Knowle House Nursing Home

Updated 25 March 2022

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 the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. We received information of concern about visiting arrangements at this service. This was a targeted inspection looking at the infection prevention and control measures the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 17 February 2022 and was unannounced.

Updated 25 March 2022

About the service:

Knowle House Nursing Home provides personal care, accommodation and nursing care for up to 35 people. On the day of our inspection there were 25 older people at the service, some of whom were living with dementia and chronic health conditions. The service is spread over three floors with a passenger lift, communal lounge/dining room, conservatory and a garden.

People’s experience of using this service:

Although regular quality audits were completed to manage oversight of the service, we found improvements were needed for the management of pressure relieving equipment and ‘as required’ (PRN) medicines. For both these concerns, we considered the risk and impact on people to be mitigated. The manager acknowledged these were areas for improvement and immediately rectified these shortfalls.

People told us they experienced safe care. People told us, “I am comfortable here, it’s clean and I love the garden.” Another person said, “The staff are all very caring, very polite and respectful.” A relative said, “All the staff are very approachable and will always make time to talk to us.” We observed, and people told us that staff met their needs with care and kindness.

Training, policy guidance and safe systems of work minimised the risk of people being exposed to harm. Staff understood how to safeguard people at risk and how to report any concerns they may have. People’s needs and the individual risks they may face were assessed and recorded. Incidents and accidents were recorded and checked or investigated by the manager to see what steps could be taken to prevent these happening again. This ensured lessons were learnt.

There were policies and procedures in place for the safe administration of medicines. Registered nurses followed these policies and had been trained to administer medicines safely.

Safe recruitment practices had been followed before staff started working at the service. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs. Nursing staff received clinical supervision and training.

The premises were well-maintained, clean and infection control measures followed. People told us the home was ‘clean’ and ‘tidy’. Relatives spoken with had no concerns about the cleanliness of the service.

Care plans had been developed to assist staff to meet people’s needs in an effective way. Staff applied best practice principles, which led to effective outcomes for people and supported a good quality of life. The care plans were consistently reviewed and updated. Referrals were made appropriately to outside agencies when required. For example, GPs, community nurses and speech and language therapists (SALT).

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. The care offered was inclusive and based on policies about Equality, Diversity and Human Rights.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food. Comments included, “Nice variety,” and “Good food”

Staff always treated people with respect and kindness and were passionate about providing a quality service that was person centred.

The care was designed to ensure people's independence was encouraged and maintained. Staff supported people with their mobility and encouraged them to remain active. People were encouraged to live a fulfilled life with activities of their choosing and were supported to keep in contact with their families.

People were involved in their care planning. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives. End of life care was delivered professionally and with compassion.

People, their relatives and health care professionals had the opportunity to share their views about the service. Complaints made by people or their relatives were taken seriously and thoroughly investigated.

Rating at last inspection:

This service was registered with us on 02/07/2018 and this is the first inspection.

Why we inspected:

This inspection took place as part of our planned programme of inspections.

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.