We carried out a review of the data available to us about The Knowls 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 The Knowls, you can give feedback on this service.
The Knowls is a residential care home registered to provide accommodation and personal care to up to 13 people. Accommodation is provided in two separate areas. The main area of the home provides communal space and bedrooms for 11 people. Another area provides self-contained accommodation for two people.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. 13 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were no identifying signs outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
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.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.
People lived in a home where there were adequate numbers of staff to meet their needs and to assist them with activities and accessing the community. Risk assessments were carried out to make sure people received their care safely and had opportunities to take part in activities which interested them and promoted their independence.
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. People were treated as individuals and were able to make choices about their day to day lives.
People were able to follow their own routines according to their preferences and abilities. Staff respected people’s routines and choices.
People were cared for by staff who were kind and caring. People looked very comfortable with the staff who supported them. When people became anxious or distressed staff remained calm and professional. Staff used verbal reassurance to help people to relax and told us physical restraint was not used at the home.
People had access to a range of professionals to meet their physical and emotional health needs. The staff had good relationships with other professionals which enabled them to seek advice and support for people.
People had support plans which gave staff clear information about how people wanted to be cared for. Staff knew people well and understood people’s different communication. This helped to make sure people received care and support in accordance with their wishes and preferences.
People lived in a home which was well led. The provider and registered manager monitored standards and were committed to making on-going improvements to people’s support and quality of life.
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 (Report published 17 May 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 re-inspection programme. If we receive any concerning information we may inspect sooner.
At the time of the inspection there were 10 people living at the home.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated Good
Improvements had been made to ensure people received safe care. How staff administered people’s medicines had been reviewed which had resulted in risks to people being reduced. People were supported by adequate numbers of staff who had the skills and knowledge to meet their needs. Staff knew how to protect people from the risk of harm and abuse. There were systems in place to identify and manage risks.
People continued to receive effective care. People were supported by staff who were well trained and competent in their roles. People’s health care needs were monitored and met. A person who lived at the home told us their doctor’s name and said “I went for a check up to make sure I am healthy. The staff take me. It makes sure I stay well.”
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
The home continued to provide a caring service to people. One person who lived at the home told us “I like living here. I like the staff. My key worker is nice. She takes me out.” Another person said “I am very happy. I love it here. The staff are lovely.” Staff were kind and caring in their interactions with people and there was a relaxed atmosphere in the home.
People received care which was responsive to their needs and preferences. People had been involved in planning and reviewing the care they received and we found care plans were reflective of people’s needs and preferences. A person who lived at the home told us “[Name of staff member] is my key worker. I like them very much. We go shopping so I can buy clothes and all the other stuff I need.” Another person said “I have meetings with [name of staff member] and we talk about what I have done and if I am happy with everything. It’s good.”
The service continued to be well led. The registered manager was very visible in the home and knew people very well. Staff told us the management within the home were open and approachable. The registered manager and provider continually monitored the quality of the service and made improvements where needed.
Further information is in the detailed findings below
This inspection took place on 15 April 2015 and was an unannounced inspection.
This was the first inspection of the service since the provider changed their legal entity from Voyage 3 Limited to Voyage 1Limited in June 2014.
The Knowls is a large detached property which is situated close to Taunton town centre. The home can accommodate up to 14 people and it specialises in providing care and support to adults who have a learning disability. All bedrooms are for single occupancy and the home is staffed 24 hours a day.
People had very complex needs and communication difficulties associated with their learning disability. Because of this we were only able to have very limited conversations with two people about their experiences. We therefore used our observations of care and our discussions with staff to help form our judgements.
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.
The registered manager had a clear vision for the home and the people who lived there. They told us they wanted to ensure people were supported to develop their skills and promote their independence. Staff told us they were proud of the standard of care they provided to people. They spoke with kindness and compassion when they told us about the people they supported. One staff member said “I think we are a really good team who all really care about the people here.”
Risk assessments were in place which enabled people to develop and maintain independent living skills. These included making hot drinks, cooking, washing up and doing their laundry.
Risk assessments detailed the potential risks and provided information about how to support the individual to make sure risks were minimised.
People were unable to look after their own medicines. Staff made sure medicines were stored securely and that there were sufficient supplies of medicines. People received their medicines when they needed them. However; improvements were needed to minimise risks to people when staff administered medicines.
Staffing levels were good and people also received good support from health and social care professionals. Staff were confident and competent when assisting and interacting with people and it was evident staff knew people well.
People were supported to eat well in accordance with their preferences and needs. There was a varied menu which had been developed with the people who lived at the home.
Routines in the home were flexible and were based around the needs and preferences of the people who lived there. People were able to plan their day with staff and they were supported to access a range of social and leisure activities in the home and local community.
The service made sure staff completed appropriate training so they could meet the needs of the people they supported. The knowledge, skills and competency of staff were regularly monitored through supervisions and observation of their practice. Staff told us they felt well supported and received the training they needed.
There were systems in place to monitor health and safety and the quality of the service provided to people.