During this inspection, we checked whether the provider had maintained the improvements they had made. We found the provider had made and sustained the required improvements and there was no longer a breach of Regulations.
Knellwood is a care home for up to 52 people who require nursing and personal care. 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. At the time of inspection there were 48 people living at the home.
The service had 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. The registered manager was not available for us to speak with on the day of inspection.
There was guidance in place to protect people from risks to their safety and welfare, this included the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely and where there were any short falls these were covered internally. The provider was in the process of trialling the deployment of extra staff at busy times to see if that further improved the quality of care.
The provider had an effective recruitment process to make sure the staff they employed were suitable to work in a care setting. Risks to people were assessed and action was taken to minimise any avoidable harm to people.
There were systems and processes in place to ensure medicines were managed safely in accordance with current guidance and regulations. Staff were sufficiently trained and regularly assessed for their competency of administering medication.
Staff raised concerns with regard to safety incidents, concerns and near misses, and reported them internally and externally where this was required. The management team analysed incidents and accidents to identify trends and implement measures to prevent a further occurrence.
People were supported by staff who had the required skills and training to meet their needs. Where required, staff completed additional training to meet individual's’ needs. People were supported to have a balanced diet that promoted healthy eating and the correct nutrition.
The management team and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were involved in making every day decisions and choices about how they wanted to live their lives and were supported by staff in the least restrictive way possible.
People experienced good continuity and consistency of care from staff who were kind and compassionate. The management team had created an inclusive and open culture at the home. People were relaxed and comfortable in the presence of staff who invested time to develop meaningful relationships with them.
People's’ independence was promoted by staff who encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.
Practical arrangements including staff rotas were organised so that staff had time to listen to people, build relationships and trust, answer their questions, provide information, and involve people in decisions.
The service was responsive and involved people in developing their support plans where possible which were detailed and personalised to ensure their individual preferences were known. People were supported to complete stimulating activities of their choice, which had a positive impact on their well-being.
Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.
The service was well managed and well-led by the management team who provided clear and direct leadership, which inspired staff to provide good quality care. The safety and quality of the support people received was effectively monitored and any identified shortfalls were acted upon to drive continuous improvement of the service.