Kazdin

About the service

Kazdin is a residential care home providing personal care to 3 people at the time of the inspection. The service can support up to 3 people. The service is in a residential area with two adapted wings with kitchens and bathrooms for the two people living in those areas of the service. There is an extensive communal garden and one person has their own private garden.

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

Right Support:

People were offered choice in aspects of daily living and could personalise their bedrooms and lounges. Arrangements were made for people to receive specialist health and social care support locally in line with people's assessed needs. The staff were actively encouraging people to develop their independence at their own pace, and for one person fighting for them to have access to a mobility vehicle again so they could get out more.

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.

Right Care:

Staff were kind and compassionate and knew what people liked and disliked and how they wanted their support provided. Staff supported people consistently and staff tailored their communication approach and shared learning and observations about people’s changing needs, moods and preferences.

Right Culture:

The leadership team were focussed on people’s strengths and wishes and worked with staff to create a culture of acceptance, understanding and celebrating people’s strengths.

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 11 March 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The registered manager assured us they had assessed the risks of COVID-19 to staff who might be at an increased risk because of their individual health needs and/or ethnicity. Whilst it was clear the registered manager knew staff well; this information had not been formally recorded for everyone. Following the inspection, the registered manager confirmed that individual risk assessments were now being completed.

We found the following examples of good practice.

Systems were in place to help manage the risks and prevent the spread of COVID-19.

There was a clear system in place for visitors to ensure they followed the current guidance on the use of personal protective equipment (PPE) and social distancing.

Visitors were asked to consent to a rapid COVID-19 test, have their temperature checked, wash their hands and complete a health declaration before they would be allowed to enter the service.

Visitors to the service had been restricted to essential visitors only. Staff were supporting people to maintain contact with their relatives through use of social media groups, video calls and letter writing.

Staff had received additional training in infection prevention and control and the use of PPE including masks, gloves, aprons and hand sanitiser. There were sufficient stocks of PPE available and staff were seen to be wearing PPE appropriately.

People and staff took part in regular COVID-19 'whole home' testing. People and staff who tested positive, followed national guidance and self-isolated for the required amount of time.

Cleaning schedules and procedures had been enhanced to include more frequent cleaning of touch points such as handrails and light switches. In addition, the service carried out monthly infection prevention and control audits.

The provider had developed specific COVID-19 policies and procedures. There was a contingency plan and risk assessment in place to manage a potential outbreak of COVID-19 within the service to keep people and staff safe.

Kazdin is a residential care home providing personal care and accommodation for a maximum of three people with a learning disability and/or autism. At the time of the inspection three people were living at the service. Two people were supported in their own self-contained flat/annexe and one person had a bedroom and en-suite facility in the main part of the house.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in the settings that provide care for people who might have mental health problems, learnings disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and the potential drivers for improvement.

As part of the thematic review, we carried out a survey with the acting manager at the inspection. They considered whether the service used any restrictive intervention practices (restraint, seclusion, and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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

People using the service benefitted from kind, caring and committed staff who kept them safe and promoted their independence whenever possible.

People were placed at the heart of the service and staff worked hard to achieve the best outcomes for people. Care was personalised and took into account people’s preferences and choice.

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 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.

People’s care was delivered safely. Staff were consistent, employed in sufficient numbers and had the skills and training to care for people safely.

People’s risks were understood and managed well. People’s rights and independence were respected and promoted. Management and staff understood their role and responsibilities with regard to the Mental Capacity Act (2005). People’s consent was sought before care was provided. When people were unable to consent and make decisions for themselves appropriate processes were followed. People were protected from discrimination and abuse because staff understood how to safeguard them.

People lived in a home that was well-maintained, comfortable and designed to meet their needs. Much consideration had been given to making sure people had opportunities to occupy their time in a meaningful way. Staff recognised the importance of family and friends and helped people maintain these important contacts.

Management and staff had developed good relationships with health and social care professionals and liaised with these services to help ensure people’s full range of care needs were met.

Governance systems ensured improvements were highlighted so action could be taken promptly. Incident and accident reports were reviewed to ensure any themes and trends were identified and acted on.

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 the service was Good (published 24 March 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 inspection programme. If we receive any concerning information we may inspect sooner.

Some of the people who lived in the home had limited communication and used other methods of communication, for example pictures and hand written questions. We therefore used these and observations to communicate with people.

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 remained safe at the service. There were enough staff to meet people's needs and support them with activities and trips out. Risk assessments were completed to enable people to retain their independence and receive care with minimum risk to themselves or others. This is particularly important for people who may challenge others. People received their medicines safely.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff were well trained and competent. 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. People's healthcare needs were monitored by the staff and people had access to healthcare professionals according to their individual needs.

The staff were very caring and people had built strong relationships with the staff. We observed staff being patient and kind. There was a calm atmosphere in the service. People's privacy was respected. People where possible, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People were able to make choices about their day to day lives. Complaints were fully investigated and responded to. One person told us "They met with the registered manager” to discuss any issues they had. People were assisted to take part in a wide range of activities and trips out according to their individual interests.

The service continued to be well led. Staff told us the registered manager was approachable. The registered manager and provider sought people's views to make sure people were at the heart of any changes within the home. The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

Further information is in the detailed findings below

Kazdin House was designed to provide independent living space for up to three people. Each person had their own living area including a kitchen or kitchenette, bathroom and lounge.

We observed the staff treating people with consideration and respect. For example, they asked people if they wished to meet and talk with us. We observed that the staff responded to each of these people with patience and kindness at all times.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. They demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have.

One person when asked said about the home, 'I am very very happy'.

One relative spoken with said, 'The home is tailored to X needs and I am happy with the placement'.

Each person has their own living area separated from each other and each area has their own facilities, including kitchens, or kitchenettes, bathroom and lounge areas.

We saw that staff treated people with consideration and respect. For example, two people were feeling unwell on the day of our visit. We observed that the staff responded to each of these people with patience and kindness at all times.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. They demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have.

One person living in the home when asked if staff were kind, said, 'Yes, the staff are kind to me'.

One relative spoken with said, 'Very happy with the way things are going'.