Byards Keep

Updated 4 September 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Byards Keep is a residential ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 CQC. 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 five days’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be available to support the inspection.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We contacted Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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

We spoke with two people who used the service, four people’s relatives and received feedback from four health and social care professionals about their experience of the care provided. We spoke with the registered manager, and three members of care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at two people's care records in full and two people's care records in part. This included medication administration records and people's daily notes. We looked at two staff's recruitment, induction, training and supervision records as well as other records relating to the management of the service.

Updated 4 September 2019

About the service

Byards Keep provides care and support for younger adults who may be living with a learning disability or autistic spectrum disorder.

The service is registered to support up to eight people, and eight people were using the service when we inspected. This is larger than current best practice guidance. The service was also secluded from the nearby residential area, and next door to another of the provider’s services for people with a learning disability. However, the risk of these things having a negative impact on people was mitigated by the design of the building and staff who supported people to access and be a part of their local community.

Staff provided support in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures 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 autism to live meaningful lives that include control, choice, and independence.

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

People were supported to live in a safe environment. Sufficient staff were deployed to meet people’s needs. Staff had been trained to identify and respond to any safeguarding concerns. This helped to keep people safe and prevent avoidable harm.

The environment had been adapted to meet people’s needs. People had privacy and personal spaces which had been designed and decorated according to their preferences. There were communal spaces and outside areas for people to use and enjoy. Some areas of the service had been marked for renovation.

Although the service was secluded from the nearby residential area, people were supported to take part in activities, to access their wider community and to do the things they enjoyed.

Staff were kind and caring. They treated people with respect and supported them to maintain their dignity. People responded positively to staff and shared friendly and caring relationships with them.

People’s needs had been thoroughly assessed and very detailed care plans and risk assessments guided staff on how best to support people. Staff showed a good understanding of people’s needs. They had received regular training, supervisions and spot checks of their performance.

Medicines were managed safely; staff had been trained and their competency regularly checked to make sure people received their prescribed medicines. The registered manager had taken proactive steps to stop the overuse of medicines.

Detailed communication assessments guided staff on how best to share information in an accessible way. Staff supported people to make day to day decisions and be in control of how they spent their time. 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 attended regular appointments and annual health reviews. Staff worked with other professionals for advice, guidance and support.

There were systems in place to manage and respond to any complaints about the service. The registered manage completed thorough investigations into any or concerns and acted to improve the service. Regular audits helped to monitor the quality and safety of the service and drive improvements.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection

At the last inspection service was rated Good (report published 28 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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.