Background to this inspection
Updated
19 June 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
This inspection was completed by one inspector.
Service and service type:
The service is a 'care home'. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the
care provided, and both were looked at on this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
Our inspection was unannounced. The inspection site visit activity started on 22 May 2019 and was completed on 23 May 2019. We requested additional evidence to be sent to us after our inspection. This was received and the information was used as part of our inspection.
What we did:
We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and professionals who work with the service. We assessed the information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
We spoke with five people who used the service We spoke with six relatives and two health care professionals. We received feedback from one health professional via email.
We spoke with the registered manager and assistant operations manager, two service support managers and three support workers, two kitchen staff and two domestic staff. We reviewed three people’s care files, two Medicine Administration Records (MAR), policies, risk assessments, health and safety records, incident reporting, consent to care and treatment and quality audits. We looked at two staff files, the recruitment process, complaints, and training and supervision records.
We observed care practice and interactions between staff and people.
Updated
19 June 2019
About the service:
Knoll House provides personal care and support for up to 20 people. Care and support is provided to adults, but predominantly to people over 65 years of age.
Knoll House provides short term rehabilitation for a period of usually two to three weeks but can be up to six weeks. People primarily stay at Knoll House following discharge from hospital, or to prevent an unnecessary admission to hospital. People were supported as part of a rehabilitation programme to help them to regain independence which enabled them to return home. There were 11 people receiving a service at the time of our inspection.
People’s experience of using this service:
Knoll House was going through a period of change and uncertainty. Previously daily support had been provided on site by the multi-disciplinary team consisting of, GPs social work team, social care staff and medical and nursing staff including occupational therapy staff. The registered manager told us recent changes to the service meant, “People were not being referred to the service, therefore beds are remaining empty. I don’t know the future for the service.”
People at Knoll House received an individualised and effective caring service. People were treated with exceptional kindness and compassion. We received positive feedback about the support that staff provided and how people were encouraged to regain the skills to continue to live independently. Staff worked positively to promote people’s health and ensure good outcomes for their physical and mental wellbeing.
There was a strong recognition that people were individuals and the care and support provided ensured that their needs were met which resulted in positive and improved outcomes for people. Respect for people’s privacy and dignity was at the heart of the service provision.
Staff were well trained and skilled and encouraged positive risk taking. They worked with people to overcome challenges and promote their independence. The emphasis of support was towards enabling people to regain essential life skills. Risks associated with people's care needs had been assessed by the management team, and informed plans of care to ensure people’s safety
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 were supported to make choices and staff supported people in the least restrictive way as possible. Staff were aware of the legislation to protect people’s rights in making decisions. This practice was kept under review.
Accidents and incidents were monitored to identify and address any patterns or themes. Learning from incidents was shared with the staff team. Records demonstrated that when an incident or accident occurred staff reported these to their management team to monitor.
Staff received supervision in line with the provider’s policy, staff felt supported and able to request a supervision if they needed one. Staff told us they were able to speak to their management team as they operated an open-door approach.
People had good health care support from professionals. When people were unwell, staff had raised a concern and taken action with health professionals to address people’s health care needs. Staff followed guidance provided to support people with their care.
Rating at last inspection: Good [report published 26 September 2016]
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk