Archived: Keller House Residential Care Home

Updated 20 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

This inspection took place on the 26 July 2016 and was unannounced. The inspection was carried out by an inspector and an inspection manager.

We looked at information we hold about the home including previous reports, complaints and notifications. A notification is information about important events which the home is required to send us by law. Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return a PIR and we took this into account when we made the judgements in this report.

We contacted the local authority and commissioners of care for Keller House and were informed that the local authority continues to support the home to improve the services provided.

As part of the inspection we spoke with the five people living in the home and six staff, which included the cook and registered manager. We contacted two relatives and the pharmacist responsible for medicine training after the inspection.

We observed staff supporting people and reviewed documents; we looked at the five care plans, medication records, two staff files, training information and some policies and procedures in relation to the running of the home.

Some people who lived in the home were unable to verbally share with us their experience of life at the home, because of their dementia needs. We spent most of the inspection in the lounge with people and 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.

Updated 20 October 2016

Keller House provides personal care and accommodation for up to 15 older people living with a dementia type illness. There were five people living with dementia in the home during the inspection and they all needed assistance with looking after themselves; including support with personal care, meals and moving around the home.

We carried out an unannounced comprehensive inspection at Keller House Residential Care Home on the 24 Mach 2015 where we found improvements were required in relation to safe care and treatment and person centred care, staff training, record keeping and quality assurance.

This was an unannounced inspection, which was carried out on 26 July 2016, to check that the provider had made improvements and to confirm that legal requirements had been met. We found improvements had been made, but additional work was required to ensure the provider was meeting the regulations.

At the time of this inspection the local authority had an embargo on admissions to the home pending improvements to the delivery of care and support needs for individuals and record keeping.

The registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality 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.

Quality assurance and monitoring systems were in place and the registered manager said audits were used to review all aspects of the services provided, although we found these were not as effective as they should be. For example, they did not identify the concerns we found with regard to medicines.

Medicines were managed and given out safely. However, systems for recording additional prescribed medicines and ensuring medicine administration records (MAR) were completed appropriately were not in place.

Staff understood people’s needs and provided the support and care they wanted in a kind and patient way. Risk assessments had been completed to identify where people may be at risk. Staff demonstrated a clear understanding of the steps that were in place to ensure risk to people was reduced, whilst enabling them to make choices and be as independent as possible.

Staff had attended relevant training, including safeguarding training, and relevant policies were in place. Staff had a clear understanding of types of abuse and what action to take if they had any concerns.

The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The management and staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of current guidance to ensure people were protected. DoLS applications had been requested to ensure people were safe and advice had been sought to from the local authority.

People were assessed before they moved into the home to ensure staff could meet their needs and care plans were developed for this information. Staff said they had read these, they felt they had a good understanding of people’s needs and provided the support and care they wanted in a kind and patient way. Care plans were reviewed and people and their relatives were involved in discussions about the care and support provided.

People said the food was very good, choices were provided and drinks and snacks were available throughout the day. Systems were in place to monitor the amount people ate and drank, to ensure they had a nutritious diet, and staff contacted the GP if they had any concerns.

There were enough staff to provide the support people needed and the recruitment procedures ensured only suitable people worked at the home. There was a relaxed atmosphere in the home, people said they were comfortable and relatives were confident that if they had any concerns the staff and manager would address them.