This inspection visit took place on 01 November 2016 and was unannounced. At the last inspection on 06 April 2016 we asked the provider to take action to make improvements because we found multiple breaches of legal requirements. This was in relation to safeguarding people from unsafe care, poor management of medicines, abuse and improper treatment, risk assessment to people’s health and safety, person centred care, premises and equipment; infection control; consent and capacity and governance of the home. The provider sent us an action plan saying they would meet the legal requirements by 30 September 2016. During our inspection visit on 01 November 2016 we found these actions had been completed.
The Knights provides accommodation for up to 31 people, who require help with personal care needs. The home is situated close to the centre of St Annes on Sea and is within easy reach of public transport, the beach and local amenities. Accommodation within the home is situated on three floors. There is a passenger lift providing access to the upper floors. Communal areas, such as lounges and a dining room are available. A limited number of car parking spaces are available to the front of the building on a private forecourt, and on road parking is also permitted. At the time of our inspection visit there were 22 people who lived at the home.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who lived at the home told us staff who supported them were kind, caring, polite and professional in their approach to their work. Comments received included, “You hear some bad things about care homes but this one is very good.” And, “I cannot find fault with anything. The staff do everything I ask.”
Staff knew people they supported and provided a personalised service. The service operated a keyworker system. This is where a member of care staff is allocated to each person and acts as a focal point and will try and ensure the person’s personal requirements are not overlooked. One person who lived at the home said, “Yes I know my keyworker they make sure I am looked after.”
Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.
Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.
We looked at the recruitment of two recently appointed staff members. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.
Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.
Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived with dementia. We found staff were knowledgeable about the support needs of people in their care.
We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without being rushed. Comments received included, “The staff are so caring and responsive when I need help.” And, “I think there is enough staff around, I don’t have to wait long if I need them.”
We found the registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.
The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.
The environment was maintained, clean and hygienic when we visited. No offensive odours were observed by the inspectors. We spoke with six people who lived at the home who all said they were happy with the standard of hygiene at the home. One person said, “My room is lovely and clean. The cleaner does a good job.”
We found equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.
We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.
People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments received included,”I like my food and get plenty to eat.” And, “You have drinks and snacks all day long.”
People told us they enjoyed the activities organised by the service. These were arranged both individually and in groups.
The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were happy and had no complaints.
We found people had access to healthcare professionals and their healthcare needs were met. People who lived at the home confirmed the service responded promptly if they felt unwell.
We observed staff supporting people with their care during the inspection visit. We saw they were kind, caring, patient and attentive.
The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. We found people were satisfied with the service they received.