Archived: Knowles Court Care Home

Updated 24 December 2020

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 25 November 2020 was announced.

Updated 24 December 2020

About the service: Knowles Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Knowles Court Care Home has five individual single storey houses. At the time of the inspection only four of the five houses were occupied, and 68 people were using the service. Headley House provides care and support to people living with dementia. Ryecroft House provides nursing care for older people, Fairfax House provides care and support to older people and Rosewood House provides support to people with learning disabilities.

The care service at Rosewood House 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, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The service was not always delivered in line with these values, because people living at Rosewood House did not have an equally suitable environment to other citizens who used the service.

People’s experience of using this service:

In three houses we found the accommodation at Knowles Court provided people with a pleasant and comfortable environment. On Rosewood House the environment was not appropriately maintained and decorated to an acceptable standard to support people to live in a dignified way. We discussed this with provider and they told us they would make immediate improvements to the environment. Improvements had begun to be implemented by the second day of our inspection.

People told us they felt safe at Knowles Court Care Home. Staff had a good understanding of how to safeguard adults from abuse.

Staff were aware of their responsibilities if they were concerned a person was at risk of harm. Care files contained detailed individual risk assessments to reduce risks to people’s safety and welfare.

Feedback from people and staff about sufficient staff being on duty was mixed. Adequate staff were deployed to meet people’s needs, however more staff on duty would enable people to lead more fulfilling lives.

We made a recommendation about this staffing.

Staff recruitment was safe. Staff had undertaken training relevant to their roles and there were clear lines of communication and accountability within the home.

A system was in place to ensure medicines were managed in a safe way. Staff were trained and supported to ensure they were competent to administer medicines.

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 practice. Mental capacity assessments and best interest decisions were usually completed when decisions needed to be made.

Most people told us they enjoyed their meals and we saw people received support with meals and drinks when required. Staff knew how to access relevant healthcare professionals if their input was required.

People and their relatives told us staff were caring and supported them in a way that considered their dignity, privacy and diverse needs.

Most people and their relatives told us they were in receipt of care that was responsive to their needs and preferences. Some people on Rosewood House were not always supported to lead fulfilling lives.

We made a recommendation about this.

People told us they knew what to do if they had any concerns or complaints about the service and the management team were accessible. Complaints had been acted on when they arose.

We saw detailed information documented about people’s end of life care and advanced care plans were in place if people wanted to record their future wishes.

Most people told us they thought the service was well led. Since our last inspection Improvements had been made, however, some areas of governance still needed to improve. The registered provider had failed to improve the quality and safety of the environment of Rosewood House. Feedback about lack of opportunities for community involvement and outings on Rosewood House had not been acted on and up to date activity records were not always kept.

People who used the service, staff and relatives were asked for their views about the service and these were usually acted on.

Rating at last inspection: Requires improvement (Report published 02 February 2018).

Why we inspected: This was a planned inspection based on the last ratings inspection.

Improvement action we have told the provider to take: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We have told the registered provider to send us an action plan. We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk