The inspection took place on 25 and 26 April 2018, it was unannounced and carried out by one inspector. The Knoll is a ‘care home without nursing’. People in care homes receive accommodation and 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 service is registered to provide care and accommodation for up to seven people who may be living with a learning disability, mental health condition and/or physical disability. There were seven people living in the service on both days of the inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice and promotion of independence. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At the last inspection, the service was rated good and at this inspection, we found the service remains good.
There was a registered manager in post. 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.
People received safe care and support. Staff knew how to support people and protect them from the risk of harm. The service had a safe, robust recruitment system and employed sufficient numbers of staff to meet people’s assessed, and changing needs. There was a good medication system in place and the records were of a good standard. Staff had been trained and had their competency to administer medication assessed. People received their medication safely as prescribed. Infection control measures were in place and staff were trained and demonstrated a good knowledge of infection control procedures. The environment was well maintained, clean and hygienic.
People’s needs had been fully assessed and their support plans updated when their needs changed. Staff were well trained and received formal and informal supervision and knew how to care for people effectively. People had a choice of sufficient food and drinks, which they had helped to shop for and people chose what they wanted to eat and drink on a daily basis. Staff ensured people’s healthcare needs were met. They worked well in partnership with other professionals to ensure that people received the healthcare they needed.
The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. Appropriate assessments had been carried out in line with legislation. Where people were deprived of their liberty, the service had made appropriate requests for authorisation. People’s independence was encouraged and supported while minimising risks to help keep them safe.
Staff were kind and caring and listened to what people had to say. They treated people with dignity and respect and ensured they had the privacy they needed. People and their families were kept fully involved in decision-making. Advocacy services were available if needed. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.
People received personalised support that was responsive to their needs. They had good community links and enjoyed a range of indoor and outdoor activities. The support plans and daily notes were detailed and informative. There was a good pictorial system in place for dealing with complaints and people had confidence that their complaints would be dealt with appropriately.
People and their families knew the registered manager well and had confidence in them. Staff felt well supported by the registered manager and discussed issues with them on a daily basis. There was an effective quality assurance system in place. The service recognised the need for improvements and ensured people received a good quality service. Confidential information was stored safely in line with data security standards.
Further information is in the detailed findings below.