This inspection took place on 6 March 2017 and was unannounced. At the last inspection on 25 November 2014 the service was rated Good. At this inspection we found the service remained Good.

Keevan Lodge is a residential care home providing personal care and support for three people with learning disabilities and mental health issues.

We observed positive interactions between people and staff which indicated to us that people felt safe and confident with the staff that supported them. Staff demonstrated a good level of understanding of safeguarding and were able to tell us of the steps they would take if abuse was suspected.

The provider ensured that people were kept safe and free from harm by ensuring that people’s health and care needs were assessed in detail to identify and mitigate any potential risks.

Safe recruitment practices were observed to ensure that only staff suitable to work with vulnerable were employed to do so.

Safe medicine management systems were in place and adhered to and appropriate staffing levels had been determined according to people’s needs and requirements.

Care staff had received an induction when they first started work followed by appropriate training in order to be able to effectively carry out their role. Records confirmed that staff were also regularly supported through supervision and annual appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The provider had policies and systems in place to support this practice.

People were not required to set prescribed menus, but were able to choose what they wanted to eat on the day depending on what they fancied at that time. Shopping lists were devised with each individual person based on their likes and dislikes and people were able to communicate the level of involvement they wished to have when preparing their own meal and where support was required.

People were supported with all aspects of their health care needs which included making appropriate referrals and accessing a variety of healthcare professionals as well as being supported to attend healthcare appointments where required.

Staff and senior managers knew the people that they supported very well and were very clear about the level of support each person required but also ensuring that each person maintained their own independence as far as practicably possible.

All staff had established caring and responsive relationships with people and knew their likes and dislikes, their needs and requirements and knew each person’s mood and behaviour changes and were observed to be responsive and respectful ensuring that the person was supported appropriately.

Records confirmed that people and relatives had been involved in the planning of care. Each care plan we looked at was detailed, person centred and gave in-depth information about the person and their care and support needs which had been set according to the person’s choices and wishes.

People were able to attend and participate in a variety of activities of their choice as and when they wished. People’s cultural and religious background and needs had also been considered and where appropriate people were supported to observe and respect those needs.

The provider ensured that all complaints and concerns raised were dealt with according to their complaints policy. Relatives confirmed they knew who to speak with if they had any concerns or issues to raise.

Relatives and staff confirmed that they knew the management structure within the home and knew who to speak with. They confirmed that the management was approachable and staff also confirmed that they felt appropriately supporting in their role.

We saw a variety of records confirming that the management regularly monitored and checked the quality of care that was delivered and were issues or concerns were highlighted these were addressed so that subsequent learning could take

People we spoke with were positive about the care and treatment provided at the home. One person commented “they are hard working. They are kind people. They give me good advice.” We saw that the way staff were interacting with people had a positive effect on their well-being.

Staff we spoke with understood the importance of obtaining the consent of the person before any care or treatment took place. Staff confirmed they had undertaken training in the Mental Capacity Act 2005 (MCA) and were aware that the service must always act in the best interests of the person when they lacked capacity.

People who use the service told us that they felt safe with the staff who supported them. One person told us “I’m safe here. They look after me properly.”

Staff were positive about working at the home and told us they were supported by the management through regular supervisions, staff meetings, good training opportunities and appraisals. Staff we spoke with confirmed that they had not been allowed to start working with people until all relevant employment checks had been carried out.

There was evidence that the manager spoke with people using the service to gain their views about their care as well as identifying any areas for improvements. There were regular house meetings and one to one sessions and records of these indicated that people were able to express their views about the service.

Staff at Keevan Lodge were open and welcoming. The house has a homely, cosy feel and is well maintained. During our inspection of the home we spoke with the manager, two support workers and people who used the services. We also spoke, by phone, to a relative of one of the people who used the service. Staff were very knowledgeable about the individual needs of people living at Keevan Lodge and how each could be assisted to maximise their independence and choice. We saw positive engagement and interaction between staff and people who use the service. People were calm, relaxed and looked well cared for. They appeared to have good relationship with staff who treated them respectfully and promoted their independence and autonomy. A relative of one of the people told us that they considered their brother to be safe at the home and to be “well catered for.”

Not everyone in the home can communicate verbally so we spent time observing people who use the service to see what effect the environment and staff interactions had on peoples’ wellbeing.

People told us that staff were kind and respected their privacy. One person commented, “I like it here”.

We observed staff supporting people in a friendly and professional way and saw that people were being offered choice with regard to menus and activities.

Staff we interviewed were able to give us examples of how they maintained peoples’ dignity, privacy, independence and how they offered choices to people on a daily basis.

We asked people who use the service what they thought about the care and treatment they receive at the service. They responded positively and said they felt supported by the staff team and that they were included in decisions about their care as far as possible.

One person commented, “I go to the park and I go to college on a Wednesday”.

We observed that the way staff were supporting people in the home had a positive effect on their well being. Staff we interviewed had a good understanding of the needs of the people they supported.

People who use the service indicated to us that they felt safe with the staff at the home.

Staff we interviewed were aware of the different types of abuse that can happen to people in a care setting. Staff were also able to give us examples of signs they would look out for that may indicate a person may be being abused.

Staff told us that if they ever suspected abuse was taking place they would inform the manager immediately. Staff confirmed that they had undertaken training in safeguarding people from abuse.

People who use the service indicated that they were happy with the staff who support them.

One person commented, “They are nice, they work hard”.

We observed staff being appropriately supported by the management so that they could provide for the care needs of the people who use the service.

People who use the service confirmed that the staff ask them how things are going and if they are happy with the care provided at Keevan Lodge.

We saw that the home was decorated and furnished to a good standard and peoples’ rooms had been individualised to reflect their own personalities. No issues were identified in relation to the maintenance of the building during our visit.

We undertook an unannounced inspection on 25 November 2014 of Keevan Lodge. This care home provides support to three people with learning disabilities. People at the home were unable to verbally express their views At the time of our inspection three people were using the service.

At our last inspection on 8 October 2013 the service met the regulations inspected.

The service had two registered managers in post at the time of our 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. One registered manager at the home was responsible for the operational side of the service and the other registered manager was responsible for the daily running of the service.

On the day of the inspection there was a calm and relaxed atmosphere in the home and we saw staff interacted with people in a friendly and respectful manner. We saw that people who used the service appeared comfortable around staff and with the registered managers.

We saw staff communicate with them in other ways such as using specific body language, gestures, facial expressions and key words.

There was a safe environment for people who used the service and staff. The majority of staff had received training in how to recognise and report abuse. Staff we spoke with were knowledgeable in recognising signs of abuse and the associated reporting procedures. Medicines were securely stored and administered.

We found the managers were aware of the recent Supreme Court judgement in respect of Deprivation of Liberty Safeguards (DoLS) and confirmed that currently nobody at the home needed applications made to deprive them of their liberty. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

Assessments were undertaken to identify people’s health and support needs and any risks to people who used the service and others. Care plans were in place to reduce the risks identified.

Staff had the skills and knowledge to support people who used the service. There were enough staff available at the service and staffing levels were determined according to people’s individual needs.

The registered managers at the home were familiar with all of the people living there and staff we spoke with told us they felt supported by the management team. Regular staff meetings were held by the service and we saw evidence of this.