Knaresborough Two Group

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of the inspection there were 6 people using the service who received personal care.

Right Support: Appropriate fire safety measures were not always in place to minimise potential risks to people who used the service. There was not always clear and robust guidance in place for staff around some people's health conditions. People were not always supported to develop new skills and gain greater confidence and independence. Staffing levels and deployment of staff had improved. We made a recommendation around the continuous review of staffing levels. Staff supported people safely with their medicines. People were supported by staff who had been recruited safely. People were supported to make their own decisions wherever possible, including around their end-of-life choices.

People were generally supported to have maximum choice and control of their lives, although further work was required around supporting people's independence, goals and aspirations. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: Assessments of people's needs were not always fully comprehensive and did not always consider each person as a whole, and the wide range of their needs. There was not always evidence that people were involved in reviews of their support plans. Staff treated people with dignity and respect. People told us they were happy and liked the staff. Staff had received suitable training to meet people's needs. People were able to personalise their own rooms and the houses were homely. The management of laundry was not in line with best practice guidance and we have made a recommendation about this.

Right Culture: Quality assurance processes were not always effective. The provider involved people through

house meetings, but we made a recommendation about ensuring engagement was as meaningful as possible. Documents were available in an easy read format for people but there were only limited aids available for people with a visual impairment. We made a recommendation about this. There was an open- door policy and people and staff told us the registered manager was approachable and knowledgeable. There was generally a positive culture within the service although some areas of support needed to be more person-centred. Staff managed incidents affecting people's safety well and there was evidence of learning from incidents. Staff worked well with professionals and lines of communication were good.