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The Knowles Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 1 November 2019

About the service

The Knowles is a care home and was providing personal care to 33 people at the time of the inspection visit. Two people who lived there were in hospital. The majority of people who live at the home are older people living with dementia. The service can support up to 40 older people or younger adults with dementia care needs. Accommodation is in an adapted building over two floors.

People’s experience of using this service and what we found

Systems to monitor the quality and safety of the service had not been fully effective in identifying areas for improvement and ensuring areas of risk were promptly acted upon. Risks associated with people’s care were not always effectively recorded and managed. This included risks related to the management of falls and people’s behaviours that were challenging. Some people’s care plans lacked detail to support staff in keeping them safe.

People were provided with a choice of meals but gave mixed reviews of the food provided. Staff supported those people who needed assistance to eat and specialist diets were catered for. However, records did not always confirm dietary advice provided by health professionals was followed.

Staffing arrangements were not consistently effective to keep people safe. Whilst people were complimentary of staff, they felt at times support was delayed. This in particular applied to at night when staff numbers reduced, and communal areas were not always supervised. This increased the risk of people’s safety not being maintained and there were people who had sustained unwitnessed falls during this time.

People received their medicines, but medicine checks showed discrepancies in medicine counts. This meant it was not possible to confirm the amount of medicine administered and remaining was correct to confirm medicines were managed safely. Medicines were stored safely.

The service had a registered manager in post but at the time of our inspection they were absent from the home and the provider had arranged for a member of the management team to support the home. People and relatives knew this staff member and spoke positively of them during our visit.

Peoples needs were assessed prior to them starting to use the service and were involved in making decisions about their care and how they would wish to be supported. Where appropriate family members were also involved in this assessment.

Staff understood how to recognise abuse and knew they had a responsibility to report any concerns to their manager, so these could be addressed. People told us they felt safe and felt at ease to report any concerns to staff.

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.

Staff had been recruited safely and staff received the training they needed to support people needs. Staff felt the training they received was effective. Staff spoke kindly of people and knew people well, so they could provide care in the way people wanted.

People told us staff were kind and caring and treated them with dignity and respect. We saw staff were respectful towards people and encouraged them to maintain their independence. People had access to a range of activities which were of interest to them including some outside visits. Visitors were welcomed into the home and spoke positively of the service.

People knew who to contact if they had any concerns. The provider had a system for responding to complaints and those received had been responded to and resolved.

People spoke positively about the management team and had confidence in them. Staff felt valued which had resulted in a positive, encouraging and supportive culture which benefited all. The management team demonstrated a commitment to further improve the service.

People and staff had opportunities to comment on the service during m

Inspection areas


Requires improvement

Updated 1 November 2019

The service was not always safe.



Updated 1 November 2019

The service was effective.



Updated 1 November 2019

The service was caring.


Requires improvement

Updated 1 November 2019

The service was not always responsive.


Requires improvement

Updated 1 November 2019

The service was not always well led.