The Knoll

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Care and treatment was planned and delivered in a way which was intended to ensure people's safety and welfare. Staff had been supported to complete training and develop the skills they needed to support people safely. There were enough staff to meet people’s needs. Staff were employed following the appropriate recruitment checks being completed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were protected from the risk of abuse. Care plans identified when people may be at risk or vulnerable and what supported they needed to keep them safe. People told us they felt safe living at the service. One person said, “I feel safe living here, I have my friends and we are all together.”

The registered manager told us they had safeguarding policies and procedures in place and had a procedure for ‘whistle blowing’. We saw this was displayed for staff to refer to should they need it. Where there had been concerns the registered manager had raised these appropriately with the local authority and worked with them to investigate these and keep people safe. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). DoLS application had been made and legal authorisations were in place where required. Where authorisations needed to be reviewed the registered manager had applied for these. Staff understood the need to gain consent from people for care and to encourage people to make decisions for themselves. Where people were unable to do this best interest decisions were in place. To ensure people’s voices were heard if family were not able to act on people’s behalf there were advocates appointed to work with people.

Staff understood their responsibilities to safeguard people and had received training on how to safeguard people. Staff told us if they had any concerns, they would raise these with the manager or could go higher if needed to the regional manager. A member of staff told us, “If anyone is at risk, we raise our concerns to local authority to investigate and inform the CQC.”

We observed staff supporting people safely.

People were involved in planning their care and managing risks. Care plan and risk assessments were person centred and aim to provide positive people outcomes for people whilst maintaining their choice and independence.

Risk assessments and care plans were person centred and provided guidance to staff on how best to support people. People were supported to live as independent lives as possible. Risk assessments helped to mitigate the risks to people by providing guidance to staff on how to provide safe support. There were detailed personal evacuation plans for people and staff practiced with people how to safely evacuate the building in an emergency. Where people needed specialist equipment the registered manager arranged for their needs to be assessed by qualified professionals such as occupational therapists to ensure they had the correct equipment.

Staff had received the appropriate training to support people safely. Staff we spoke with knew people well and how they wished to be supported whilst maintaining their independence. Care plans and risk assessment were detailed providing all the information staff needed. One member of staff said, “I know people really well and I have read their risk assessments.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We observed staff supporting people safely and meeting their individual needs.

The registered manager told us they had a consistent staff team and rotas we reviewed reflected this. Appropriate checks were in place before staff started worked including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had received training to enable them to have the skills and knowledge they needed to support people. Where people had specific needs, staff had received specialist training, for example in learning disability, autism and epilepsy. Staff had regular supervision to discuss their training and support needs and regular staff meetings.

Staff told us they felt there was enough staff on duty to provide support to people. One member of staff said, “I get on well with people and like supporting them.” Staff told us they felt they had the correct training to help them provide care. The registered manager told us they kept people’s care needs and staffing under review and had recently asked for some extra funding from the local authority to provide additional staffing hours for one person.

We observed people had good relationships with staff. One person said, “We have a good laugh with staff about all sorts of things.” There were enough staff available to spend time interacting and supporting people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.