Archived: Keats House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider demonstrated that, despite concerns and the imminent closure of the home, they remained committed to ensuring a culture of continuous learning and improvement. They followed safe recruitment processes and ensured there were always enough staff on duty to meet people’s needs and keep them safe. The provider had worked on an action plan of improvements and continued to work closely with the local authority. People were fully involved and supported with their move to new accommodation. Accidents, incidents and safeguarding concerns were logged, appropriately investigated and reported. Medicines were managed safely and the environment was safe, clean and hygienic.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us that the provider and staff knew them well and they were supported to keep safe.

The provider demonstrated that, despite concerns and the imminent closure of the home, they remained committed to ensuring a culture of continuous learning and improvement. They told us they had learned a lot during the process of being under the provider concerns and had made changes to their service due to this. They confirmed that all their environmental checks were in place and said they had daily audits in place covering areas such as the safety and cleanliness of the home. The provider also confirmed that people’s individual risk assessments were updated as and when necessary. Staff told us they were able to share their views and that the managers door was always open if they had to raise any issues.

We saw that the provider had worked on an action plan of improvements and continued to work closely with the local authority. Organisational audits were in place, which helped identify where further improvements may be needed. We looked at the minutes from team meetings and saw that these provided further opportunities for learning. The provider logged accidents, incidents and safeguarding alerts, and these were appropriately investigated and reported. The provider kept up to date with developments in practice, through working with local health and social care professionals, attending forums and meetings.

People told us they were ‘sad’ that the home was closing. They said they liked living in the home and that the staff were kind and supported them well. People were fully involved and supported with the transition. They were able to choose where they moved to and were not made to go anywhere they didn’t want to. One person wanted en-suite facilities in their new home and it was confirmed that this had been achieved.

The deputy manager told us that people and staff were sad about the home closing and said that one person was finding it especially hard to leave. They said that relatives were, “Quite sad as well”. The deputy manager also said, “It is our duty of care to make sure that we support them with their moves and make sure they are happy”. The provider told us, “We are now supporting people to move due to the closure of the service. We are working to give the people here choice about where they are moving to and not to just take the first thing. This is a difficult time and some people have been here for a long time, we know them very well and want to make this as smooth as possible for them”.

The local authority held weekly ‘home closure’ meetings, during which they reviewed the progress of people’s assessments in respect of moving to new accommodation. The local authority confirmed that people’s choices, as well as needs were being fully considered and described how some people had rejected placement offers, as they did not meet their personal requirements.

We saw the provider had processes in place for ensuring communication was shared appropriately with people living in the home, relatives, staff, the local authority, CQC and other care providers. Care plans showed input from other health care professionals such as mental health team, GPs and social workers etc. There were effective systems to ensure people had assessments completed and were supported to have a smooth transition. The provider and staff ensured people’s information and personal belongings were transferred safely. Contact with people’s new placements was being maintained, to help make sure people settled well and safely into their new accommodation.

People told us they felt safe and well looked after in the home. One person told us the staff were nice and cared about people. People’s relatives told us that they felt the staff were experienced and their family member was safe in the service.

Staff told us they received safeguarding training and were aware of their responsibilities to report and respond to concerns. Staff said they would have no hesitation in reporting any concerns. The deputy manager explained how abuse could happen between clients, people from outside, relatives and staff and that some types of abuse could be physical, psychological, neglect and sexual. They told us, “I would alert my manager and get a statement from the person. If necessary, I would call the police. The local authority safeguarding team would be contacted and CQC informed.” The provider told us they had a safeguarding policy and all staff completed safeguarding training. They said there had not been any recent safeguarding concerns but, if there were, they would raise an alert and escalate matters to the local authority’s safeguarding team. They would also complete the necessary forms and conduct an internal investigation.

People were relaxed during our visit. They interacted well with the staff and it was evident that they knew the staff well and vice versa. People spoke freely with us and weren’t inhibited or directed by staff. We observed that people could access all parts of the service and felt comfortable to come into the office area for a chat when they wanted.

Safeguarding policies and procedures were in place and kept up to date to reflect best practice and to help keep people safe. We saw the service was working within the principles of the Mental Capacity Act 2005 (MCA) and, when required, appropriate legal authorisations were in place to deprive a person of their liberty. Staff had received suitable training to help ensure they understood capacity and consent. Policies and procedures were also in place to support this.

People and their families confirmed that they were involved in planning their care and support, which included understanding and managing risks.

The provider told us about a person who had lived in the home and explained how they had been supported to understand and manage risks in their day-to-day life. These included healthier eating options, personal care and compliance with medication, to help ensure their mental health and wellbeing was promoted and maintained.

We saw that people interacted well with staff and responded positively to support and guidance, that helped them understand risks and stay as safe as possible. For example, we saw staff supporting one person to go out and do their own shopping. We also saw there were posters to educate people on good hand hygiene and people were supported to understand the safety reasons for not smoking in the house.

There were processes in place for monitoring people’s mental health. There were also systems and processes for reviewing people’s medication, recognising when people were in danger of relapsing and knowing what action to take. We saw evidence that people were supported to attend medical appointments and yearly check-ups, including mental health reviews, as well as opticians and chiropody appointments.

People told us they liked living in the home and felt safe there. People were relaxed and had access to all areas of the home. People also benefitted from spending time in a well-maintained garden.

The deputy manager told us there were audits in place to ensure the environment remained safe for people living and working in the home.

There was a pleasant atmosphere in and around the home and garden. It was a sunny day, so the French windows leading out to the garden were open and we observed people enjoying the outdoor space. There was a seated area on the patio and the garden was well kept. There was also a designated smoking area, so people didn’t smoke in the house. We saw that all environmental checks were in place and up to date, including daily cleaning and infection control checks. The house was clean, homely and tidy, although it would benefit from a coat of paint and some new furniture. We saw there were lockable filing cabinets for confidential files like care plans and staff files. The medicine cabinet was locked and COSHH products were also locked away.

The provider had processes in place to make sure the environment remained safe for people to live and work in. The maintenance folder provided evidence that equipment had been serviced appropriately and was safe to use. There were also regular audits, including health and safety, daily cleaning and infection control.

People told us they liked living in the home and the staff were kind and supported them well. One person told us they liked to play snooker at the local pub and said staff supported them to do this. Another person said, “The staff are nice and care about people.” People’s relatives and representatives gave positive feedback about the staff team and acknowledged good working relationships with people who used the service. Relatives told us they felt the staff were experienced and their relative was safe in the service.

Staff told us they felt supported in their roles. They said they completed mandatory training, as well as training that was specific to people’s needs. Staff said that additional training could be requested if they felt this was needed. Staff also told us that the service had safe staffing levels. The deputy manager told us there were currently 3 staff on during the day and evening shifts and 1 member of staff for a waking night shift. They said the registered manager was also on call, should any problems or issues arise. The provider confirmed that he was ensuring staffing levels remained safe and appropriate, although they would be adjusted accordingly as people moved out of the home.

We saw the service had enough staff to support people safely. The staffing levels included the provision of one-to-one support, so people could take part in activities, attend appointments and go on visits, as and when they wanted. We observed people’s needs being met in a timely manner and saw staff were able to spend time with people engaging in a variety of activities.

Safe recruitment checks were in place, which helped ensure only suitable candidates were employed. The checks included 2 employment references, Disclosure and Barring Service (DBS) police checks, photographic identification and an application form. Records confirmed staffing levels were safe. Staff training was monitored to ensure everyone completed the required training. Records showed staff received regular supervisions and appraisals in line with the provider’s policy.

People benefitted from living in a home that was generally clean and hygienic. People were aware of infection control procedures, particularly in respect of food and hand hygiene.

The deputy manager told us that infection prevention and control (IPC) was one of the areas that was audited regularly. They confirmed there were sufficient supplies of personal protective equipment (PPE), which they used when providing personal care or preparing food. The deputy manager said, “We have IPC training and Food safety. We need to ensure that we always wash our hands, when we prepare food, give personal care and arrive at the service this is an important part of IPC. The house is cleaned on a daily basis and we have daily cleaning logs.”

We saw the house was generally clean and hygienic and there was clear infection control guidance for people in the home. We saw the kitchen was clean and well maintained. It had the correct chopping boards, a food probe, 2 sinks and posters regarding hand hygiene. We also saw food was labelled and stored correctly.

We saw there were regular IPC audits in place, including a daily cleaning rota and checklist, which helped ensure effective infection prevention and control procedures were maintained within the home.

People benefitted from staff supporting them with managing and administering their medicines safely and as prescribed.

The deputy manager told us staff completed medication training for managing and administering people’s medication and the people living in the home were always involved in their medication procedures and reviews. They said people’s medication came in blister packs but staff always followed the ‘R’ principles by checking it was the right person, right dose, right time and right route, as well as respecting each person’s right to refuse.

The service had a Quality Management Policy in place, which the provider had reviewed in March 2024. The policy acknowledged the potential risks associated with managing people’s prescribed medicines. It also described the actions taken to minimise those risks, such as daily counts of all medicines and checks of the medicines administration records. The policy confirmed that any medicines errors were recorded and investigated. It also confirmed that all staff who administered people’s medicines were trained and completed annual refresher training.