The Knowls

Updated 31 December 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

The Knowls 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.

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

This inspection was unannounced.

What we did before the inspection

We looked at all the information we had received from and about the home since the last inspection. We sought feedback from professionals who commission the service on behalf of people. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

We met 12 people who used the service. Some people were not able to verbalise their views to us, but five people told us about their experience of the care provided. We spent time in communal areas of the home observing the interactions between people and staff. We spoke with five members of care staff. The registered manager was available throughout the day and the operations manager also met with us during the inspection.

We reviewed a range of records. This included three people’s support plans and multiple medication records. We looked at records of staff meetings and at health and safety records.

Updated 31 December 2019

About the service

The Knowls is a residential care home registered to provide accommodation and personal care to up to 13 people. Accommodation is provided in two separate areas. The main area of the home provides communal space and bedrooms for 11 people. Another area provides self-contained accommodation for two people.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 13 people. 13 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were no identifying signs outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

People lived in a home where there were adequate numbers of staff to meet their needs and to assist them with activities and accessing the community. Risk assessments were carried out to make sure people received their care safely and had opportunities to take part in activities which interested them and promoted their independence.

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 were treated as individuals and were able to make choices about their day to day lives.

People were able to follow their own routines according to their preferences and abilities. Staff respected people’s routines and choices.

People were cared for by staff who were kind and caring. People looked very comfortable with the staff who supported them. When people became anxious or distressed staff remained calm and professional. Staff used verbal reassurance to help people to relax and told us physical restraint was not used at the home.

People had access to a range of professionals to meet their physical and emotional health needs. The staff had good relationships with other professionals which enabled them to seek advice and support for people.

People had support plans which gave staff clear information about how people wanted to be cared for. Staff knew people well and understood people’s different communication. This helped to make sure people received care and support in accordance with their wishes and preferences.

People lived in a home which was well led. The provider and registered manager monitored standards and were committed to making on-going improvements to people’s support and quality of life.

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 rating for this service was Good (Report published 17 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.