Background to this inspection
Updated
13 October 2020
The inspection
This was a targeted inspection to check whether the provider had met the requirements of the breaches in relation to Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 17 Good governance and Regulation 18 Staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 Notification of other incidents of the Care Quality Commission (Registration) Regulations 2009.
Inspection team
The inspection team consisted of two inspectors.
Service and service type
Keepence Homes 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection. This was due to the current pandemic to allow the service time to implement any additional infection control measures for the visit.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
People in the service had limited verbal communication and expressed themselves mainly through signing, gestures, expressions and sound. We observed two people during our time in the service and spoke with the registered manager and one member of staff at the service.
We reviewed a range of records. This included three people’s care records and all four medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and meeting minutes. We spoke with two relatives and three members of staff away from the service.
Updated
13 October 2020
About the service:
Keepence Homes is a care home that was providing personal to people with a learning disability. Four people were living in the home at the time of the inspection.
People’s experience of using this service:
¿ Risk assessments for people were available, however did not contain enough specific detail for staff to be aware. Where there was a more serious risk we found there was not always an assessment in place. Health and safety records demonstrated that appropriate action was not always undertaken in a timely manner.
¿ We saw that learning outcomes from incidents were not recorded to prevent a reoccurrence or risk assessments updated in light of this. The service had not made the required notifications to CQC when events had occurred in the service in order for these to be effectively monitored, this included one allegation of abuse, three serious injuries and one event that stopped the running of the service.
¿ Medicines administration was not always safe. There were no pictorial pain assessments in place to help people who could not communicate verbally indicate they may be in pain.
¿ Recruitment checks were not always thoroughly completed before staff started working for the service. Staffing levels were negatively impacting on people’s involvement in external activities and support.
¿ The service was not always working within the principles of the Mental Capacity Act and assessments had not always been completed appropriately.
¿ People were treated with kindness and compassion and were comfortable and relaxed in the presence of staff. We observed staff interacting with people in a friendly and respectful way.
¿ People were not supported to attend activities of their choosing or spend time outside of the service on a regular enough basis.
¿ Staff we spoke to felt supported by the registered manager and told us they were approachable and listened to them.
¿ The provider did not have evidence of how they monitored, reviewed and improved the quality of care people received.
More information is in Detailed Findings below.
Rating at last inspection:
Good (report published 7 October 2016).
Why we inspected:
This was a planned inspection based on the rating at the last inspection.
Follow up:
We have told the provider they must take action to improve the service. We will continue to monitor the service and complete a further inspection to assess whether the improvements have been made.