Kismet House is registered to provide accommodation and personal care for nine people with mental health needs. At the time of our visit there were nine people living at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

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 practice.

Risks to people were assessed and where required a risk management plan was in place to support people manage an identified risk and keep the person safe.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. People told us they felt safe living at the service.

The provider ensured that new staff completed an induction training programme which prepared them for their role. Staff completed training which ensured people at the service were safe. Staff were supported through a supervision programme. Supervision is where staff meet one to one with their line manager to discuss their work and development.

People were supported to maintain good health and had access to external health care professionals when required.

Staff were caring towards people and there were good relationships between people and staff. Staff demonstrated an understanding of the needs and preferences of the people they cared for.

Support provided to people met their needs. Supporting records highlighted information about what was important to people and how to support them. People were involved in activities of their choice.

There were systems in place to assess, monitor and improve the quality and safety of the service. Staff described the deputy manager and the provider as supportive. Comments from people confirmed they were happy with the service and the support received.

Further information is in the detailed findings below.

We carried out this inspection to follow up compliance actions made at an inspection which took place 23 October 2012. We spoke with five of the nine people who lived in the home. They all told us they were happy living at Kismet House and felt they were supported well by staff. We also spoke with three members of staff.

We found that following an audit of the care plans the registered manager had identified the need to develop new consent forms for people to sign. We saw this was being action by staff.

We saw each person had a personalised care plan which described the care and support they required. Records maintained by staff showed that care was delivered in line with the person's plan.

People spoken with told us they felt safe living at Kismet House. Staff understood the various signs of abuse and knew what action they needed to take to ensure people were safe.

At the inspection on 23 October 2012 we were told there was no system in place to regularly assess and monitor the quality of the service. At this inspection we found the provider had systems in place to assess and monitor the service provided. This system included obtaining opinions of people who lived in the home.

At the inspection on 23 October 2012 we found the home was responsive and dealt with incidents but they were failing to inform the correct people as required by law. During this inspection we found the registered manager had informed all the correct people when an incident had occurred.

At our last visit in October 2012 we found that the registered person did not protect service users against the risks associated with the unsafe use and management of medicines because the arrangements for recording, safe keeping, dispensing and safe administration of medicines did not prevent errors from being made. We judged this to have a major impact on people using the service and issued a warning notice to the provider.

We visited the service on 29 November 2012 to follow up the warning notice. We found the warning notice had been complied with and that people were now protected from the risk associated with the unsafe use and management of medicines. This is because the provider has reviewed and changed the arrangements for recording, safe keeping, dispensing and safe administration of medicines.

At our last visit in October 2012 we were told there was no system in place to regularly assess and monitor the quality of the service. We judged this to have a moderate impact on people using the service and issued a compliance action requiring the provider to take appropriate action to address this area. We also found the service was responsive and dealt with incidents but failed to inform the correct people as required by law. We judged this to have a minor impact on people using the service and issued a compliance action requiring the provider to take appropriate action to address this area.

These compliance actions will be followed up at a later date.

We carried out this inspection in response to some concerns we received relating to the health and well being of people at the home. When we visited we spoke to eight people who lived at the home. All confirmed to us that they were "happy" living at Kismet and were positive about the staff who supported them.

Each person had a plan which described the care and support they required and how staff should provide it. We saw there were risk assessments in place for some people which promoted well being and prevented crisis.

Staff spoken with were aware of issues of abuse and knew how to report any worries or concerns.

People had access to a spacious lounge and dining area. Communal areas had been comfortably furnished and were well maintained. The environment promoted a homely feel for the people who lived there.

We saw that the processes for administration of medication were inadequate.

We saw there was an ad hoc approach to assessing the quality of the service. We were told there was no system in place to regularly assess and monitor the quality of the service. The service was responsive and dealt with incidents but they were failing to inform the correct people as required by law.

We have made compliance actions requiring the provider to take appropriate action to address these areas.

We carried out this inspection on the 21 and 22 May 2015 and was unannounced. Kismet House is a care home providing personal care and accommodation for a maximum of nine people. It supports the care and welfare of younger and older adults with a mental health diagnosis and provides mental health rehabilitation services. The home is located in Weston Super Mare. Nine people were living at the home when we visited.

The home has 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.

People who lived at Kismet House felt safe, and were supported by a staff group who had been trained to work effectively with people who had mental health conditions. Staff understood safeguarding policies and procedures, and followed people’s individual risk assessments. People’s dependency levels were regularly reviewed. People’s medicines were managed safely. However we found that people coming into the home were not asked to sign in, this could have put people’s safety at risk.

The service was on the whole compliant with the Department of Health’s Code of Practice on the prevention and control of infections and related guidance. The provider had arrangements to keep the service clean and hygienic. However, we found that staff did not regularly wear protective clothing when preparing food and if they did, did not change it every time they moved out of the food preparation area.

People were supported by staff that had a good understanding of their needs. Staff had been supported through effective training and supervision. The majority of staff we spoke with had awareness of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. This is legislation that protects people who lack mental capacity to make decisions and who are or may become deprived of their liberty through the use of restraint, restriction of movement and control. The manager was adhering to the act including the Deprivation of Liberty Safeguards.

People who used the service told us that they enjoyed their meals. Staff knew which people had particular dietary needs and supported people with those. People were provided with fresh drinks at regular intervals. People’s food and fluid intake was monitored. Staff monitored people’s health and involved the relevant health and social care professionals to ensure people were supported to maintain good health.

People who used the service and relatives spoke in very complimentary terms about the staff. A relative told us they had chosen the home for their relative because the staff were kind and caring. People were encouraged to give their views through every day dialogue with staff, reviews of their plans of care and through an annual satisfaction survey. Staff respected people’s privacy.

People were able to receive visitors without restrictions.

People contributed to decisions about their care and support. All relatives we spoke with told us they were involved in discussions and decisions about their family members. Plans of care reflected people’s individual needs and how they wanted to be supported.

Staff were encouraged to report concerns about the delivery of care. People and relatives told us that they were happy with how their concerns were dealt with.

Relatives told us that they found staff to be honest and open. The provider had adequate procedures for monitoring the quality of care and the home environment. The manager had developed a range of systems to monitor and improve the quality of the service provided. We saw that the manager had implemented these. Staff enjoyed their work and were supported and managed to look after people in a safe way.