We carried out a review of the data available to us about Housing 21 - Knaves Court 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 Housing 21 - Knaves Court, you can give feedback on this service.
People’s experience of using this service:
People were supported by a dedicated staff team who were keen to develop their knowledge and experience and were supported by a committed registered manager and management team.
People received support that was exceptionally personalised and responsive to their needs. Staff knew people well. People were holistically supported and felt positive about the impact the support they received had on their life. Strong caring values were embedded in the service. People knew how to and felt able to complain and this feedback was acted upon. No one was currently receiving end of life care. However, staff had delivered a positive palliative care approach in the past.
Staff were consistently supported to be effective in their role and develop their knowledge and confidence. There was continuous learning by staff and following incidents. People and staff were engaged in the service, asked for feedback and ideas which were acted upon. The service was closely monitored and areas for improvement identified. The provider worked in partnership and made links with the local community to the benefit of people using the service.
People had their risks assessed and planned for to help keep them safe. Staff understood their safeguarding responsibilities and knew how to keep people safe. People were supported to have their medicines as prescribed and were protected from the risk of cross infection. Lessons were learned when things had gone wrong.
People had their needs assessed and care plans detailing these were put in place. People had access to other health professional to help keep them well. Staff received training to be effective in their role. People were supported to maintain a diet of their choice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this.
People were supported by a kind and caring staff team who helped them to remain independent and were treated with dignity and respect. People were involved in decisions about their care and were involved in improving the service.
Rating at last inspection: At our last inspection in August 2016 (report published October 2016) the service was rated as good overall.
Why we inspected: This was a scheduled inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Knaves Court is an extra care housing scheme that provides accommodation and care. The service is registered with CQC to provide personal care to people living at the scheme. At the time of the inspection there were 37 people using the service who received personal care from the provider. 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 not always supported by consistently effective medicines management systems. Staff members knew how to recognise and report allegations of abuse. People were protected by effective risk management systems. People were supported by sufficient numbers of staff to keep them safe. Staff members were recruited safely to ensure they were appropriate to work in their role.
People were enabled to consent to their care and support. People were cared for by staff who had the skills to support them effectively. People were supported to meet their nutritional and day to day health needs.
People were supported by a staff team who were caring in their approach and understood their needs. People were enabled to make day to day choices about their care. People’s privacy, dignity and independence were promoted and they were treated with respect. People were supported to maintain important relationships with friends and relatives.
People and their representatives were involved in planning and reviewing their care. The care people received met their needs and preferences. People were supported to take part in leisure opportunities. People told us they knew how to complain and felt confident their concerns would be addressed by management.
People told us the service was well-led and they felt supported by the staff and management team. People were supported by a committed, motivated staff team. Quality assurance checks were completed across the service to identify areas for improvement and further develop the service provided to people. Where improvements were identified in the quality assurance process the registered manager began to take action straight way to resolve these concerns.
Below is a summary of what we found. The summary is based on our observations during the inspection, observations and discussion with the people using the service, the staff supporting them and from looking at records. We used the evidence we collected during our inspection to answer the five questions.
Is the service safe?
From our observations and the information we saw in care plans, policies, procedures and audits, the provider's safety monitoring systems were robust. The training records showed that staff received regular training on safeguarding. Staff showed that they had a clear understanding of their role in providing care and in safeguarding the people they supported. Staff demonstrated that they knew people well and understood their support needs.
We saw evidence that when people lacked the capacity to make decisions on important areas of their lives, best interests and safeguarding discussions had taken place.
The registered manager told us that there were no Deprivation of Liberty Safeguarding orders in place at Knaves Court. At the time of our inspection the registered manager said that in the light of the recent changes to the legislation, they would review the safeguarding requirements for some the people who used the service.
Staff rotas showed that the management had taken people's care needs into account when making decisions about the number of staff required and the skills and experience staff would need. The night time staffing levels and on call system showed that the provider had taken steps to ensure the staffing provision was safe.
There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's care needs had been assessed and detailed care plans were in place. There was evidence that people and their families were involved in the assessments of their needs and care plan reviews as much as possible.
The staff we spoke with, and care plans we looked at, provided evidence that people were supported to maintain their independence and to live active lives.
All care, activity plans and risk assessments were reviewed regularly. We saw evidence that the care provided was constantly adapted to meet people's needs and staff were informed of any changes to people support needs.
We saw evidence that people were supported by a wide range of health care professionals. This meant their health and welfare needs were being met.
Is the service caring?
We observed that staff supported each person in a way which met their individual needs. The staff showed warmth, consideration and respect for people. One member of staff we spoke with said, 'I love watching people getting together and spending time talking'. Another member of staff said, 'It is really heartening to see people able to get their independence back'. We saw that staff showed people respect and ensured their dignity was maintained at all times.
We spoke with one of the people who used the service. They said, 'I am really glad I came here. It has taken me a while to adjust, but I feel really safe and happy here".
The registered manager and staff we spoke with told us they enjoyed their work and tried to ensure people had a good life. The staff we spoke with demonstrated that they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We saw that care plans were focused upon the needs of the individual and contained detailed information about people's choices and preferences. The information showed that people had an individual support plan which was adapted regularly to meet their changing needs.
There was evidence of regular support provided from external health professionals. The service was also supported by Age UK and other local organisations who regularly visited people who used the service. This meant that people's health and welfare was regularly reviewed and monitored.
Staff we spoke with told us that if they had any concerns, they could always talk with the managers and senior staff. They said they would always listen and address anything they raised. We saw that the provider had a compliments and complaints policy and procedure in place. We saw that complaints had been successfully resolved and many compliments had been received.
We saw that staff received regular training which equipped them with the knowledge and skills to meet people's support needs.
Is the service well-led?
The service had a clear management structure in place. The managers and the staff we spoke with were very knowledgeable about the people who used the service, changes to legislation and developments in care provision.
We saw on the staff rota that senior staff were available to give advice and support. One of the staff we spoke with said, 'The managers and senior staff are very supportive and I never worried about asking questions or asking for help'. We saw that there were systems in place to provide feedback to staff about changes and developments.
Knaves Court was an Extra Care Housing provision for people aged 55 years and over. Some of the people living at Knaves Court had care requirements and staff were available 24 hours a day to provide care and support. As an extra care housing provision Knaves Court were not required to be registered with CQC for accommodation, this was because people were living in their own homes. They were however registered to deliver personal care to people, this is the area we looked at during the inspection.
We saw from care plans we viewed that people had been given the opportunity to discuss and give signed consent to the care delivery prior to it taking place. The eight people we spoke with were complimentary of the care provided at Knaves Court. We saw that staff completed records to confirm people had been appropriately supported with medication. We found that record keeping required further attention.
People living at Knaves Court were invited to comment on the quality of the service provided via a satisfaction survey and 'resident meetings'.
Knaves Court was an Extra Care Housing provision for people aged 55 years and over who had care needs. Accommodation comprised of 60 flats including two respite flats. Staff were available 24 hours a day. In house facilities consisted of a shop, restaurant, hairdressing salon and a well being suite. As an extra care housing provision Knaves Court were not required to be registered with CQC for accommodation, this was because people were living in their own homes. They were however registered to deliver personal care to people, this is the area we looked at during the inspection.
During our visit we used a number of different methods to help us understand the experiences of people using the service. This is because some people had complex needs which meant they were not able to tell us their experiences. We observed interactions between staff and people using the service, spoke with ten people who lived at Knaves Court, six staff members and the manager. Through a process called 'pathway tracking' we looked at care plans, spoke with people about the care they received and asked staff about how they provided support. This helps us establish whether people were getting appropriate care that met their needs and supported their rights.
During the visit we spoke with people sitting in the communal dining and lounge areas as well as the garden. We asked them about the care provided at Knaves Court. They told us, 'The staff here are very kind, they will do anything for you'. Another said, 'I'm very happy with the care, it is comfortable here, the staff are very good'. We saw that staff interacted well with the people living at the court taking time to stop and chat.
We viewed training records and spoke to staff about training that was available to them. The staff we spoke with told us training was available to support their knowledge and development. The manager and staff told us that staff had one to one supervisions with a senior member of the care team. We noted there were some gaps in the training available to staff. The manager had produced an action plan to address this.
During the inspection we looked at the process the service had in place to monitor the quality of the service provided at Knaves Court. There had been audits and action plans completed. People living at the court had been given the opportunity to complete a questionnaire on the quality of the service Knaves Court provided.