Keyll House

Keyll House is a residential care home providing accommodation and personal care to up to six people with learning disabilities and/or autistic people. There were six people living at the home at the time of our inspection.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Based on our review of safe, responsive and well-led the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

People did not always receive the support they needed to enable them to pursue their interests or engage with activities which were meaningful to them. Staffing issues sometimes limited people’s access to the community.

People were supported to develop their skills and to be as independent as possible.

Right Care

People’s care was not always flexible enough to take into account their needs and preferences. The provider told us they were aware of this and had plans in place for a more flexible staff shift pattern to better meet people’s needs.

People were supported by a kind and caring staff team who treated them with respect. Staff understood their responsibilities to protect people from abuse and knew how to report concerns should they need to.

Right Culture

There was a positive ethos at the service and people were involved in planning their own care and were encouraged to give their views about the support they received.

People's relatives were able to give their feedback about the support their family members received and their views were listened to.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 September 2019.

Why we inspected

The inspection was prompted in part due to concerns received about people’s safety and access to meaningful activities outside of the home. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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 good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Keyll House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to people being able to be involved in their local community. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Keyll House is a residential care home providing personal care to six younger adults with a learning disability and/or autism. At the time of the inspection six were living in the service. The service can support up to six people.

Keyll is a new service that was registered with CQC on 13 September 2018. This was their first inspection.

People had their own rooms with en-suite facilities. There was a kitchen, several lounges and a garden for people to use.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were cared for by enough staff who were caring and treated them with respect and dignity. Staff knew how to keep people safe from harm and from becoming unwell. Health needs were met, and specialist professionals were involved as needed. Medicines were safely managed and how people’s care was planned was personalised. Staff were recruited safely and carefully.

A clear system of leadership and governance was in place to ensure a quality service was developed for people. We found the registered manager and provider were keen to hear any ways they could improve the service following the inspection. Any feedback was immediately picked up and work started to further improve the service.

Complaints and concerns were responded to and fully investigated. We received a mixed response from relatives that included extremely positive feedback and some concerns. The concerns have been shared with the registered manager, with consent of the relative, to improve communication and outcomes for people and their relative.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the service’s registration date.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.