The Knowles

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. People’s care plans demonstrated staff had considered people’s individual preferences and used this information to complete a personalised care plan for staff to follow.

People told us their physical care needs were met. One comment was, “I can go to bed and get up when I want to. I am an early riser.” While people were pleased with the care from staff, people and relatives said there was limited mental and physical stimulation. However, the majority of people said activities and getting involved in hobbies and interests had begun to improve.

Staff told us people’s care plans provided them with the information they needed to respond to people’s needs and preferences. However, we found 1 example where staff would benefit from further guidance in relation to supporting a person who was anxious. While staff demonstrated they knew how to support the person to manage their anxieties, this information was not included within their care plan. The provider agreed to take action to address this.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People had regular access to a visiting GP and staff advocated for people who were not able to communicate their needs. People were supported to obtain help from other health and social care professionals and referred to specialist health teams where appropriate.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Where people had identified communication or cognition difficulties, there was a communication plan in place. The service appropriately identified people’s individual communication needs to make sure information was always provided in an accessible way. This included making reasonable adjustments for example interpreting and translation for people who don’t speak English as a first language. One staff member shared some people living at the home had difficulties with hearing and so they wrote things down for the person to help aid communication.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider held meetings with people and their relatives to obtain views of the service. Records of those meetings showed they were well attended and people felt confident to provide any ideas or feedback. In one meeting people said they wanted to go to the seaside on a trip and this took place. The management team also shared updates through a group WhatsApp to relatives and newsletters were shared with family that included past and planned activities and important events. One staff member told us any concerns raised by family would be shared with and investigated by senior management.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The Knowles had a good relationship with the local doctor surgery who supported the home with a weekly visit and as needed out of hours. Staff told us they worked in partnership with other health professionals for example, the district nurse.

People’s needs were assessed before they moved into the home and care plans reflected any reasonable adjustments the person needed to ensure their needs were met. For example, some people required extra monitoring to ensure their health and wellbeing were maintained.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People felt what was important to them, was valued by staff. Staff respected people’s individual choices, especially in relation to food and choices to be offered, for example people were supported with appropriate cultural foods. Staff gave examples showing how they supported people from marginalised groups to access the service and achieve the best possible outcomes. For 1 person, staff respected 1 person’s choice and needs by preparing food choices which reflected the person’s history and cultural influences.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. At the time of our inspection, no one was receiving end of life care.

Where people had consented to a specific decision, in the event of a cardiac emergency, they were supported to complete a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plan. ReSPECT plans are used to document a person’s wishes for their clinical care in emergency situations, where the person would not be able to make decisions or express their wishes.

While care plans guided staff to liaise with health professionals and families on behalf of the person, they did not always reflect people’s religious, cultural needs and lacked person centred elements such as what mattered to them. However, staff shared examples of how they had promoted emotional support to people when they were receiving end of life care, ensuring people had visits from family and that the person was made comfortable such as being in their preferred clothing.

Staff had begun to work with people and their relatives to find out what good care meant for them in the future, including at the end of people's lives and to record this in people’s care plans.We saw communication from the home has asked relatives for any end of life wishes and preferences so people’s wishes could be known and followed.