Background to this inspection
Updated
22 May 2019
The inspection:
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.
Inspection team:
One inspector carried out the inspection.
Service and service type: Keepers Cottage is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Keepers Cottage is also a domiciliary This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides personal care and accommodation services to people with learning disabilities or autistic spectrum disorder.
The service had a manager registered with the Care Quality Commission. 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 since the last inspection. This included details about incidents the provider must notify us about, such as abuse.
• Feedback from the local authority and professionals who work with the service.
• We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection:
• We spent time with people in the communal areas of the home and in their rooms and we saw how staff supported the people they cared for.
• We spoke with five people who lived at the home, to gain their views about the care provided, and two relatives.
• We also spoke with the registered manager, the provider’s representative and seven care and senior staff members.
• We reviewed a range of records. This included two people's care records and multiple medication and records, and records about safeguarding people’s liberty and freedoms.
• We also looked at records relating to the management of the home. These included systems used to check the quality of the care provided, such as residents surveys. We also checked how complaints and any accidents and incident were managed. In addition, we saw checks made on medicines administered and the training undertaken by staff.
Updated
22 May 2019
About the service: About the service: Keepers Cottage is a care home that was providing accommodation and care to eight people at the time of the inspection. The service is also a domiciliary care agency. It provides care to people living in their own houses and flats. At the time of the inspection, six people were supported through the domiciliary agency. Care is offered to people living with learning disabilities,
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the local area. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service:
•People were complimentary about the care provided by staff, and the way the service was run.
• People had developed strong bonds with the staff who cared for them, and enjoyed expressing their affection for staff. People were confident to ask for assistance and reassurance from staff when they wanted this, and staff took time to provide this in the ways people preferred.
• Staff knew what was important to the people they cared for and spoke warmly about them, and ensured their rights to dignity, independence and privacy were respected.
• People and staff told us they saw the registered manager often and found them approachable.
• Staff knew people’s health and well-being needs well, and supported people to see health professionals when need. This ensured people’s health and well-being needs were met.
• There were sufficient staff to care for people at times people wanted assistance.
• Staff understood risks to people’s safety and supported them to stay as safe as possible.
• People were supported to have their medicines safely and checks were undertaken to ensure these were administered as prescribed.
• The risk of infections and accidental harm was reduced, as staff used the knowledge and equipment provided to do this.
• People made their own decisions about their lives and care. Where people needed support to make some decisions staff assisted them, using people’s preferred ways of communicating.
• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.
• People told us staff knew how to care for them. Staff had received training and developed the skills they needed to care for people, through induction and on-going training.
• The views of people, their relatives, and other health and social care professionals were considered when people’s care was assessed, planned and reviewed, so people’s needs continued to be met.
• Staff ensured people had opportunities to do things which they enjoyed and which responded to their individual needs.
• Systems were in place to take any learning from complaints and to further improve people’s care.
• The service was not providing care to people at the end of their lives, at the time of the inspection. The registered manager confirmed they would work with people, their families, and other health and social care professionals to ensure the preferences of people and people’s best interests would be considered when planning end of life care.
• The registered manager and provider checked the quality of the care provided and developed the service and based suggestions from people, their relatives and staff.
• The registered manager kept up to date with best practice developments, so they could improve the care provided further.
Rating at last inspection: Good. The last report for Keepers Cottage was published on 13 September 2016.
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk