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Archived: Knyveton Hall Rest Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 November 2018

This unannounced inspection took place on 26 July and 2 August 2018. Both days were unannounced. The aim of the inspection was to carry out a comprehensive review of the service and to follow up on the seven requirement notices that were issued at the previous inspection in November 2017.

Knyveton Hall is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to accommodate a maximum of 39 people who require support with personal care. There were 28 people living in the home at the time of our inspection.

Accommodation is provided in individual bedrooms on the ground, first and second floors. Some rooms have ensuite facilities. There is a large lounge and a dining room on the ground floor.

The service was led by a registered manager. 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.

At the last inspection we identified that management systems in the service were not effective and this had resulted in seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to person centred care, acting in accordance with the Mental Capacity Act 2005, the management of risk and of medicines, receiving and acting on complaints, staff support and training, record keeping and good governance. Required notifications had also not always been submitted to CQC. The service was rated as inadequate in relation to the question: is the service safe? Rated as requires improvement with regard to the questions is it effective? Is it responsive? Is well led? And was rated good for is the service caring? At that inspection the service received a rating of requires improvement overall.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions is the service safe? Is the service effective? Is the service responsive? And is the service well led? to at least good. This inspection was carried out to check that improvements to meet legal requirements planned by the provider after our last inspection had been made.

The registered manager had taken ownership of the concerns and had employed a specialist care home consultant to support the work required to improve the service. At this inspection we found that improvements had been made in all areas, and that all except two of the regulations had been complied with. We found that there were still shortfalls in the management of medicines and auditing processes which had not identified the issues noted at this inspection. The registered manager gave us assurances that work to complete improvements was ongoing and agreed to keep us informed when outstanding actions were completed. This is the second time that the service has been rated as Requires Improvement overall. However, the registered manager has demonstrated that they are making and will continue to make the required improvements and this is recognised in the improved ratings for three of the four areas which were previously rated inadequate or requires improvement. You can see what action we told the provider to take at the back of the full version of this report.

All the people we spoke with told us they felt safe and well cared for. Visitors, staff and health professionals confirmed that they had observed improvements in the service. We received only positive comments about Knyveton Hall throughout our inspection.

People told us their care and support needs were met and that the staff were kind, caring and respe

Inspection areas

Safe

Requires improvement

Updated 15 November 2018

The service was not always safe.

People were not always protected against the unsafe management and use of medicines.

The assessment and management of risks was not always effective.

Systems and procedures to prevent the spread of infection were not always robust.

Staff were safely recruited and there were enough staff to make sure that people received the care and support they needed.

Effective

Good

Updated 15 November 2018

The service was effective.

Staff were supported through training and supervision to be confident and capable in their work.

Staff made timely referrals to healthcare professionals, and acted on their recommendations.

People told us that the food was good and they enjoyed the meals at the service

Caring

Good

Updated 15 November 2018

The service was caring.

People were treated with dignity, respect and kindness. Their independence was promoted.

People, and where appropriate their relatives, were fully involved in decisions about their care and support.

People’s independence was promoted.

Responsive

Good

Updated 15 November 2018

The service was responsive.

Care planning was focused on the person’s whole life, including their goals, skills, abilities.

People who used the service and their visitors felt confident that if they complained, this would be taken seriously.

People were supported to make decisions about their preferences for end of life care.

Well-led

Requires improvement

Updated 15 November 2018

The service was well led but required further improvements.

The provider had taken steps to meet their responsibilities to manage the service under the Health and Social Care Act 2008 but work was still required to fully meet these.

Action had been taken to improve quality monitoring systems but further work was required to ensure these were fully effective.