Knightwell House

Updated 23 March 2024

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.

Inspection team

This inspection was carried out by 1 inspector.

Service and service type

Knightwell House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Knightwell House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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

Notice of inspection

This inspection was unannounced.

Inspection activity started on 09 January 2024 and ended on 24 January 2024. We visited the location on 09 and 10 January 2024.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. 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. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people about their experience of living at the service. We spoke with 2 relatives. We spoke with 5 staff members including the registered manager and provider. We reviewed 4 care records, 2 medicine records and 1 recruitment file. We reviewed a range of records including those that related to how the service was monitored, how staff were trained and provider policies.

Updated 23 March 2024

About the service

Knightwell House is a residential care home providing personal care to 10 older people at the time of the inspection. The service can support up to 13 people with learning disabilities and autism.

The home is set out over 3 floors with communal spaces for people to use.

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

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.

Right Support:

People had not always had all of the risks associated with their care assessed or mitigated. Care plans needed further information about how to reduce risks in people’s care. Whilst systems in place supported people to receive their medicines safely, medicine competency checks for staff had not been recorded.

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.

Staff supported people to access health and social care support and people had their individual dietary needs met.

Right Care:

Improvements were needed in maintaining oversight of refresher training for staff to ensure they had current knowledge of the topic area.

The service had enough staff to meet people’s needs and staff understood how to protect people from poor care and abuse. Staff received training on how to recognise and report abuse and they knew how to apply it.

People could communicate with staff and understand information given to them because they were supported by a consistent staff team who understood their needs.

Right Culture:

Systems to oversee the quality of the service were not always effective. We identified care records were not always up to date, oversight of when training needed to be completed was not in place and on-going checks on the suitability of staff needed to improve.

The service enabled people to feedback their views about the care they received and acted on this feedback.

Staff placed people’s wishes, needs, and rights at the heart of everything they did.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

We carried out a targeted infection control inspection which did not rate the service (published 09 April 2021). The last rating for this service was good (published 17 January 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well- led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Knightwell House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to how the provider monitors the quality of the service. Please see the action we have told the provider to take at the end of this report.

We have made a recommendation around how the service is assessed and monitored for the risk of a closed culture.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.