We carried out an unannounced inspection of Khaya Project on 9 October 2018. Khaya Project is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Khaya Project is registered to provide accommodation and support with personal care for a maximum of five people with a mental health condition. There were three people living in the home at the time of the inspection.

At our last comprehensive inspection on 22 August 2017, the home was rated as ‘Requires Improvement’ as robust risk assessments were not in place for one person to ensure they were safe at all times. During this inspection we found improvements had been made and the home has now been rated ‘Good’.

The home had a manager, who was the provider and registered with the Care Quality Commission as a provider. Like registered managers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the home is run.

Risks had been identified and assessed, which provided information to staff on how to mitigate risks to keep people safe. Staff had been trained in safeguarding adults and knew how to keep people safe.

Medicines were managed safely. We found that people’s Medicine Administration Records (MAR) had been completed accurately. Medicines was being administered as instructed on people’s MAR, or in accordance with the provider’s policy. Medicines were stored securely.

Systems were in place to reduce the risk and spread of infection. There was a daily cleaning schedule and people were encouraged to clean their own rooms.

There were sufficient staffing levels to support people and staff had time to provide person centred care. Pre-employment checks had been carried out to ensure staff were suitable to care for people. Premises safety checks had been carried out to ensure the premises was safe.

Staff had the knowledge, training and skills to care for people effectively. Staff felt supported to carry out their roles and received regular supervisions.

People had choices during meal times and were supported with cooking meals when required. People told us they enjoyed the food. People had access to healthcare services.

Staff were aware of the principles of the Mental Capacity Act 2005 and sought people’s consent before supporting them.

People told us that staff were friendly and caring. Our observations confirmed this. People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights. People had been involved with making decisions about their care.

People received care that was shaped around their individual needs, interests and preferences. Care plans were person centred and staff knew how to provide personalised care to people.

People were aware of how to make complaints if they wanted to and staff knew how to manage complaints.

People had an activities schedule, which included accessing the community. Group activities were organised and people were encouraged to participate in these activities.

Staff felt well supported by the management team. People were complimentary about the management of the home. Quality assurance and monitoring systems were in place to make continuous improvements.

We carried out an unannounced inspection of Khaya Project on 22 August 2017 and 12 September 2017. Khaya Project is registered to provide accommodation and support with personal care for a maximum of five people with a mental health condition. On the first day of the inspection there were five people living in the home. On the second day of the inspection there were four people living in the home, as one person had moved out.

At our last comprehensive inspection on 22 April 2015, the home was rated as Good. During this inspection we changed the rating to Requires Improvement.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the home is run.

Risks were not always robustly managed. We saw that some people had risk assessments in place. However, one person had not been risk assessed, which placed them at greater risk of harm.

Quality assurance systems were in place but were not always effective. For example, the audits had not identified the shortfalls we found during the inspection with risk assessments.

Staff were aware of how to identify abuse and knew who to report abuse to within the organisation and outside the organisation.

Premises safety checks had been carried out by qualified professionals. These checks did not highlight concerns.

Medicines were managed safely. People received their medicines as prescribed. Medicine records were completed accurately and were stored securely. Staff had been trained with medicines and competency assessed to check their understanding of medicines.

Pre-employment checks had been carried out to ensure staff were fit and suitable to provide care and support to people safely.

There were appropriate staffing levels. Staff told us they had time to provide person centred care and had enough staff to support people.

Staff had received training required to perform their roles effectively. People were being cared for by staff who felt supported.

Staff had been trained on the Mental Capacity Act 2005 and knew the principles of the act. People had capacity to make their own choices and were independent.

People had the level of support needed to eat and drink enough and were supported with cooking healthy meals.

People had access to a range of health care professionals, which included services that supported people with drug and alcohol problems.

People had a positive relationship with staff. We observed staff were caring.

People’s privacy and dignity were respected by staff.

People were able to participate in activities if they wanted to. There was a weekly activities timetable for each person.

Care plans were person centred and detailed people’s preferences, interests and support needs. People were involved with making decisions on their care.

Staff told us the culture within the home was like being part a family and told us the home was well-led. People’s feedback was sought from resident meetings and key worker meetings.

We identified a breach of regulation relating to risk assessments. You can see what action we have asked the provider to take at the back of the full version of this report.

This unannounced inspection took place on 22 April 2015.

Khaya project is a five bed service providing support and accommodation to people with mental health difficulties. At the time of the inspection four people were living there. It is a large house in a residential area close to public transport and other services. The house does not have any special adaptations. People lived in a clean, safe environment which was suitable for their needs.

The service 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 and associated Regulations about how the service is run. The registered manager is also the registered provider.

People were safe at the service. They were supported by caring staff who treated them with respect. Systems were in place to minimise risk and to ensure that people were supported as safely as possible.

During this inspection, we found that the arrangements for managing medicines were good and that people received their prescribed medicines appropriately.

People were cared for by staff who had the necessary skills and knowledge to meet their assessed needs, preferences and choices and to provide an effective and responsive service. Staff also received the support and training they needed to carry out their role.

The staff team worked closely with other professionals to ensure that people were supported to receive the healthcare that they needed.

Staff supported people to make choices about their care. Systems were in place to ensure that their human rights were protected and that they were not unlawfully deprived of their liberty.

People were happy with the food provided and this met their cultural needs.

People were asked for their feedback about the service and about what they wanted. They were actively involved in developing their care plans and in agreeing how they should be supported.

The manager closely monitored the quality of service provided to ensure that people received a safe and effective service that met their needs.

As part of our inspection we spoke with one of the two people using the service. They told us, "everything is all right. I like living here." The other person was out of the home during our visit.

People’s privacy, dignity and independence were respected. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights. Staff encouraged and supported people to be as independent as possible and to access their local community.

There were effective systems in place for managing medication.

There was also an effective complaints system available.

People using the service had been living at the Khaya Project for a long time and were happy with the support they received.

Two out of the three current residents told us that they were happy with the services provided by the home. The third felt he had outgrown the service and was in the process to move on to a less supported environment.

People’s potential for living in the community is assessed over a long period due to their complex mental health needs.

Residents are encouraged to access services in the community and to be part of the community.

People told us that the staff were always available to help them with any aspect of their needs. Residents received personalized care and support which reflected to their lifestyle choice.

People using the service told us that they enjoyed living at the Khaya project, as they were supported to do things that they wanted to do. One person told us: “Everything is perfect I get support with my illness and to make the choices that I like”. This person also told us that they get adequate support to access healthcare services in the community to meet their needs. Another person told us: “Staff involve me in my care plan and they explain things to me. I am also involved in my reviews and sign my care plan”. All the people we spoke with were positive about the service they received at the Khaya Project.

We spoke with people using the service about the staffing in the home and they told us that all the staff treated them with dignity and respect. They told us that the staff were always available to help them with any aspect of their needs. One person told us: “I go to clubs regularly with the support of staff, which gives me opportunities to socialise, develop my confidence and to meet new people”. This person also told us that staff work by the rules, which helps to keep them focused on their personal goals. We received other comments about the staff which included: “Staff make you feel comfortable”, “Staff are okay”, and “Staff always remind you of your appointments, which is so important”.

We spoke to a social care professional who told us: ”The home was very good. They supported our service user quite well, despite the complex nature of their needs”.