CQC report explained · a residential care home
What the CQC found at The Knole
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from avoidable harm. Risk assessments, emergency plans, safe recruitment, medicines procedures and infection control arrangements were in place, although some staff raised concerns about weekend staffing.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Outstanding
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found the home was consistently managed and had systems for quality checks, feedback and learning. However, some staff did not feel respected, supported or valued, and more time was needed to see whether improvement work had made a difference.
What inspectors found, March 2023
The Knole is Rated Good; inspectors found safe, personalised care, but weekend staffing and staff culture still needed improvement.
This was an unannounced focused inspection on 7 February 2023. Inspectors looked only at Safe and Well-led because concerns had been raised about safeguarding, staff skills, training and staffing. They spoke with people, relatives and staff, and reviewed care records and management information.
The home was rated Good for Safe and Well-led. Inspectors found that people were protected from avoidable harm, medicines were managed safely, staff were recruited safely and infection control arrangements were effective. They also found that the manager investigated incidents and used lessons learned to improve the service.
There were some areas to watch. Staff gave mixed feedback about weekend staffing and whether they felt respected and supported by managers. The building was larger than the recommended model for people with learning disabilities and autistic people, although inspectors found it safe, clean and adapted to people's sensory and physical needs.
Safe medicines support
Medicines were stored, given and recorded safely. Staff received training and checks of their medicines practice.
“Medicines were stored, administered and disposed of safely. Medication administration records (MAR) were accurately completed and showed people received their medicines as prescribed.” from the report
Protection from harm
Staff understood safeguarding responsibilities and knew people's needs. The manager investigated incidents and shared learning with the wider team.
“People were kept safe from avoidable harm. Staff had attended safeguarding training and understood their responsibilities around reporting concerns.” from the report
Personalised support
Care was adapted to people's communication, sensory and behavioural support needs. People were also supported with work and volunteering.
“Staff provided people with personalised, proactive and co-ordinated support in line with their communication plans, sensory assessment and positive behaviour support plans.” from the report
Activities and employment
People were supported to take part in activities and to pursue paid or voluntary work.
“People were supported to take part in activities and gain voluntary and paid employment.” from the report
Weekend staffing
needs fixingSome staff felt the home would benefit from more staff at weekends. The manager said staffing numbers and skills were being reviewed and adjusted, but this remained an area for improvement.
“Some staff told us they felt the home would benefit from more staff working at the weekend.” from the report
Staff culture
needs fixingSome staff said they did not feel respected, supported or valued by managers. Improvement measures and a timetable were in place, but inspectors said more time was needed to see the effect.
“Some staff told us they did not feel respected, supported and valued by the management team.” from the report
Size of the communal home
minorThe environment did not meet the inspection guidance principles because more than six people lived in one communal home. Inspectors still found it safe, clean and considerate of people's needs.
“The environment did not meet the principles of Right support, right care, right culture as there were more than 6 people living in one communal home.” from the report
Complex risk assessment
needs fixingProfessionals gave mixed feedback about how risks were assessed and managed for people with more complex and profound needs. The provider gave evidence of actions taken and plans to keep learning.
“We received mixed feedback from professionals about the assessment and management of risk for people with more complex and profound needs.” from the report
- 01How many staff are planned to work at weekends, and how do you adjust staffing numbers and skills when people's needs change?
- 02What specific actions have been taken to improve how staff feel respected, supported and valued by managers?
- 03How do you assess and manage risks for people with more complex and profound needs?
- 04What refurbishment or renovation work is planned for the older parts of the building, and when will it be completed?
- 05What were the ratings for Effective, Caring and Responsive at the last comprehensive inspection?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 4 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2021
Inspected but not rated; inspectors were assured that infection prevention and control arrangements were safe.
This was an announced, targeted inspection on 18 February 2021. It checked infection prevention and control arrangements during the COVID-19 pandemic, including how an outbreak was managed.
Inspectors found good practice. The home had followed its outbreak plan, increased cleaning, used protective equipment properly, arranged testing, screened visitors and supported people who had to isolate.
The inspectors were assured that the home was preventing infections, managing outbreaks, using protective equipment safely and keeping its infection control policy up to date. The service was inspected but not rated, so this report does not give an overall quality rating.
Outbreak planning
The home followed its outbreak plan and maintained adequate staffing during a recent COVID-19 outbreak.
“During a recent COVID-19 outbreak in the service, the provider followed their contingency plan for an outbreak to ensure people were supported by adequate numbers of staff.” from the report
Cleaning and ventilation
Cleaning had increased during the pandemic, and the environment was regularly cleaned and ventilated.
“Staff ensured the service was regularly cleaned and the environment was adequately ventilated.” from the report
Protective equipment and testing
Staff used protective equipment appropriately, and people and staff were tested in line with national guidance.
“Staff used the Personal Protective Equipment (PPE) provided appropriately.” from the report
Support during isolation
People were supported to stay occupied when they had to isolate in their rooms after testing positive for COVID-19.
“People were supported to remain occupied when they had to isolate in their rooms after testing positive for COVID-19” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently screened before entering the home?
- 02How are people and staff currently tested for COVID-19 or other infections?
- 03What is the current plan for maintaining enough staff during an infectious disease outbreak?
- 04How would people be supported to stay occupied and well if they had to isolate in their rooms?
- 05What cleaning and ventilation arrangements are in place now?
This was a targeted inspection of infection prevention and control under Safe; the other areas of care were not assessed and the service was not rated. This explanation was written from the published report of 6 March 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Knole
3 rated inspections over 6 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- March 2021Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- February 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- July 2012
Registered with the Care Quality Commission on 27 July 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
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