Knoll House

Updated 7 July 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Knoll house is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service also provides care and support to people living in eight 'supported living' flats, so they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

This service is also registered as a domiciliary care agency although it was not currently providing any domiciliary care to people.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service short notice of the inspection. This was because it is a small service and we needed to be sure the registered manager would be in the office to support the inspection and we wanted to be sure there would be people at home to speak with us.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually 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 spoke with three people who used the service and two relatives about their experience of the care provided. People who used this service were able to communicate verbally. We were advised how to adapt our verbal pitch and pace to ensure all persons had the opportunity to engage in conversations.

We spoke with eight members of staff including the CEO, registered manager, members of the management team, senior support workers and support workers. We spoke with two visiting professionals.

We reviewed a range of records. This included three people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 July 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, Right care, Right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Knoll House is a residential care home and supported living service providing personal care and support services to autistic people, people with a learning disability and people with a mental health condition. The residential care home can accommodate up to nine people and the supported living apartments can accommodate up to eight people in one adapted building. At the time of our inspection five people were living in the residential care home. Eight people were living in the supported living apartments, however not everyone who used this service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

Knoll House is also registered to provide domiciliary care in the community although at the time of this inspection no one was currently in receipt of this service.

The residential accommodation within the service included specialist flats for people living with complex needs in addition to 'moving on' flats. The moving on flats are designed to enable people to live more independently and prepare them for moving into their own accommodation. The supported living flats all have their own kitchen and laundry facilities to promote and enable people to live an independent life.

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

Right Support

People had a choice about their living environment and were able to personalise their rooms and flats. The residential home was currently going through a refurbishment. People had been involved in choosing the colour scheme in the lounge and dining areas and one person told us how they had suggested additional pictures in the lounge.

People were supported to have the maximum possible choice, control and independence and they had control over their own lives. People chose how to spend their day and staff encouraged people to make their own decisions.

People were supported by staff to pursue their interests. One person told us about their interests and future goals. Another person told us about their college course, they were proud of their achievements.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Staff communicated effectively with people. Staff told us how best to communicate with people and how to adapt our pace to enable people to participate fully in the conversation.

People played an active role in maintaining their own health and wellbeing. One person informed us why they intended on becoming fit and healthy. Staff actively encouraged people to take healthier food and drink options.

Right care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff had been recruited safely and all relevant pre-employment checks had been taken.

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Documents were printed in easy read formats and each person had a communication passport.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. People were actively involved in co-producing their own risk assessments.

Right culture

People could choose to have their relatives or significant others involved in the service. The registered manager told us they respected people's choice to involve others in the care and support provided.

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. Staff told us their main reasons for working was to enable people to be independent and live fulfilling lives.

People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Each person was supported by key working staff who worked with the person to review monthly goals and wellbeing.

People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. People were actively encouraged to be involved in the community. The location of the home was within an easy walk of local amenities.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity. People were included in regular meetings and they were actively involved in reviews of support and care needs.

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 (published 12 December 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support Right care Right culture.

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.