We carried out a review of the data available to us about Knowle Manor on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Knowle Manor, you can give feedback on this service.
There was a registered manager in place at the time of the inspection. 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 administration of people’s creams was not robust. The registered manager told us a new creams administration system had recently been introduced, but ‘teething’ problems still needed work. Not all staff had received training in the administration of medicines and staff competency had not been checked.
Staff received training and support required to meet people’s needs, although, some training was overdue. The registered manager was aware and in the process of addressing this. The registered manager told us they had not recruited any new staff members in over two years, but recruitment procedures were in place. We found people were cared for, or supported by, sufficient numbers of staff, although the registered manager told us they were going to review the staffing level to make sure they were appropriate.
People’s care plans contained sufficient and relevant information to enable staff to provide consistent, person centred care and support. We received mixed views about the activities, but we saw there was opportunity for people to be involved in a range of activities within the home and the local community, although, outings were limited. From the activities we saw people were smiling and engaging in a positive way.
People told us they felt safe in the home. Staff had a good understanding of safeguarding vulnerable adults and systems and processes were in place to protect people from the risk of harm. Risks to people were identified and managed safely and accident and incidents were analysed accurately. Infection control management was robust and the home was clean, tidy and odour free.
People’s mealtime experience was good. One person did say the meals were not hot enough. We were told there was only one hot plate working but a new one had been purchased and was in the process of being fitted. People had access to healthcare services to make sure their needs were met.
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 were able to individualise their bedrooms and communal areas were comfortably furnished and homely. Staff were aware of people’s care and support needs, they treated people with kindness and had a good rapport with people. People told us they liked living at Knowle Manor and they were well cared for. Staff understood how to treat people with dignity and respect. People were supported to remain independent and advocacy services were available if required. People’s end of their life wishes were recorded in their care plans.
People and staff found the management team approachable and said they listened to them. We found some of the quality assurance systems needed to be improved to ensure people received a consistent quality service. For example, the medication audit had not identified the concerns found with the administration of people’s creams.
There had been no recent complaints, but a complaints procedure was in place and people told us they would raise any concerns with the registered manager.
This was an unannounced inspection that took place on 30 November 2015. At our previous inspection in October 2013 we found the provider met the regulations we looked at.
Knowle Manor is a residential home and is registered to provide accommodation and personal care for up to 29 older people. At the time of our inspection there were 25 people using the service.
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 told us they felt safe in the home, and we found they were protected from potential abuse because staff were trained in safeguarding vulnerable adults and understood how to identify and report concerns. The provider ensured that robust background checks were undertaken before staff commenced working at the service and further protected people by ensuring the premises wre clean and well maintained.
We saw risk assessments in people’s care plans which showed the provider understood how to minimise individual risk and ensure that people were safe. Information in the risk assessments was regularly reviewed and updated, meaning staff always had access to information about people’s current care and support needs.
Medicines were stored, administered and managed safely. People had access to their medicines when they were needed.
All people we spoke with expressed a high level of confidence in the care and support they received and were very complimentary about the staffs skills. We saw staff were supported to deliver care through regular training, supervision and appraisal.
People told us they had access to health professionals when they needed it and we saw evidence in care plans that this was the case. A visiting health professional we spoke with told us they felt the provider delivered a good standard of care.
Care plans contained appropriate mental capacity assessments. Staff received training in the Mental Capacity Act (2005) and understood how this impacted on the ways in which they worked with people. People told us they made choices connected to their care and daily lives and we observed during the inspection that people were free to choose how they spent their time.
The service had a creative and innovative approach to food, drink and mealtimes which people told us they enjoyed. The provider had given thought to ways in which they could make mealtimes a sociable occasion and we observed this in action during the lunchtime meal on the day of our inspection.
People spoke highly of the care they received and told us they had nominated key workers who provided extra personal services such as shopping. Throughout the inspection we observed people were relaxed and appropriately familiar with staff. We found that privacy and dignity were respected.
The provider undertook assessments of people before they began using the service. This ensured they were able to provide the care and support that people needed. Care plans contained personalised information about people’s past lives, likes, dislikes and preferences.
The provider had robust systems in place to manage any complaints or concerns and people told us they felt able to discuss any issues with the registered manager.
The registered manager included people who used the service and staff in making decisions about the service. People and staff told us they felt listened to and that the registered manager was approachable.
There was a robust programme of audit in place to ensure and drive forward the service delivery.
We spoke to five people who lived at Knowle Manor. All were very complimentary about the care they received. They told us staff were approachable, attentive and helpful. We were told, "You can have a laugh and a joke with the staff." We also spoke to relatives of people who used the service. They were very complimentary about the standards of care being provided.
We spoke with people who used the service who told us about the wide range of activities available. Most recently people had visited a local donkey sanctuary.
During our visit to Knowle Manor we saw domestic staff cleaning people's bedrooms, bathrooms and toilets. All areas were exceptionally clean and fresh smelling. There was evidence of robust policies and procedures that were put into practice daily, for example, hand washing, prevention of cross-contamination in the kitchen and laundering procedures.
We saw the home provided people with information about how to raise concerns and make complaints. We saw the agenda and minutes from residents meetings and found the complaints policy was a standing item on the agenda
People said they had choices as to how they spent their days and one person said 'we do all sort of things here, I am very happy here'. One person said 'I do what I can for myself because that's what I want'. Another person said 'I like to wear make up and have nail polish on and staff help me to do that'. One person did jobs in the home like checking the milk delivery which he said he really enjoyed.
Visitors told us they were very happy with the care their families received. One visitor said 'Staff take into account individual needs, she has her own routine and staff respect that'. 'She likes to be coordinated and they help her choose clothes that match and put make up on her'. Another visitor said 'My mum loves it here the staff are brilliant they do lots of things like the Monday Club'.
Staff we spoke with said that people were treated with respect and dignity. One staff member said 'I treat people here like I would treat a member of my family, this is their home and we should respect that'. Care plans had information on people's choices on how they wanted to be cared for and preferences such as what time people wanted to get up and whether they preferred a bath or shower.
People we spoke with were very satisfied with the care they received. One person said, 'We're definitely well looked after. If you're not very well they get the doctor or the nurse.' Another person said, 'It must be one of the best places.'
People were very complimentary about the staff and told us they were treated with respect. One person said, 'The staff are marvellous. They bring me tea and toast in bed at 7 o'clock on a morning and then I choose what time to get up.' Another person said, 'Staff are very good. They will do anything. They ask what I want, they always knock and ask if they can come in.'
People told us the care they received met their individual needs and wishes. One person told us they used to be very active and staff still encouraged them to do this. They said, 'I've got my own jobs, I get up early and they are always pleased to see me when I get up.' Another person said, 'I've always loved my jewellery and make up, and they still help me with it now.' People did not raise any concerns about the care they received.
Visitors told us good systems are in place to make sure people get the right care to meet their needs. They praised the staff and said people received a good service. One visitor said, 'The manager and staff arrange extra things to keep people interested and do things in their own time.' They discussed recent events which included a Christmas fair and Greek and Spanish themed evenings.
A healthcare professional told us they had 'no concerns and would recommend the service' and 'people were very happy with the care they received'.
Staff we spoke with said people were treated with respect and their privacy and dignity was upheld. One member of staff said, 'We have a great staff team. Everyone listens to the residents and we offer as much choice as we can. We prompt each other, its good team work.' Another member of staff said, 'We make sure people's needs are met. We find out what people like. We involve them in the care plans. Staff did not raise any concerns about the care people received although some staff thought they were sometimes too busy to spend quality time with people.