Calvert Trust Kielder

Calvert Trust Kielder is a care home providing accommodation and personal care for up to 20 people with a range of health or physical disabilities including people with a learning disability. Six people were using the service when we visited. The focus of the service is to provide a short break for people with a wide range of activities, which mostly occur outdoors either in the forest or at the nearby reservoir. People usually stay at the service for one to two weeks.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service and what we found

People told us they were safe and well looked after by staff. People were safeguarded from potential abuse. Risks associated with people’s care and daily activities had been assessed and action taken to minimise these.

The service was kept clean and tidy and people’s medicines were well managed.

Staff were safely recruited, and enough staff were continually deployed to safely meet people's needs. Staff received a range of training and had regular supervision and annual appraisals completed.

People told us they liked 'holidaying' at the service and staff were supportive. People said staff were caring and showed them kindness and consideration. Staff knew people well.

People’s care needs had been assessed and their choices were respected. A wide selection of nutritious food and plenty of refreshments were available, including for people on special diets. The service worked with other professionals to make sure people’s health and wellbeing was maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The design of the service and the care staff provided, allowed people to have as much independence as possible and maintain their privacy and dignity.

The service was well led. Staff told us the management team were supportive. A number of quality checks and audits were completed. People were supported to engage in the running of the service as much as possible. There was clear evidence the service worked in partnership with other agencies to support people who were visiting the service. Some minor updates in some paperwork was needed and the management team agreed to address this.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The provider sent us an action plan to show us how they were going to address the concerns we had found and we returned to check they now met all of the regulations. We also visited to follow up on a safeguarding concern which had been raised although the investigation was not yet complete. We will report on this in due course.

We found that the provider had improved their medicines procedures and were now meeting Regulation 12. Medicines were managed safely. Only trained staff administered medicines. People confirmed they received their medicines at the correct time.

The Calvert Trust Kielder complex is set up to provide residential respite care with the main focus being on adventure activities for up to 20 people with various healthcare needs. At the time of our inspection there were six people who had a range of physical and learning disabilities using the service.

The service is based in the Kielder forest area with people staying for one or two weeks, with some choosing to stay longer. The service is used by people from all areas of the country and because the service is part of a larger complex, accommodation and activities is extended to other people and their families on the same site including those who are both able bodied and those less so.

The service had 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 said they received good care from kind, caring and considerate staff. They also confirmed they felt safe while visiting and staying at the service. Relatives and staff also told us the service was safe for people to stay at.

Staff knew how to report safeguarding concerns and we found the provider had dealt with previous safeguarding concerns appropriately.

Where potential risks had been identified an assessment had been completed. The benefits of people taking risks and the measures needed to keep them safe were considered as part of the assessment.

Accidents and incidents were logged and investigated with appropriate action taken to help keep people safe. Health and safety checks were completed and procedures were in place to deal with emergency situations.

We found there were sufficient staff deployed to provide people’s care in a timely manner. People, relatives and staff felt staffing levels were appropriate. There were effective recruitment checks in place to help ensure staff were suitable to be employed at the service. Staff received the support and training they required and records confirmed training, supervisions and appraisals were up to date.

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 and were currently being reviewed.

People gave positive feedback about the meals and refreshments available to them. We saw people received the support they needed with eating and drinking.

The service was adapted to suit the needs of people with a range of disabilities, with an emphasis on enabling people to participate in the wide range of outdoor and indoor activities by providing specialist assistance and equipment.

People’s needs were assessed to enable personalised care plans to be developed. Care records contained details of their preferences. Care plans were in the process of being fully reviewed to keep them up to date.

Meetings were held so that people could share their views and suggestions and in order to keep them up to date with what their expectations should be during their stay.

People did not raise any concerns about their care but knew how to complain. Previous complaints were investigated and resolved in line with the provider’s complaint’s policy.

People, their relatives and staff said the registered manager, head of care and other staff were approachable and the service had all the requirements needed for a homely, friendly atmosphere.

A range of audits were carried out to check on the quality of people’s care. The provider had complied with their legal responsibilities and advertised the latest service ratings in the reception area and on their website.

Part of the Calvert Trust Kielder is set up to provided residential respite care with a focus on activities, for up to 20 people with a range of disabilities. At the time of our inspection there were 12 people who had a range of physical and learning disabilities using the service. The service is based in the Kielder forest area and people are able to use the service from any location in the country and usually stay for one to two weeks, but can stay longer if they wish. The service is part of a larger facility on the same site which provides holiday accommodation/activities to people and their families and day activity breaks to a variety of groups including those who are not disabled. This part of the service is outside of the scope of our regulations.

The service had 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.

We found some areas of the management of medicines needed to be improved. For example, there was not always information regarding 'as required' medicines, staff did not fully detail individual medicines on people's medicines administration record and risk assessments were not always in place. The provider sent us an updated version of their medicines policy but we were not able to see the new practices and audits in place and will return to check this at a future date.

Staff were aware of safeguarding responsibilities and knew how to implement safeguarding and whistleblowing procedures. The provider took safety seriously and risks identified were assessed and reviewed and people were kept as safe as possible. Accidents were recorded, reported and monitored by the provider.

We found the provider had already undertaken some refurbishment work within the hydro pool area but that there was more to complete. The provider told us that this was due to be completed in the near future.

There were enough staff employed at the service who had been recruited safely, who received appropriate support and who were continually trained to meet the needs of the people using the service.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’. It also ensures unlawful restrictions are not placed on people in care homes and hospitals. We found the provider was complying with its legal responsibilities.

People were able to enjoy enough food and refreshments to meet their needs and if people needed additional support from staff, this was provided. Special dietary needs were also catered for.

We observed staff speaking with people in kind, respectful and reassuring ways. People told us they felt their dignity and privacy were respected by staff. They also told us staff encouraged them to be as independent as possible and involved them with the running of the service and to be fully informed as to what was happening.

People’s had been assessed for their needs and their care records were detailed and had been updated as the need arose.

The provider had a large range of outdoor and indoor activities for people to participate in. People told us that this was the main reason for coming to stay at the service.

The provider had in place a complaints policy and people were aware of how to use it. We found that complaints were investigated appropriately and there had been two since the last inspection.

People and their relatives thought the service was well led. We found the provider had audits in place to measure and monitor the quality of the service and meetings took place to discuss various aspects of the service with the staff and the people using the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to medicines. You can see what action we told the provider to take at the back of the full version of this report.

People told us that consent was gained before care was delivered.

We found people's needs were assessed and care and treatment was planned and delivered in line with their individual care plans. One relative said, 'I absolutely trust them to care for X, I know I can go on holiday and they will do anything and everything to support X.'

Records were available to show that the manager monitored the administration records of medication. This meant that people's medicines were checked regularly by the manager to see that staff were administering and disposing of them properly.

People were cared for by staff who were supported to delivered care and treatment safely and to an appropriate standard. One relative said, 'The consistency of the staff is a brilliant thing, they are all so knowledgeable. They have a solid staff group and to me that is a real indicator of the service.'

We found that the provider had an effective complaints procedure in place and this was advertised clearly throughout the service. All staff we spoke with told us they were aware of the complaints procedure and would support any one who wished to raise any concerns.