Knowle Court

People benefited from safe admission procedures. Most people and relatives said they felt safe and staff knew what to do if someone was at risk. Improvements were needed in the quality of risk assessments, staff understanding of DoLS and adherence to risk management guidance, particularly around moving and handling. Environmental safety, maintenance, cleanliness, infection prevention and control, staff deployment and team working also required some improvement. Medicines management systems included some good practice, but errors and recording issues were identified.

People’s care plans, although detailed, person-centred and included detail about people’s backgrounds and cultural needs, were not always reviewed regularly or developed with involvement from people or, where appropriate, their families. Staff supported people’s health and wellbeing and worked effectively with health and social care professionals. Monitoring of people’s care outcomes required improvement to make sure the care provided was effective and met people’s needs. People’s wishes regarding end-of-life care were documented. The service followed the Mental Capacity Act, with decision-specific capacity assessments and best-interest processes in place, and staff sought people’s consent before providing care. People generally spoke positively about the food although cartoon images were used to show people choices when photographs or the available options would have been more suitable for people living with dementia.

People’s privacy and dignity needs were not always met although improvements in this area were seen during the assessment. Staff knew people well and responded promptly and kindly to their needs. The provider had taken action to make sure all people could access communal areas, and they told us they were looking at developing the outdoor space to make it safe for people to access as they chose. Opportunities to access meaningful activities and the local community were limited. The provider had made changes in staffing arrangements to address the need for better social care and activities.

Systems were in place to manage complaints and obtain feedback, and people felt comfortable raising concerns with staff.

Recent management changes and communication issues had affected staff morale and the quality of care. A new management team was being established, with plans to improve communication, staff support, involvement and consistency. Governance systems were in place but were not yet fully embedded or consistently effective in identifying and addressing concerns. The provider was open and responsive to the assessment and recognised the improvements needed.