Background to this inspection
Updated
16 October 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was unannounced and carried out on the 23 and 24 July 2015. On the first day of inspection three inspectors and three experts by experience in the care of the elderly visited the service. An expert by experience is a person who has personal experience of using care services or caring for someone who uses this type of care service. On the second day two inspectors returned to complete the inspection process and to provide feedback to the registered manager and clinical lead nurse.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the home, what the home does well and improvements they plan to make. We reviewed previous inspection reports and notifications before the inspection. A notification is information about important events which the home is required to send us by law.
During the course of the inspection we spoke with the registered manager, the clinical lead nurse, the chef, housekeeping staff, 20 people who used the service, 10 relatives and 14 staff members including the activities co-ordinator. We also spoke with two healthcare professionals who visited the service on a regular basis. Following the inspection we spoke with the area manager responsible for the service and contacted Healthwatch.
Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Some people who used the service had complex needs which meant they could not share their experiences. We used a number of methods to help us understand their experiences. For example, on one of the units, Headley House, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living with dementia who could not always talk with us.
Updated
16 October 2015
Knowles Court Residential and Nursing Home has five individual single storey houses and is situated in Holmewood, a residential area on the outskirts of Bradford. At the time of the inspection only four of the five houses were occupied.
Headley House provides care and support to people living with dementia. Rycroft House provides nursing care for older people, Fairfax House provides care and support to older people and Rosewood House provides support to people with learning disabilities.
The service is part of BUPA Care Home (CFHCare) Limited and is registered to provide nursing and personal care services for up to 146 people. A total of ninety people were living at Knowles Court at the time of the inspection.
We inspected Knowles Court Residential and Nursing Home on the 23 and 24 July 2015 and the first day of the visit was unannounced. Our last inspection took place in October 2014 and at that time we found the service was meeting the regulations we looked at. However, we did bring to the attention of the registered manager some areas of service delivery which could be improved.
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.
The home had a safeguarding policy in place which made staff’s aware of their roles and responsibilities. We found staff knew and understood how to protect people from abuse and harm and kept them as safe as possible. The care plans in place were person centred and contained individual risk assessments which identified specific risks to people health and general well-being, such as falls, mobility and skin integrity.
There were procedures in place in relation to Mental Capacity Act 2005 (MCA) that included steps that staff should take to comply with legal requirements. Staff we spoke with had a general working knowledge and understanding of the MCA 2005. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to submit one when required.
We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GPs, hospital consultants, community health nurses, opticians, chiropodists and dentists. We found medication policies and procedures were in place and staff responsible for administering medication received appropriate training.
People told us they found the staff caring, and said they liked living at the home. Relatives gave us positive feedback about the care and support their family members received. Throughout the inspection we saw staff were kind, caring and patient in their approach and had a good rapport with people.
We saw wherever possible people had been involved in planning their own care and the records we reviewed had consent to care and treatment forms in place that had been signed by the person or their relative. Relatives told us they were involved in all aspects of family members care and treatment and kept informed of any significant changes in their general health or well-being.
Staff were careful to protect people’s privacy and dignity and people told us they were treated with dignity and respect. We saw information relating to people’s care and treatment was treated confidentially and personal records were stored securely.
People told us staff were responsive to their needs and when they asked for something this was provided. The activities plan for the home showed that activities took place every day of the week and people were encouraged to participate in local community events.
We saw the complaints policy had been available to everyone who used the service. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.
Staff told us communication within the home was good and staff meetings were held to keep them up to date with any changes in policies and procedures or anything that might affect people’s care and treatment. Staff were confident senior management would deal with any concerns relating to poor practice or safeguarding issues appropriately.