Knowles Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this service. This key question has been rated good: This meant people were safe and protected from avoidable harm.

This service scored 66 (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 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a positive culture, based on openness and honesty. Staff reported concerns which were investigated and reported on. Staff commented on a learning culture, with one staff member saying, “We have undertaken loads of training recently, if I asked for any support around training or undertaking my job, I know I would receive it.” A relative said, “I am aware of how to complain and feel that action would be taken if I did.” Lessons learnt from incidents and accidents were analysed and shared with the staff team during handovers and team meetings.

Staff at the service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. A person told us, “I was in hospital 2 weeks ago – I was just off my food – staff called the Dr, he is here a lot. They got me to hospital, and I was back the next day. I had a chest infection. They were quick.” There was limited evidence of information being collected before people started to use the service; no admissions had taken place since the new manager was recruited. A new document had been implemented for any future admissions. This was robust and evidenced all the information required prior to a new person coming into the service. Hospital passports required further detail to ensure people’s needs could be met, if they moved elsewhere. This was fed back to the manager who was aware and taking appropriate action.

Staff at the service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. People and relatives told us they felt safe, they would speak with staff if they were worried, and they always felt listened to. Their comments included, “[My relative] has been here about 12 months – her dementia has deteriorated but I do feel that she is very safe and cared for. I come almost every day, at different times, all I want to know is that she is being looked after to our standards, and she is. Yes, I have seen the care plan just before Christmas and it is up to date. [My relative] must have help to eat and drink. I often come at lunch time to help but they [staff] are very good at helping her to eat safely – she has put weight on.”

Systems that were in place to manage risk were not always effective. Risk assessments were not always person centred, and some lacked important information. Staff generally knew people well and worked with individuals to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff supported people safely and appropriate equipment was available if people needed assistance. Staff told us they encouraged people to make their own choices, and they respected their decisions. One staff member said, "We help people to make their own choices, such as what they want to wear. Sometimes we may think their choice is not appropriate because of the weather, but ultimately, it's up to them. We encourage people and give advice." The manager had identified the actions required and was taking action to address concerns discussed at feedback.

Staff at the service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff were observed to check equipment prior to use and ensured that the person was well supported prior to hoisting from chair to wheelchair. One relative said, “My family member uses a walking frame, this is always close by." One staff member said, "The bungalows are well maintained, when something needs repairing, we report it, and it gets repaired or replaced quickly." Health and safety checks and environmental audits were regularly completed and action taken when required. The maintenance person was on site and knew people well, chatting to people whilst undertaking their checks. We did however find that the radiators were hot and uncovered in some areas and that pipes in one toilet were hot and exposed. This was raised with the manager who informed us that radiator covers had been ordered and took immediate action to chase this up alongside closing off the toilet with exposed pipes.

There was enough staff on duty to meet people’s health needs and provide prompt support when people requested assistance. Safe recruitment practices were followed. Some gaps in staff training and support meetings had been identified and improvements were being made. Action had been taken to ensure this was monitored and sustained. There was less use of agency staff and permanent staff had been successfully recruited which meant staff knew people’s needs. A person told us, “I feel safe with these lasses they all live over there, they are great. I come from there. They know what they are doing [name] is great.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff told us personal protective equipment (PPE) and all cleaning materials needed were available. We observed cleaning taking place and where there was the occasional malodour, this was quickly removed through cleaning practices. Infection prevention control audits took place regularly and actions were taken to address areas identified as needing improvement. Staff confirmed they had received infection control training. A relative told us, “If the staff know that the floor is dirty after someone has been eating – they clean it up straight away.”

Systems were in place to safely store and administer medicines. People were receiving their medicines on time and stock levels checked, including controlled drugs, were correct

documentation around people’s specific needs, including covert administration, where medicines are hidden in food or drink, was person-centred and involved the correct professions. Cream and transdermal patch charts were used to ensure people were receiving these medicines correctly and effectively. Improvements could be made to ensure correct documentation when people were receiving their ‘as and when required’ medicines. Staff informed us they had good relationships with the people’s GPs and staff at the community pharmacy where prescriptions were dispensed. Improvements had been made to ensure monthly medicines were received in a timely manner. Audits also picked up on the medicine fridge temperature readings that were outside the correct range. This had been escalated and acted upon, and evidence of this was shown to us during the inspection.