24 January 2019
During a routine inspection
The Knights Centre is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to people living with dementia, with a mental health condition, physical disability and sensory impairment and older people. Not everyone using The Knights Centre receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, four people were in receipt of personal care and support.
The service had a registered manager. 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 and relatives told us staff were safe and reliable. The provider followed appropriate procedures to ensure people were safeguarded against harm and abuse. Staff were knowledgeable about types, signs of abuse and the actions they needed to take if they had any concerns. Staff rotas and daily care logs showed staff generally supported people in line with their preferred and agreed times. There were suitable and sufficient staff to meet people’s needs safely. People’s medicines management needs were met in a safe manner. There were systems in place to learn lessons when things went wrong.
People’s needs were assessed before they started receiving personal care support. People told us that their healthcare and dietary needs were met by staff who knew them well. Staff were provided with regular training and supervision to do their job effectively. However, the provider did not always maintain accurate supervision records. We have made a recommendation in relation to staff supervision records. People were supported to access healthcare services where this was requested.
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.
People and relatives told us they found staff caring and considerate. Staff involved people and their relatives in the care planning process, and treated them with dignity and respect. People were encouraged to remain as independent as possible. People’s cultural and religious needs were identified, and met by staff who respected their needs.
People and relatives told us they received care that was responsive to their needs. Staff were knowledgeable about people’s likes, dislikes and their routines, and met their personalised needs. The care plans were regularly reviewed and included information on the support people required. People and relatives knew how to raise concerns and make a complaint. They told us they had never had to complain. People’s end of life care needs were met in a caring, dignified and compassionate way. However, the provider did not always record people’s end of life care wishes. We have made a recommendation in relation to people’s end of life care plans.
The registered manager had a good understanding of the needs of people who used the service and their responsibilities in notifying us of incidents. There were systems in place to ensure the quality and safety of the service. However, the registered manager did not always keep records of the audits and checks. We have made a recommendation in relation to record keeping of audits and checks.