The Knowles

Updated 21 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

The inspection team consisted of 2 inspectors and an Expert by Experience. 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

The Knowles 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. The Knowles 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.

What we did before the inspection

We reviewed information we had received about the service since they registered with the CQC and sought feedback from the local authority 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. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and 5 relatives about their experience of the care provided. We spoke with 14 staff including the registered manager, operations manager, chef, care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke to 2 health care professionals who were visiting the service and carried out general observations of the way people were supported.

We reviewed a range of records, including 3 people’s care records. We looked at 3 staff files in relation to recruitment and staff support and a range of records relating to how the service operated and was managed.

Updated 21 March 2024

About the service

The Knowles is a residential care home providing personal care for to up to 38 people. The service provides support to younger and older adults some of whom are living with dementia. At the time of our inspection there were 36 people using the service and 2 people were in hospital.

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

Fire safety risks were not always identified or responded to in a timely way. Some audits and checks to monitor the safety of the service were not always effective as they failed to identify the issues we found, for example issues around infection control and prevention. People felt safe living at The Knowles. People received their medicines safely, when needed by staff trained in medicines management. Staff were recruited safely.

A range of quality monitoring systems were in place; however, further improvement was needed. We made a recommendation to implement robust systems and checks to monitor the safety of the service. The registered manager and staff team demonstrated their commitment to ensuring people received a quality service and worked with other professionals to achieve good outcomes for people. Staff felt supported by the management team.

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.

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 26 May 2022).

Why we inspected

We received concerns in relation to the staffing levels and culture of the service. As a result, we undertook a focused inspection to review the key questions safe and well led only. 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 improvements 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 see what action we have asked the provider to take at the end of this full report.

The provider took immediate action to make improvements to mitigate any risks to people.

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

We identified a breach in relation to assessing and managing safety risks within the environment.

Please see the action we have told the provider to take at the end of this report.

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.