Keswick House

Updated 6 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Keswick House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Keswick House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback form the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who lived at the home and seven relatives. We also spoke with the registered manager, deputy manager and two care staff.

We looked at three care records in detail. We also looked at specific aspects of people’s care records where we had identified risk and reviewed three medicine administration records (MARs). We also viewed three staff files.

We asked the registered manager to send us further evidence regarding recruitment, audits, infection prevention and control policy and training records following the inspection.

Updated 6 July 2022

About the service

Keswick House is a residential care home providing personal care to up to 13 people. The service provides support to people living with learning disabilities and/or autism. At the time of our inspection there were 13 people using the service. People live in their own rooms but have full access to communal lounges and dining areas and use the communal kitchen to prepare their meals.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.

Right Support

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. People were encouraged to be independent and do what they could for themselves and work towards goals that were important to them. People were supported to engage in activities of their choice and encouraged to pursue their interests. Staff encouraged people to play an active role in arranging and attending health appointments and leading an active healthy life. Staff supported people to administer their own medicines in a safe way that enabled them to maintain independence over their health. People were encouraged to design and personalise their own bedrooms and were supported to purchase décor of their choice. Staff used different communication styles to ensure people fully understood them and they communicated in line with people’s needs. Staff supported people in a way that was least restrictive to them and people were not unnecessarily restrained.

Right Care

People received compassionate support from caring staff. Staff treated people with dignity and respected their privacy. Staff supported people in a person-centred way and focused on their individual needs. People’s support plans reflected a range of their needs and considered their preferences in detail to ensure their wellbeing was promoted. People received care that considered their diversity and staff supported them to meet their cultural needs. People were encouraged to pursue their interests and were supported with opportunities that enriched their lives such as going on holidays of their choice. Staff had safeguarding training and understood how to keep people safe. The service made safeguarding referrals to relevant authorities when needed. The service had a sufficient number of skilled and experienced staff to meet people’s needs. Staff encouraged people to take positive risks. Staff were skilled at communicating with people in a way they understood and in line with their needs.

Right Culture

People led independent and empowered lives because of the ethos led by staff within the home. Staff turnover was low which meant that people received consistent care from staff who knew them well and understood their needs. People were involved in the planning of their own care and took an active role in driving improvements in the quality of the service. People undertook roles in the service such as dignity champions and fire marshalls to promote a better quality of life. People were supported by staff who understood how to support people living with a learning disability or autism and were aware of their strengths and sensitivities. Staff focused on people’s wishes, needs and preferences when providing care to people.

Governance systems in place were not always sufficiently robust to ensure effective quality checks were undertaken. The home was safe but required investment so refurbishment could be undertaken to make it a more positive sensory environment for people.

The registered manager acknowledged at the beginning of the inspection that they were aware the home needed updating and significant investment. We did not find any evidence that this was impacting on people at the time of inspection and people told us they were happy with their home.

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

Rating at last inspection

This service was registered with us on 13 May 2020 and this is the first inspection. The last rating for the service under the previous provider was Requires Improvement, published on 10 December 2019.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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