Keate House Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider and leaders encouraged transparency and openness about safety. Staff understood their responsibility to raise concerns and report incidents. Opportunities to learn from safety events were communicated to staff to help support improvement and prevent recurrence.

The provider actively engaged with people and their relatives to minimise risks creatively and effected strategies which showed innovation, to maximise people’s autonomy and independence.

The provider demonstrated innovation when it came to promoting safety, they actively sought out best practice and utilised the learning from this to drive improvement for people and embed good practice. An example of this in practice was a provider led project with the aim of reducing falls.

Over time, the provider had identified an increase in the number of falls during peaks of extreme heat. This led to the installation of air con in the communal areas, which led to a significant reduction in falls.

The provider had also introduced a podiatry package for people, which included access to regular podiatry appointments and routine foot care and support. This helped to improve people’s overall mobility and balance. Over time, a reduction in falls was observed due to people’s improved foot health.

This was an example of research led decision making which was evidenced by a measurable reduction in falls.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Processes were in place to help ensure that when people moved between services, key information about the person was included to help ensure continuity of care was met. Processes were followed to ensure relevant information was gathered and shared when people were admitted to, or discharged from, the home.For example, the provider used a ‘Care Companion’ process to support hospital admissions, communication of key information to hospital staff and, continuity of care during transfers between services.

A relative confirmed, “We viewed this home a year ago, it’s been a seamless transition, [Name] has settled so well.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Policies and procedures were in place to help ensure people’s safety, such as a whistleblowing and safeguarding policy. Any accidents and incidents were recorded appropriately with suitable and timely actions taken in response to help reduce the risk of recurrence.

Staff understood risks regarding abuse/and or person safety and were able to explain how they would report a safeguarding concern and had a knowledge of The Deprivation of Liberty Safeguards (DoLS) and the key requirements of the Mental Capacity Act 2005 (MCA).

People and their relatives told us they felt Keate House was a safe place to live. One person told us, “Safe? Yes, very much so.” A relative confirmed, “I feel [Name] is safe and I have total peace of mind.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Although we were assured staff knew people well enough to manage and mitigate their risks, further details were needed in some people’s plans of care. For example, for 1 person who was at risk of developing a urine infection, there was minimal guidance for staff on what the signs of this looked like. For another person with skin integrity needs, staff were instructed to reposition the person ‘regularly’ as opposed to defining a specified time frame. In addition, records of position changes were not always properly maintained. We spoke with the registered manager about this who confirmed people’s care plans would be amended accordingly.However, we were assured the provider balanced risk alongside person centred care.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Signage was used throughout the home to help people living with a cognitive impairment to better navigate the home. People had access to an enclosed garden where people enjoyed planting seeds and feeding the birds. A relative told us, “[Name] has always loved gardening and being outdoors, and here they can tend to the flowers and plant beans.”

There was also a ‘pub’ onsite, the ‘Keate Arms’, where people could enjoy a drink and a game of darts. In addition, an outbuilding had been modified into the ‘Keate Tea room’, this was particularly popular with relatives who could enjoy catching up with their loved one over tea and cake!

Processes were in place to help ensure the environment was kept safe. For example, risk assessments and regular checks of the environment were carried out to ensure the safety and well-being of both people and staff.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff had been recruited safely and there were enough staff deployed to meet people’s needs. The provider used a staff dependency tool to help achieve this.

For example, we observed an increased staff presence in areas where people required greater assistance, such as with their mobility needs. Although people told us staff treated them very well, some commented there could be more staff in the daytime. Comments from people included, “Just about enough [Staff], it’s the daytime that struggle”, “There is always someone around” and “Not always, they could do with more [Staff].”

Staff had received training and support to help them carry out their roles. However, we observed a few gaps in staff training records where training was overdue. We spoke to the registered manager about this who confirmed plans were in place to ensure staff completed any overdue training in the near future.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff were suitably trained in IPC (Infection, prevention and control) practices and the home had sufficient stocks of PPE.

When asked if the home was kept clean, people told us, “Yes it’s lovely,” and “It’s very good.” A family member confirmed, “It’s a nice, clean home.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

For people who were prescribed PRN (as and when required medicines), some PRN protocols required additional person-centred information to help better guide staff on when to administer such medicines. We spoke to the registered manager about this who confirmed this information would be added immediately.Although some person-centred information relating to the use of PRN medicines was available in other parts of the care plan, this meant staff had to look in 2 different places, which could lead to confusion and the risk of PRN medicines not being used appropriately.

However, we were assured people were given these medicines appropriately, as staff knew people well enough to know when these medicines were required.

We saw some positive examples of effective medicines management. For example, staff performed a daily count of medicines each day, this helped to minimise the risk of any medicine errors.