Knowles Court Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was working towards ensuring people’s care and health treatment was effective by assessing and reviewing their health and care needs with them. People told us they felt involved in their care and support plans. One relative said, "I get involved in the care plans, if I ask to see them, they [staff] always show me, and they [staff] listen to me.” Staff told us there were effective systems in place to assess and monitor people’s needs. This included handover meetings between incoming and outgoing staff on shift, daily flash meetings and staff meetings. However, documentation was not up to date for everyone, this was fed back to the manager who evidenced that action was being undertaken to address gaps in care planning.

The provider was working towards planning people’s health care and treatment with them. People told us the provider prepared nutritious meals in accordance with their preferences. One person said, “I have lots to choose from, but I could eat their curry every day. Just give me curry. I do have other food, but I love their curry.” Staff told us how they monitored people's nutritional health. Staff were able to provide examples of how they monitored people's health regularly, such as people’s hydration and nutrition. Where people required additional support from other professionals such as district nurses, these visits were recorded and recommendations followed. We did however observe one person assessed to need IDDSI level 5 diet taking and eating a crust of toast. Staff saw and followed up appropriately but did not recognise the potential risks and this had not been shared with the Unit Manager. The same person was a very high risk of falls, and it was known that they regularly unplugged their sensor mat, but this was not recorded, or any action taken to try and mitigate this. This was fed back to the manager and appropriate action taken.

The provider worked well across teams and services to support people. People told us staff raised concerns with other professionals when needed and they felt supported to access health professionals. One person said, "If I am not well, they [staff] will call a doctor. The optician also visits me in the home." Staff told us they worked alongside health and social care professionals. One staff member said, "We work with other professionals such as district nurses, GP's and social workers, it's important we all work together and that we follow their advice and protocols.” The provider and staff worked in partnership with other health and social care agencies to deliver good outcomes for people and ensure their needs were met and reviewed.

Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People told us they were supported to live healthier lives and their choices were respected. One person told us how the provider met their specific preferences around their meal choices. Staff told us how they supported people to eat healthy meals and take part in exercise, such as armchair exercise programmes. People were referred to health care professionals to support their wellbeing and support them to live healthy lives.

The provider was working towards monitoring people’s health and treatment, this was taking place for some people, however not all. We found that some peoples care plans were inconsistent, with some giving good detail and personalisation and others not having the detail required to support people to receive safe and effective support. There had been an audit of people's care plans and risk assessments, action was being taken to ensure they accurately reflected people's needs, with appropriate guidance for staff about the support people needed. Where these had been updated reviews were carried out regularly to ensure people's support and outcomes were monitored.

The provider told people about their rights around consent and respected their decisions. Staff empowered people to make their own decisions about their care and support. People told us their choices were respected. One person told us, “I choose what time I go to bed and what time I get up. I choose to join in if I want to do bingo and other stuff.” Staff told us they received mental capacity training and promoted people's best interests. One staff member said, "We assume everyone has capacity at the time when asking a question, we take people’s answers on face value. “Another staff member told us, "I have had MCA [Mental Capacity Act] training. It’s important to always act in a person’s best interest and for people to be able to make their own choices as much as possible." We checked whether the service was working within the principles of the Mental Capacity Act (MCA), and whether any conditions or authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. Assessments of people’s mental capacity and best interest meetings had taken place to ensure decisions made were appropriate and least restrictive. This related to the decisions concerning where a person should live and personal care.