9 January 2024
During an inspection looking at part of 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.