30 and 31 March 2015
During a routine inspection
This inspection took place on 30 and 31 March 2015 and was unannounced. This was our first inspection of this service, at this location. We last inspected this service at a different location in September 2013 and found no breaches of legal requirements at that time.
H F Trust - Keilder House provides personal care and accommodation for up to ten people living with a range, and combination, of physical disabilities, learning disabilities, dementia and Downs syndrome. At the time of our inspection seven people were in receipt of care from the service.
At the time of our inspection a registered manager had been in post and registered with the Care Quality Commission since July 2014. A registered manager is a person who has registered with the 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 who lived at the service were unable to communicate with us verbally due to the nature of their conditions. There were systems in place to protect people from abuse and channels through which staff could raise concerns. Records showed, and the registered manager confirmed that no safeguarding matters had arisen within the 12 months prior to our inspection. Historically, safeguarding incidents had been handled appropriately and referred on to the local authority safeguarding team for investigation.
A process was in place to assess people’s needs and the risks they were exposed to in their daily lives. Regular health and safety checks were carried out on the premises and on equipment used during care delivery. Care records were regularly reviewed and medicines were managed and administered safely.
Recruitment processes were thorough and included checks to ensure that staff employed were of good character, appropriately skilled, and physically and mentally fit. Staffing levels were determined by people’s needs. Staff records showed they received regular training and that training was up to date. Supervisions and appraisals for staff were conducted regularly and staff confirmed they could feedback their views during staff meetings or their individual sessions with their manager.
CQC monitors the operation of Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act (2005). These safeguards exist to make sure people are looked after in a way that does not inappropriately restrict their freedom. We saw the registered manager had applied for DoLS for people living at the home. In addition, people’s ability to make informed decisions had been assessed, and the ‘best interest decision making process applied correctly. These decisions were well documented and information about people’s ability to consent and their capacity levels were clear within their care records.
People’s general healthcare needs were met. A range of healthcare professionals were regularly involved in people’s care due to the nature of their conditions and staff did not hesitate to contact these professionals where there were concerns about their health or welfare. People’s nutritional needs were considered and specialist advice was sought and implemented where necessary, for example from the speech and language therapy team (SALT).
Our observations confirmed people experienced care and treatment that protected and promoted their privacy and dignity. Staff displayed caring and compassionate attitudes towards people. People had individualised care plans and risk assessments which were reviewed regularly. Staff were aware of people’s individual needs. People’s individuality and diversity was taken into account. People had good access to their local community and we saw that two people enjoyed trips out during our inspection.
Healthcare professionals linked to the service spoke highly of the registered manager and the positive leadership that she delivered. Systems were in place to monitor care delivery and ensure that people received safe and good care. Audits were done regularly and any identified issues that needed to be addressed were formulated into action plans so they could be resolved.
The organisation had electronic monitoring systems in place to guide staff and direct them on who to notify when certain incidents occurred. A new electronic system was being introduced to record people’s personal information and care needs. The provider looked for ways to innovate, in order to gain the best possible overview of the service and care delivered.