A single inspector carried out a this inspection on 4 September 2014. As part of the inspection we talked with the registered manager, care co-ordinator, training officer and the staff. We reviewed information given to us by the provider. We met and spent time with six people who lived at Knaves Court and spoke with family members. Below is a summary of what we found. The summary is based on our observations during the inspection, observations and discussion with the people using the service, the staff supporting them and from looking at records. We used the evidence we collected during our inspection to answer the five questions.
Is the service safe?
From our observations and the information we saw in care plans, policies, procedures and audits, the provider's safety monitoring systems were robust. The training records showed that staff received regular training on safeguarding. Staff showed that they had a clear understanding of their role in providing care and in safeguarding the people they supported. Staff demonstrated that they knew people well and understood their support needs.
We saw evidence that when people lacked the capacity to make decisions on important areas of their lives, best interests and safeguarding discussions had taken place.
The registered manager told us that there were no Deprivation of Liberty Safeguarding orders in place at Knaves Court. At the time of our inspection the registered manager said that in the light of the recent changes to the legislation, they would review the safeguarding requirements for some the people who used the service.
Staff rotas showed that the management had taken people's care needs into account when making decisions about the number of staff required and the skills and experience staff would need. The night time staffing levels and on call system showed that the provider had taken steps to ensure the staffing provision was safe.
There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's care needs had been assessed and detailed care plans were in place. There was evidence that people and their families were involved in the assessments of their needs and care plan reviews as much as possible.
The staff we spoke with, and care plans we looked at, provided evidence that people were supported to maintain their independence and to live active lives.
All care, activity plans and risk assessments were reviewed regularly. We saw evidence that the care provided was constantly adapted to meet people's needs and staff were informed of any changes to people support needs.
We saw evidence that people were supported by a wide range of health care professionals. This meant their health and welfare needs were being met.
Is the service caring?
We observed that staff supported each person in a way which met their individual needs. The staff showed warmth, consideration and respect for people. One member of staff we spoke with said, 'I love watching people getting together and spending time talking'. Another member of staff said, 'It is really heartening to see people able to get their independence back'. We saw that staff showed people respect and ensured their dignity was maintained at all times.
We spoke with one of the people who used the service. They said, 'I am really glad I came here. It has taken me a while to adjust, but I feel really safe and happy here".
The registered manager and staff we spoke with told us they enjoyed their work and tried to ensure people had a good life. The staff we spoke with demonstrated that they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We saw that care plans were focused upon the needs of the individual and contained detailed information about people's choices and preferences. The information showed that people had an individual support plan which was adapted regularly to meet their changing needs.
There was evidence of regular support provided from external health professionals. The service was also supported by Age UK and other local organisations who regularly visited people who used the service. This meant that people's health and welfare was regularly reviewed and monitored.
Staff we spoke with told us that if they had any concerns, they could always talk with the managers and senior staff. They said they would always listen and address anything they raised. We saw that the provider had a compliments and complaints policy and procedure in place. We saw that complaints had been successfully resolved and many compliments had been received.
We saw that staff received regular training which equipped them with the knowledge and skills to meet people's support needs.
Is the service well-led?
The service had a clear management structure in place. The managers and the staff we spoke with were very knowledgeable about the people who used the service, changes to legislation and developments in care provision.
We saw on the staff rota that senior staff were available to give advice and support. One of the staff we spoke with said, 'The managers and senior staff are very supportive and I never worried about asking questions or asking for help'. We saw that there were systems in place to provide feedback to staff about changes and developments.