This inspection took place on 8 and 9 August 2016 and was unannounced.

Keys Hill Park provides accommodation and support to a maximum of thirty six people. They support people who have a learning disability, autistic spectrum disorder or mental health needs. It does not provide nursing care. Accommodation is provided through eleven different properties on the site with small groups of people living in each one. Each property has a communal lounge and a kitchen. On the day of our inspection there were thirty three people living in the home.

The provider has another service, The Gables, which is situated about a mile away from Keys Hill Park. The Gables was inspected by the same inspector and in the same week as Keys Hill Park. This is because the two services operate closely together. They have the same management team and some staff work across both services. Some records for both services are also held at the offices in Keys Hill Park.

There was 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 were safe living in Keys Hill Park. Risks to people were identified and managed, this included risks relating to the management of the premises. There was a clear reporting structure and oversight of incidents and accidents. Staff understood their responsibilities regarding adult safeguarding.

There was sufficient staff which ensured people were safe.

Medicines were safely managed and active measures were being taken to reduce the potential for medication errors.

Staff spoke highly of the training they received. They were supported to provide effective care through management support, good team work and effective training. New staff were provided with a detailed induction that gave them the skills and knowledge to undertake their new role.

Staff understood the basic principles of the Mental Capacity Act and ensured people were supported to make decisions.

People’s nutritional needs were supported. Staff supported people to maintain good health; this included encouraging people to eat healthily. People were supported to access healthcare services where required.

People were supported by kind and caring staff, who encouraged them to be involved in decisions about their care. There was a strong emphasis on independence. Staff supported and encouraged people to be as independent as possible.

People were involved in writing and reviewing their care plans. However, there were some restrictions in place which limited the amount of choice and control people had. Staffing sometimes impacted on the support given to people to participate in activities. This meant that care was not always delivered in a way that met people’s individual needs and preferences.

People knew how to complain. The provider investigated and responded to complaints appropriately.

Staff and managers told us person centred care, inclusivity, and promoting independence were key values of the service. However, some ‘house rules’ had developed which appeared to undermine some of the values the service promoted.

Staff enjoyed working at the home and spoke positively of the support the management team provided. People were encouraged to participate in the running of the home and share ideas. Quality audits were in place which helped the provider monitor the quality of the service delivered and take action when needed.

The provider had introduced a culture and values programme, which aimed to encourage staff to take accountability and display key values and behaviours. This had had a positive impact on staff morale and on how staff carried out their roles.

We met and spoke with seven people who were living in Keys Hill Park during this inspection.

One person told us that they had only very recently moved in and said, “So far, I’m very happy here, everything’s lovely.” Another person told us, “It is rather nice here. The staff are very good; they understand me and know how to help me…”

People we spoke with confirmed that they had regular reviews of their care with the staff. One person told us, “I look at my folder quite a lot with the staff; that way we can see how I’m getting on…”

We observed people choosing and preparing their own lunches and we saw that people made drinks as and when they wanted.

All the people we spoke with told us that they were supported to take their medicines at the prescribed times, as needed. They also told us that they knew what medicines they had been prescribed, what they were for and how and when to take them.

All the staff we met and spoke with made positive comments about working at Keys Hill such as, “…It’s an amazing place to work…” and, “The training is excellent here…”

When we spoke with people about making a complaint we received comments such as, “…I used to have a lot in the past but I don’t have any now…”, “…I can talk to management or any of the staff…”, “…tell my keyworker; it always gets sorted…” and “…I’d go to the house leader but I’ve never had to complain…”

People told us that they knew what information was in their care plans and that they were involved in making decisions about their care and support.

People said they were able to give feedback about the service during regular 'house' meetings and we were told that staff responded to any issues or concerns they raised.

Each person we spoke with told us that they were happy with the support they received and felt their needs were being met. Everybody we spoke with told us that their privacy and dignity were respected by staff.

The people we spoke with at length, all told us that the staff were very good and always had time to talk and listen. Everybody we spoke with told us that they felt safe using the service and had no concerns regarding the way they were supported by staff.

We noted the summarised results of a 'Service User Family Satisfaction Questionnaire', which was included with the Keys Hill Park information brochure. Typical comments were that people had made very good progress and were very happy and contented.

Everyone we spoke with spoke very highly of the staff, management and provider. One person said: "I'm very happy with everything here. The staff are really good and they've helped me a lot." Another person told us: "My key worker is great, we get on really well together and they've always got time for me."

One person said, of the staff, "I don't think we ever stop laughing". Another person told us that they had started to do a college course and that they were really enjoying it.

Other comments made by people we spoke with included: "It's an amazing place, I love it here. I've got a good life now." "I feel safe here, my life is very different now." "This is the house of my dreams!" "It's just amazing, I totally love it!"

During the visit to the scheme we spoke with five people who use the service. They told us that staff were very good and that they “trusted staff".

They told us that they felt safe in the scheme and that their needs were met.

A person told us: “We get on very well with others and staff. We share responsibility. We do have all we need here and privacy is respected, we can stay in our rooms if we want privacy.”

Another person who uses oxygen at night stated that staff were very competent and “would pick up very quickly if I am becoming ill".

She explained how she felt much better after moving to a room upstairs.

All people with whom we talked told us about their activities both in the scheme and outside in the community.