Archived: Knowle Manor

There was a registered manager in place at the time of the inspection. 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.

The administration of people’s creams was not robust. The registered manager told us a new creams administration system had recently been introduced, but ‘teething’ problems still needed work. Not all staff had received training in the administration of medicines and staff competency had not been checked.

Staff received training and support required to meet people’s needs, although, some training was overdue. The registered manager was aware and in the process of addressing this. The registered manager told us they had not recruited any new staff members in over two years, but recruitment procedures were in place. We found people were cared for, or supported by, sufficient numbers of staff, although the registered manager told us they were going to review the staffing level to make sure they were appropriate.

People’s care plans contained sufficient and relevant information to enable staff to provide consistent, person centred care and support. We received mixed views about the activities, but we saw there was opportunity for people to be involved in a range of activities within the home and the local community, although, outings were limited. From the activities we saw people were smiling and engaging in a positive way.

People told us they felt safe in the home. Staff had a good understanding of safeguarding vulnerable adults and systems and processes were in place to protect people from the risk of harm. Risks to people were identified and managed safely and accident and incidents were analysed accurately. Infection control management was robust and the home was clean, tidy and odour free.

People’s mealtime experience was good. One person did say the meals were not hot enough. We were told there was only one hot plate working but a new one had been purchased and was in the process of being fitted. People had access to healthcare services to make sure their needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were able to individualise their bedrooms and communal areas were comfortably furnished and homely. Staff were aware of people’s care and support needs, they treated people with kindness and had a good rapport with people. People told us they liked living at Knowle Manor and they were well cared for. Staff understood how to treat people with dignity and respect. People were supported to remain independent and advocacy services were available if required. People’s end of their life wishes were recorded in their care plans.

People and staff found the management team approachable and said they listened to them. We found some of the quality assurance systems needed to be improved to ensure people received a consistent quality service. For example, the medication audit had not identified the concerns found with the administration of people’s creams.

There had been no recent complaints, but a complaints procedure was in place and people told us they would raise any concerns with the registered manager.

We spoke to five people who lived at Knowle Manor. All were very complimentary about the care they received. They told us staff were approachable, attentive and helpful. We were told, "You can have a laugh and a joke with the staff." We also spoke to relatives of people who used the service. They were very complimentary about the standards of care being provided.

We spoke with people who used the service who told us about the wide range of activities available. Most recently people had visited a local donkey sanctuary.

During our visit to Knowle Manor we saw domestic staff cleaning people's bedrooms, bathrooms and toilets. All areas were exceptionally clean and fresh smelling. There was evidence of robust policies and procedures that were put into practice daily, for example, hand washing, prevention of cross-contamination in the kitchen and laundering procedures.

We saw the home provided people with information about how to raise concerns and make complaints. We saw the agenda and minutes from residents meetings and found the complaints policy was a standing item on the agenda

People said they had choices as to how they spent their days and one person said 'we do all sort of things here, I am very happy here'. One person said 'I do what I can for myself because that's what I want'. Another person said 'I like to wear make up and have nail polish on and staff help me to do that'. One person did jobs in the home like checking the milk delivery which he said he really enjoyed.

Visitors told us they were very happy with the care their families received. One visitor said 'Staff take into account individual needs, she has her own routine and staff respect that'. 'She likes to be coordinated and they help her choose clothes that match and put make up on her'. Another visitor said 'My mum loves it here the staff are brilliant they do lots of things like the Monday Club'.

Staff we spoke with said that people were treated with respect and dignity. One staff member said 'I treat people here like I would treat a member of my family, this is their home and we should respect that'. Care plans had information on people's choices on how they wanted to be cared for and preferences such as what time people wanted to get up and whether they preferred a bath or shower.