Knowles Court Care Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this service. This key question has been rated requires Improvement. This meant people’s needs were not always met.

This service scored 61 (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 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

While the provider made sure people were at the centre of their care, as we have explored in the caring key question, improvements were needed to ensure consistency, by ensuring care plans and risk assessments contained all the information regarding individual’s needs. The provider was working in partnership with people, relatives and other professionals to ensure this was implemented. One relative told us, “There is a new activities co-ordinator who seems really good, she asked me what Mum likes. Mum likes to play with balloons with her. She seems to help at lunch time and talks to all the residents. Residents seem happier.” We observed good interaction throughout the visits with staff having good knowledge of individuals and their wants and needs.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Information was available and shared between services as needed to ensure people's care and treatment needs could be assessed and met. People’s care records did not always fully evidence how people’s care was planned and delivered, so we could not be fully assured that continuity, inclusion and a holistic approach to people’s needs was always being delivered. This was fed back to the manager who gave reassurance on action being undertaken to address this issue. On our second day of visiting, further work had been undertaken.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs, for example, when choosing meals or activities for the day. The manager took immediate action to provide information in larger print and pictorial information was also made larger. Relatives told us they were kept updated with people’s health and wellbeing. One relative told us, "The staff are very good, really good at keeping me updated." Staff told us people attended regular meetings where they could express their views and make suggestions into the service.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. People told us staff listened to their views and acted on feedback. People and their relatives knew how to voice their opinions or raise complaints and felt free to do so. Their comments included, “I would be able to complain, I am sure. The manager is approachable” and “I discuss things with staff, and it is resolved, there are no issues.”

The provider made sure that people could access the care, support and treatment they needed when they needed it. Referrals were made for treatment when they needed it. One person told us, "The doctor and other professionals visit regularly, if I need anyone then I would ask anyone of the girls here and they would sort it for me." Staff told us they raised concerns with external professionals such as district nurses, physiotherapists and doctors as and when needed. Partners told us the provider raised referrals as and when required. Records detailed people accessed health professionals such as opticians and dentists as required. We reviewed examples where the provider sought advice and guidance from professionals such as occupational therapists and physiotherapists.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Care plans for some people included information around people’s identity, things which were important to them, their wishes and relationships they wanted to maintain. A person commented, “My relative comes every morning before going to school, it’s never an issue whatever time they come, they know all the staff and are always made welcome.” Action was being undertaken to ensure this information was implemented in everyone’s care plans.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. We reviewed 3 peoples end of life plans, 1 had some clear information in. This person was receiving palliative care. The other 2 were more generic. They highlighted relatives had been approached to discuss further information in relation to people’s wishes but this had not yet been formulated into a plan. This was fed back to the manager who was aware and had already commenced action to address this gap in care planning.