for monitoring the quality of service that they received.