Knebworth Care Home

Knebworth Care Home is a residential care home providing personal and nursing care to 64 people. At the time of the inspection. The service can support up to 71 people in a purpose-built building.

People’s experience of using this service and what we found

People and their relatives told us they were happy with the care provided and living at the service. They told us they felt safe. Infection control was promoted, and medicines were managed well.

People told us they felt listened to and staff were kind. There were enough staff to meet people’s needs and their approach was person-centred.

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 and their relatives told us they could speak up. There were meetings and contact with people, relatives and staff to get their views. Feedback was collated and shared. Lessons were learned from events, accidents and feedback.

The manager had recently changed but the service had been well supported by the provider’s management team while waiting for the new manager to start. The new manager started at the home just before the inspection commenced but feedback about their approach was positive.

There were quality assurance systems in place and these were used effectively to help maintain and further develop the standards in the home.

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 inspection for this service was a focused inspection and therefore was not rated (published 30 March 2021). The last rated inspection for this service found the rating to be good (published 28 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about leadership, falls and incidents and staffing. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

The overall rating for the service has remained good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Knebworth Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ People were chatting and engaging with staff and this was not impacted by staff wearing masks. The activities organiser was providing support to help prevent loneliness and boredom for people.

¿ Information was displayed about COVID-19 giving clear and accessible advice.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID-19. This included if a person who was isolating was unable to have their door closed. Control measures were put in place.

¿ The home was clean and there was cleaning ongoing during our visit.

¿ People were in cohorts on their units and considered communal areas as part of their home. Staff only worked on their allocated units and they had separate entrances and exits to the home and allocated lifts.

¿ There was a visitor’s pod for use when visits were permitted. This was separate to the home to help promote people’s safety. There was also regular virtual contact with friends and family.

¿ The home was considered to be in an outbreak at the time of inspection due to people who had attended hospital testing positive, so visitors were stopped for 28 days in line with national guidance. However, the home managed the outbreaks well and maintained strict processes to minimise the risk of others being affected.

¿ When people tested positive for COVID-19 they had to isolate in their rooms, for a set period of time. Staff were clear on what it meant to isolate and what symptoms of COVID-19 to look out for. People returning from hospital or those new to the home had to isolate for 14 days. Where this was not possible, for example for someone who would be at increased risk to have their door fully closed, a risk assessment was completed.

¿ Staff had received training on putting on and taking off personal protective equipment (PPE), infection control and COVID-19. They told us they felt very supported and had enough information to do their jobs.

Knebworth Care home 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.

Knebworth Care Home provides accommodation for up to 71 older people, some of whom live with dementia. The home is registered to provide nursing care. At the time of the inspection there were 50 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People, relatives and staff felt that the service was well run. There were systems in place to monitor the quality of the service and address any shortfalls. The management team worked with other agencies to improve and maintain standards.

People felt safe and were supported by staff who knew how to reduce risks and there were effective infection control practices. Lessons learned were shared and any incidents were reviewed.

People were supported by sufficient staff who were recruited safely. Medicines were managed safely in most instances. We found that staff were trained and had regular supervision.

The principles of the Mental Capacity Act 2005 were adhered to and people’s choices were respected. People were involved in their care.

People were supported to eat and drink enough and risks of malnutrition were monitored. There was regular access to health professionals and the design of the building suited people’s needs. People were treated with dignity and respect. Privacy and confidentiality was promoted. We found that staff were kind and friendly.

People’s care needs were met in a way they liked. Individual care plans included the appropriate information to help ensure care was provided in a person centred and safe way. Where people were supported at the end of their lives, this was done with dignity and kindness. People enjoyed the activities provided. We found complaints were responded to and feedback was sought.