Keys Hill Park

About the service: Keys Hill Park is a care home service. It is registered to provide personal and nursing care for up to 36 younger adults who are living with a learning disability and/or a mental illness. At the time of our inspection 27 people were living in the service. The accommodation was across 11 separate houses on one site with small groups living in each house. Each house had a communal lounge and kitchen.

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 choice, control, and independence. People using the service received planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

Staff had not completed all of their mandatory set by the provider. Training had been booked for staff to attend.

Action plans had not been put in place to address less favourable responses given by people as a result of the survey. The registered manager told us they spoke with people individually to address any concerns.

People were treated kindly by staff who understood people’s individual needs and preferences.

People and their families were involved in the planning of their care and people met with staff and other health professionals to review their care.

People felt safe living in the service and were cared for by staff who understood how to safeguard people from the risk of abuse.

Risks relating to people’s health and wellbeing had been identified and plans were in place to manage these risks.

Environmental risks had been assessed and measures were in place to mitigate known risks.

People had choice and control over their care and treatment and were supported to maintain their independence.

Staff understood and applied the principles of the Mental Capacity Act 2005 in their day to day works. Best interest decisions were clearly documented.

Medicines were being managed safely in the home.

Activities took place in the home and people could access employment, education and social activities in the local community.

People attended regular meetings to discuss their concerns. Staff also met regularly to discuss the service and people’s care needs.

There were quality assurance systems in place to monitor and assess the quality and safety of the service.

Rating at last inspection: Good (report published 30 September 2016).

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to inspect as per our re-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

Keys Hill Park provides accommodation and support to a maximum of thirty six people. They support people who have a learning disability, autistic spectrum disorder or mental health needs. It does not provide nursing care. Accommodation is provided through eleven different properties on the site with small groups of people living in each one. Each property has a communal lounge and a kitchen. On the day of our inspection there were thirty three people living in the home.

The provider has another service, The Gables, which is situated about a mile away from Keys Hill Park. The Gables was inspected by the same inspector and in the same week as Keys Hill Park. This is because the two services operate closely together. They have the same management team and some staff work across both services. Some records for both services are also held at the offices in Keys Hill Park.

There was a registered manager in post. 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.

People were safe living in Keys Hill Park. Risks to people were identified and managed, this included risks relating to the management of the premises. There was a clear reporting structure and oversight of incidents and accidents. Staff understood their responsibilities regarding adult safeguarding.

There was sufficient staff which ensured people were safe.

Medicines were safely managed and active measures were being taken to reduce the potential for medication errors.

Staff spoke highly of the training they received. They were supported to provide effective care through management support, good team work and effective training. New staff were provided with a detailed induction that gave them the skills and knowledge to undertake their new role.

Staff understood the basic principles of the Mental Capacity Act and ensured people were supported to make decisions.

People’s nutritional needs were supported. Staff supported people to maintain good health; this included encouraging people to eat healthily. People were supported to access healthcare services where required.

People were supported by kind and caring staff, who encouraged them to be involved in decisions about their care. There was a strong emphasis on independence. Staff supported and encouraged people to be as independent as possible.

People were involved in writing and reviewing their care plans. However, there were some restrictions in place which limited the amount of choice and control people had. Staffing sometimes impacted on the support given to people to participate in activities. This meant that care was not always delivered in a way that met people’s individual needs and preferences.

People knew how to complain. The provider investigated and responded to complaints appropriately.

Staff and managers told us person centred care, inclusivity, and promoting independence were key values of the service. However, some ‘house rules’ had developed which appeared to undermine some of the values the service promoted.

Staff enjoyed working at the home and spoke positively of the support the management team provided. People were encouraged to participate in the running of the home and share ideas. Quality audits were in place which helped the provider monitor the quality of the service delivered and take action when needed.

The provider had introduced a culture and values programme, which aimed to encourage staff to take accountability and display key values and behaviours. This had had a positive impact on staff morale and on how staff carried out their roles.

One person told us that they had only very recently moved in and said, 'So far, I'm very happy here, everything's lovely.' Another person told us, 'It is rather nice here. The staff are very good; they understand me and know how to help me'

People we spoke with confirmed that they had regular reviews of their care with the staff. One person told us, 'I look at my folder quite a lot with the staff; that way we can see how I'm getting on'

We observed people choosing and preparing their own lunches and we saw that people made drinks as and when they wanted.

All the people we spoke with told us that they were supported to take their medicines at the prescribed times, as needed. They also told us that they knew what medicines they had been prescribed, what they were for and how and when to take them.

All the staff we met and spoke with made positive comments about working at Keys Hill such as, 'It's an amazing place to work' and, 'The training is excellent here'

When we spoke with people about making a complaint we received comments such as, 'I used to have a lot in the past but I don't have any now', 'I can talk to management or any of the staff', 'tell my keyworker; it always gets sorted' and 'I'd go to the house leader but I've never had to complain'