Keble Court

Updated 30 May 2018

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, looked at the overall quality of the service, and provided a rating for the service under the Care Act 2014. A service provider is the legal organisation responsible for carrying on the adult social care services we regulate.

This announced inspection of Keble Court took place on 25 April, 2018. When planning the inspection visit we took account of the size of the service and that some people using the service could find unfamiliar visitors unsettling. As a result this inspection was carried out by one adult social care inspector.

Before the inspection the provider completed 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. We reviewed the information included in the PIR along with information we held about the service, for example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information contained within the provider’s website.

During our inspection we spoke with four people living at Keble Court and one visiting relative. We used a range of different methods to help us understand the experiences of people using the service who were not always able to tell us about their experience. These included observations and pathway tracking. Pathway tracking is a process which enables us to look in detail at the care received by an individual using the service. We pathway tracked the care and support of five people.

Throughout the inspection we observed how staff interacted and cared for people across the course of the day, including mealtimes and when medicines were administered. We spoke with the manager, the general manager of the Keble Court complex, an area manager and five staff.

We reviewed each person’s care records, which included their daily notes, care plans and medicine administration records (MARs). We looked at six staff recruitment, supervision and training files. We examined the provider’s records which demonstrated how people’s care reviews, staff supervisions, appraisals and required training were arranged.

We also looked at the provider’s policies and procedures and other records relating to the management of the service, such as staff rotas covering March and April 2018, health and safety audits, medicine management audits, infection control audits, emergency contingency plans and minutes of staff meetings. We considered how comments made by people, relatives and staff were used to drive improvements in the service.

Following the visit we spoke with the relatives of three people living at Keble Court.

This was the first inspection of this service.

Updated 30 May 2018

Keble Court provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation, in a shared site or building. At Keble Court this accommodation consists of individual flats in one complex, which have been bought by individuals and is their own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support provided by the service. Not everyone living at Keble Court received regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to five older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

This comprehensive inspection took place on 25 April 2018 and was carried out by one inspector. The inspection was announced, which meant the provider and staff knew we would be visiting. We announced the inspection to ensure that people we needed to speak with would be available. At the time of inspection the service was supporting five people, who lived in four different flats. At the time of inspection one person had recently been admitted to hospital for treatment.

The service had a manager in place at the time of our inspection who was not yet a registered manager. 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. The service manager was in the process of completing their registration with CQC.

People were kept safe from harm by staff who knew what to do in order to maintain their safety. Staff promoted people’s independence by discussing any risks to their safety with them and how these could be managed. Risks to people were assessed and action was taken to minimise any avoidable harm. Medicines were managed safely and administered as prescribed, in accordance with current and relevant professional guidance.

The provider operated thorough recruitment procedures to ensure staff were safe to support older people living in their own home. Needs and risk assessments detailed the number of staff required to support each person and there were always enough staff to provide care and support to meet people’s needs safely.

Staff supported people to safely manage the control and prevention of infection by maintaining high standards of cleanliness and hygiene in their homes, particularly in relation to the safe preparation of food.

Staff raised concerns with regard to safety incidents, concerns and near misses. The manager analysed incidents and accidents to identify trends and implement measures to prevent a further occurrence.

The provider had enabled staff to develop and maintain the necessary skills and knowledge to meet people’s needs effectively. People were supported to eat and drink enough to meet their nutritional needs.

Staff supported people to maintain their health and ensured they were referred promptly to appropriate healthcare professionals whenever their needs changed.

The registered manager and staff clearly understood their responsibilities in relation to the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way. People were involved in making every day decisions and choices about how they wanted to live their lives. The provider's policies and procedures supported this practice.

People's independence was promoted by staff who encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.

People experienced good continuity and consistency of care from staff who were kind and compassionate. People were relaxed and comfortable in the presence of staff who invested time to develop meaningful relationships with them.

The service was responsive and involved people in developing their support plans which were detailed and personalised to ensure their individual preferences were known. People were supported to complete stimulating activities of their choice, which had a positive impact on their well-being.

People were supported by staff to maintain special relationships with relatives to ensure people did not feel lonely and were protected from the risks associated with social isolation.

Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

The service was well managed and well-led by the manager who provided clear and direct leadership, which inspired staff to provide good quality care. The manager had developed an open and inclusive service. They had a clear vision and set of values based on social inclusion that the staff fully understood and delivered in practice. Staff felt listened to, supported and involved in the development of the service.

The safety and quality of support people received was effectively monitored and identified shortfalls were acted upon to drive continuous improvement of the service.