Knowle Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service under a new provider. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to admission and detailed care plans developed based on the assessment of need. However, some care plans had not been reviewed for over 4 months which meant we could not be assured they reflected the person’s current needs. There was no evidence that people, or where appropriate their families, had been offered opportunities to contribute to the assessment of their needs. This was supported by people we spoke with, who confirmed they had not been involved. A relative told us, “I haven’t discussed [person’s] care plan. No Care plan review.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Professional health and social care advice was sought as needed. However, we did not always see the advice included in people’s care plan. For example, we were told 1 person was following a ‘Food first approach’ advised by the speech and language therapist (SALT) but this was not mentioned within the person’s care plan.

Recognised clinical tools were used to assess risks to people’s health and wellbeing, results of which were used to plan people’s care. Detailed care plans including evidence-based information were in place for health conditions such as diabetes and dementia although a lack of regular reviews meant we could not be assured of how effective these were.

People’s feedback about the food they received was generally good. Food served was nutritious and choice was offered although people were asked for their choices for the main meal well in advance of the meal which is not always appropriate for people living with dementia.

The provider did not always work well across internal staff teams.

The provider was recruiting to key roles to strengthen teamwork within the service. Some issues had arisen due to poor communication between previous management and the staff team. The provider had recognised this and was taking action to improve communication and ensure information was shared clearly and effectively between staff at all levels.

Advice from health and social care professionals was sought as needed and the local authority told us the provider had been responsive to their engagement.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control.

Staff worked well with partners to promote people’s health and wellbeing, and systems were in place for any changes to people’s health to be communicated across the staff team. Examples of supporting people to maximise their choice and control were limited but some good examples were seen. Requests for support from appropriate health and social care professionals were made as needed.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Reviews of people’s needs and care plans were not always completed in a timely way and did not always record whether any discussion had taken place with the person or, where appropriate, their family to assess if the planned care was effective in meeting the person’s needs and preferences.

The provider respected people’s rights around consent when delivering person-centred care and treatment.

The service was working within the legal framework of the Mental Capacity Act (MCA). Mental capacity assessments were decision specific and best interest processes were followed where people lacked capacity to make decisions.

Staff sought consent from people before delivering care.