We carried out a review of the data available to us about Knowle Hill 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 Hill, you can give feedback on this service.
Knowle Hill is a residential care home that provides accommodation and personal care for older people and people living with dementia. The home can accommodate up to 74 people in one adapted building over three floors. At the time of this inspection there were 65 people using the service.
People’s experience of using this service and what we found
People told us they felt safe living at Knowle Hill. There were enough staff available to keep people safe and meet their needs. People were supported by staff who were trained and knowledgeable about how to safeguard adults from abuse. Risks to people were assessed and staff knew how to keep people safe from avoidable harm. People were supported to take their medicines as prescribed. The home was clean, and people were protected from the spread of infection.
People were cared for by staff who were knowledgeable and skilled. People were happy with the care they received. They were involved in developing their care plans and people’s care plans were detailed enough so staff knew what care to provide to each person. 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’s nutritional needs were met, and people were satisfied with the food provided at Knowle Hill, though some people told us they did not know what would be on offer at lunchtimes until lunch was served. People were supported to maintain their health and staff worked alongside community health professionals to ensure people received effective care.
People and their relatives were positive about the staff team. They told us staff were kind and caring. People were supported by staff who knew them well. We observed staff treat people with dignity and respect. People were supported and encouraged to remain involved in decisions about their care. People's privacy was respected, and their independence was promoted.
People’s care plans were person-centred and contained information about their life history and preferences for receiving care. This supported staff to provide personalised care to people. However, some people told us they did not have enough to do, to keep them occupied throughout the day. We found some activities did take place, however improvements were required in this area. We have made a recommendation about the development of activity provision in the home. The provider had a suitable complaints procedure in place and we found complaints had been investigated and acted upon. The provider had systems in place to ensure people who received care at the end of their life were cared for in accordance with their expressed wishes and any pain was effectively managed.
The home was well-run. People were supported by a team of staff who were happy in their jobs and well-supported by their managers. An experienced registered manager and senior staff completed a range of regular checks on the quality and safety of the service. The provider, registered manager and staff all demonstrated a desire to provide person-centred, high-quality care. People, relatives, staff and visiting professionals had regular opportunities to express their views about the service.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 26 October 2018). At the last inspection we identified one breach of regulation in relation to medicines management.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of any regulations.
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.
Knowle Hill is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Knowle Hill can accommodate up to 74 people who require accommodation and personal care. The home is purpose built over three floors and each floor has communal lounges and dining areas. At the time of our inspection there were 64 people living in the home.
There was a registered manager employed at Knowle Hill. A registered manager is a person who has registered with the CQC 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. Staff had received training in their responsibility to safeguard vulnerable adults. They all knew what action to take if they witnessed or suspected abuse.
People’s medicines were not always managed safely. Some aspects of the medicine system were well managed, however medicine administration records for topical medicines were not adequately completed. This posed a risk to people’s health.
People’s needs were assessed before they moved into the service. Suitable risk assessments were in place, such as moving and handling, use of equipment and risk of falls. People's care records were sufficiently detailed and person centred. They set out what care the staff needed to provide. People's care plans and risk assessments were kept under review.
People living at Knowle Hill were happy with the staffing levels in the home. However, staff felt the staffing levels were too low and this was affecting their ability to deliver person centred care. We have made a recommendation about staffing levels.
Staff were kind and caring. We observed staff treat people with dignity and respect. People we spoke with and their relatives were very positive about the staff at Knowle Hill and the care they received.
Staff received regular supervision, appraisals and appropriate training to support them to carry out their jobs effectively.
People were supported to have maximum control and choice over their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.
People had access to a range of activities at Knowle Hill, which were tailored to their personal preferences and abilities. They were also supported to access the local community.
The registered provider had an appropriate complaints procedure in place. People’s complaints were recorded, investigated and responded to appropriately.
The registered manager and team leaders completed various audits of the service to identify anything that could be improved. Audits were usually acted upon, however not all audits resulted in necessary improvements being implemented. We have made a recommendation about the audit system used by the registered provider.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the end of this report.