Archived: The Knowle Limited

Updated 22 April 2017

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.’

This inspection took place on 21 February 2017 and was announced. The provider was given short notice of our inspection. We did this because the service was small and the registered manager was sometimes out of the office and we needed to be sure a senior member of staff would be available. The registered manager was on annual leave so we spoke with the deputy manager. The inspection was carried out by an adult social care inspector and a specialist advisor. The specialist advisor was a registered nurse who was experienced in the care of people with mental health issues.

Before our inspection, we reviewed the information we held about the service. This included correspondence we had received and notifications submitted by the service. A notification must be sent to the Care Quality Commission every time a significant incident has taken place, for example, where a person who uses the service experiences a serious injury.

We gathered information from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. This information was reviewed and used to assist with our inspection. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.”

We used a number of different methods to help us understand the experiences of people who lived at the service. We spent time observing the daily life in the service including the care and support being delivered. We spoke with two people living at the service. Some people living at the service chose not to speak with us. We spoke with the deputy manager, the finance officer and two care workers. After the inspection we contacted the registered manager to obtain some further information about the service. We looked around different areas within the service, the kitchen, communal areas, bathroom, toilets and some people’s rooms. We reviewed a range of records including the following: four people’s care records, three people’s medication administration records, three people’s financial administration records, three staff records and records relating to the management of the service.

Updated 22 April 2017

A scheduled inspection took place on 21 February 2017 and was announced. The registered provider was given short notice of our inspection. We did this because this was a small service and the registered manager was sometimes out of the office and we needed to be sure that a senior member of staff would be available. The service was last inspected on 13 October 2015.

The Knowle Limited is registered to provide accommodation for up to 13 people, some of whom may have mental health problems or learning disabilities. The main building was formerly two Victorian villas that have been renovated to form one large house. All bedrooms are single. Communal areas and bathing facilities are provided. At the time of the inspection there were nine people living at the service. One person was in hospital at the time of our inspection.

There was a registered manager for the service in post 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection we found a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safeguarding service users from abuse and improper treatment. The provider sent us an action plan telling us about the action they would complete to reach compliance. At this inspection we checked to see if sufficient improvements had been made. We saw some improvements had been made at the service to safeguard people from harm. However, we found one safeguarding concern had not been reported appropriately to the local safeguarding authority. This showed that further improvement was required.

We found a continued breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Safeguarding service users from abuse and improper treatment.

We found a few people’s risk assessment and care plans would benefit from containing more information about their early warning signs of a potential relapse and becoming unwell.

We saw the process in place to ensure incidents were reported appropriately to the Care Quality Commission required improvement.

People and staff we spoke with did not express any concerns regarding the staffing levels at the service.

We saw that appropriate pre-employment checks had been carried out to ensure staff were of good character and suitable to work with vulnerable adults.

The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.

People we spoke with were satisfied with the quality of care they had received and made positive comments about the staff.

People we spoke with told us they had been fully involved in their care planning and actively involved in any reviews.

In people’s records we found evidence of involvement from other professionals such as doctors and community psychiatric nurses (CPN).

People’s individualised diets were being met. We received positive comments from people we spoke with about the quality of the food.

Staff were supported to deliver care safely and to an appropriate standard.

Staff had undertaken training to give them the skills and knowledge to carry out their roles effectively.

People we spoke with said they were treated with dignity and respect.

People we spoke with were confident that if they raised any concerns or complaints, these would be taken seriously and appropriate action taken.

The service actively sought the views of people living at the service to continuously improve the service.

There were processes in place to monitor the quality and safety of the service. However, we saw some processes required improvement.

We saw the system in place to ensure policies were reviewed so they reflected key legislation and guidance required improvement.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.