We carried out a review of the data available to us about Knoll House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Knoll House, you can give feedback on this service.
About the service
Knoll House is a residential care home and supported living service providing personal care and support services to autistic people, people with a learning disability and people with a mental health condition. The residential care home can accommodate up to nine people and the supported living apartments can accommodate up to eight people in one adapted building. At the time of our inspection five people were living in the residential care home. Eight people were living in the supported living apartments, however not everyone who used this service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
Knoll House is also registered to provide domiciliary care in the community although at the time of this inspection no one was currently in receipt of this service.
The residential accommodation within the service included specialist flats for people living with complex needs in addition to 'moving on' flats. The moving on flats are designed to enable people to live more independently and prepare them for moving into their own accommodation. The supported living flats all have their own kitchen and laundry facilities to promote and enable people to live an independent life.
People’s experience of using this service and what we found
Right Support
People had a choice about their living environment and were able to personalise their rooms and flats. The residential home was currently going through a refurbishment. People had been involved in choosing the colour scheme in the lounge and dining areas and one person told us how they had suggested additional pictures in the lounge.
People were supported to have the maximum possible choice, control and independence and they had control over their own lives. People chose how to spend their day and staff encouraged people to make their own decisions.
People were supported by staff to pursue their interests. One person told us about their interests and future goals. Another person told us about their college course, they were proud of their achievements.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
Staff communicated effectively with people. Staff told us how best to communicate with people and how to adapt our pace to enable people to participate fully in the conversation.
People played an active role in maintaining their own health and wellbeing. One person informed us why they intended on becoming fit and healthy. Staff actively encouraged people to take healthier food and drink options.
Right care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff had been recruited safely and all relevant pre-employment checks had been taken.
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Documents were printed in easy read formats and each person had a communication passport.
People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. People were actively involved in co-producing their own risk assessments.
Right culture
People could choose to have their relatives or significant others involved in the service. The registered manager told us they respected people's choice to involve others in the care and support provided.
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff told us their main reasons for working was to enable people to be independent and live fulfilling lives.
People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Each person was supported by key working staff who worked with the person to review monthly goals and wellbeing.
People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. People were actively encouraged to be involved in the community. The location of the home was within an easy walk of local amenities.
Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People were included in regular meetings and they were actively involved in reviews of support and care needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 December 2019).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support Right care Right culture.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Knoll House is a residential care home and supported living service providing personal care and support services to adults living with autism, learning disabilities and mental health conditions. The residential care home can accommodate up to nine people and the supported living apartments can accommodate up to eight people in one adapted building.
Knoll House is also registered to provide domiciliary care in the community but no people are currently in receipt of this service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The residential accommodation within the service includes specialist flats for those living with complex needs in addition to 'moving on' flats. The moving on flats are designed to assist people in developing independent living skills and prepare them for moving into their own accommodation. The supported living flats all have their own kitchen and laundry facilities to promote people’s independent living skills further. At the time of the inspection there were eleven people living at the service; five in the residential service and six people in supported living.
There were deliberately no identifying signs, intercom, cameras, or anything else outside to indicate it was a care home or supported living accommodation. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were safe. Effective systems were in place to keep people safe and staff understood how to keep people safe. People’s risks were assessed and staff understood how to manage risk. People were supported by a sufficient number of safely recruited staff. People were supported on a 1:1 basis when needed to maintain their safety. Medicines were stored and administered safely and clear protocols were in place to guide staff when to administer ‘as required’ medicines. Staff followed infection control procedures. When incidents occurred, lessons were learned and action was taken to reduce the risk of reoccurrence.
People’s needs were assessed in a holistic way and people’s choices were considered. Staff understood how to meet people’s needs. People were supported by staff who were appropriately trained and had the skills to provide effective care. The service was proactive in engaging in further training where skills gaps were identified. People in residential accommodation were given a choice of meals and drinks. People in supported living accommodation were supported to undertake shopping and prepare meals for themselves. People were supported by staff continuity where possible to meet their needs. People’s weights and blood pressure was monitored when needed and people were supported to access health professionals. People lived in a home that was adapted to promote their independence and meet their needs. People were able to personalise their flats and rooms in line with their preferences.
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.
People were supported by kind and caring staff who knew them well. People had a good rapport with staff. People were supported to make decisions regarding their own care. Staff promoted people’s independent living skills and encouraged positive risk taking. People were supported by staff who promoted and respected their dignity.
People were involved in planning personalised care and were supported to design their own care diaries. People’s diverse needs were considered in care planning including how to support people to appropriately express their sexuality. People’s communication needs were considered and documentation was in pictorial form to support people’s understanding. People’s relationships with their families were encouraged and people had been supported to re-establish positive relationships. People were supported to engage in activities of their choice. A complaints policy was in place and complaints were addressed in line with the policy. People’s end of life wishes and preferences had been discussed with them and documented.
The provider promoted an empowering person-centred environment which focused on people developing their independent living skills. Health professionals told us the provider was open and honest when things went wrong. Effective audit systems were in place to check the quality of the service. Multiple audits were undertaken at varying levels of management to ensure that action was taken to address any issues identified. The provider engaged people, professionals and staff in the running of the service and made changes in response to feedback provided. The provider was focused on continuous learning in order to improve care provided to people. The provider worked closely with health and social care professionals to promote a positive care experience for people.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Knoll House is a residential home and supported living service which provides personal care and support services to adults with autism, learning disabilities and mental health conditions. The service can accommodate up to eight people in supported living apartments and nine people in residential accommodation. The residential accommodation within the service includes two specialist flats for those living with complex needs in addition to three ‘moving on’ flats. The moving on flats are designed to assist people in developing independent living skills and prepare them for moving into their own accommodation. At the time of the inspection there were two people living at the service; one person in supported living and one in the residential service. Three further people were living at the service on a part-time basis as they transitioned to living there full time.
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 were supported by a staff team who could recognise potential signs of abuse and knew how to report any concerns. Staff understood how to minimise risks to people they supported, including the risk of injury. People were supported by sufficient numbers of safely recruited staff members. People received their medicines safely and as prescribed.
People were cared for by a staff team who had the appropriate skills and training to support them effectively. People were encouraged to make decisions about their own care and their consent was sought before support was provided. People received sufficient amounts of food and drink that they were enabled to choose. Where people had special dietary requirements these needs were appropriately met. People were supported to maintain their day to day health and access healthcare professionals when needed.
People were supported by a staff team who were kind and caring in their approach. People felt valued and important and enjoyed living at the service. People were encouraged to make choices about their day to day care and how they spent their time. People’s privacy and dignity was respected and upheld. People’s independence was promoted.
People received care and support that met their individual needs. People were involved in the development of their own care and support plans and participated in regular reviews. People were supported to pursue leisure activities and personal activities of their choosing. People felt able to make a complaint or raise any concerns if they needed to.
People were living in a service that was well-led and managed. They were supported by a staff team who were committed, motivated and felt supported in their roles by the management team. People were involved in making decisions about the service and the support they received. The provider and registered manager completed effective audits and quality assurance checks. This meant that they were identifying any areas of improvement required and taking action to ensure any required improvements were made.