CQC report explained · a residential care home
What the CQC found at The Knowls
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable risk assessments, safe premises and safe medicines procedures. Staff had safeguarding training and recruitment checks were completed before they started work.
- Effective?
- Good
- People had detailed support plans, suitable training and access to healthcare professionals. Staff supported people with food, healthcare and decisions in line with the Mental Capacity Act.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were supported to make choices, follow their routines and develop independence.
- Responsive?
- Good
- Care was personalised and people were supported with relationships, hobbies, activities and community access. Communication needs and complaints were also addressed.
- Well-led?
- Good
- The home had visible and approachable leadership, regular audits and an action plan for improvements. Staff reported good teamwork and felt listened to.
What inspectors found, December 2019
Rated Good; inspectors found safe, kind and personalised care, with some planning still in progress.
The CQC made an unannounced inspection visit on 3 December 2019. One inspector spoke with people and staff, observed care and checked support plans, medicines records, staff records and health and safety information.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, detailed support plans and care that promoted choice, independence and community activities.
People were described as comfortable and relaxed with kind staff. The home had systems for checking quality and responding to incidents or complaints. Inspectors also noted that the home was larger than current best practice guidance, although they said its design and location reduced the impact of this.
Choice and independence
People were supported to make day-to-day decisions, follow their own routines and build skills for greater independence.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Kind and respectful staff
Inspectors saw people who appeared comfortable with staff. Staff stayed calm when people were anxious or distressed and did not use physical restraint.
“People were cared for by staff who were kind and caring. People looked very comfortable with the staff who supported them.” from the report
Personalised support
Support plans gave staff detailed information about people's needs, preferences and communication. Staff knew people well and helped them follow their chosen routines.
“Support plans were very comprehensive which made sure staff had all the information they required to meet the person's needs in accordance with their preferences.” from the report
Activities and relationships
People were supported to keep in touch with family and friends, pursue hobbies and take part in activities at home and in the community.
“People took part in activities at the home and in the community. During the inspection some people took part in an art session and other people went out shopping.” from the report
Quality monitoring
The provider and manager used regular checks and action plans to monitor standards and make improvements.
“There was a series of audits which were completed regularly in house and an annual quality and compliance audit completed by the provider.” from the report
Home is larger than current guidance
minorThe home accommodated 13 people and was larger than current best practice guidance. Inspectors said the building design and location helped reduce the negative impact.
“13 people were using the service. This is larger than current best practice guidance.” from the report
End of life plans not yet written
needs fixingThe home had general end of life policies, but no individual plans had been written at the time of inspection.
“The provider had policies and procedures regarding end of life care and dealing with a sudden death, but we were told no individual support plans had been written.” from the report
Active support programme still being introduced
minorThe provider was still introducing programmes intended to formalise people's goals and aspirations.
“The provider was in the process of implementing 'Active support programmes' for everyone.” from the report
- 01How will you create an individual end of life support plan if my relative needs this care?
- 02What progress has been made with the Active support programme for my relative?
- 03How does the home's size affect daily life, privacy and individual support?
- 04How will you support my relative's preferred routines, hobbies and contact with family?
- 05How do you make sure staff understand my relative's communication and support plan before working with them?
This was a planned but unannounced inspection covering all five CQC questions, including the care provided and the home's premises. This explanation was written from the published report of 31 December 2019 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, May 2017
Rated Good and remained Good; inspectors found safe, kind and personalised care, with earlier medicines risks addressed.
This was an unannounced comprehensive inspection on 21 April 2017. One inspector spoke with two people living at the home, three staff members and three social care professionals. The inspector also reviewed care plans, staff files, medicines records and quality checks.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. Inspectors found enough trained staff, suitable checks for new staff, systems to manage risks and good support with health, nutrition and decisions.
People were treated kindly and respectfully. Staff knew people's needs and preferences, supported activities and family relationships, and involved people in planning their care. The manager was visible and the provider used regular checks to monitor and improve the service.
At the previous inspection in April 2015, some medicines practices were not safe. This inspection found that the home had changed its procedures by using labelled pots, a lockable container and protected time for medicines administration. The overall rating remained Good.
Improved medicines safety
The home changed how medicines were labelled, carried and administered after risks were identified at the previous inspection.
“Staff placed a person's medicines in a pot with the person's name on the lid and transported the medicines in a lockable container.” from the report
Skilled staff and health support
Staff received training and support to understand people's complex needs. People had health action plans, hospital passports and access to health professionals.
“People were supported by staff who had the skills and knowledge to meet their needs.” from the report
Kind and respectful care
Inspectors saw a calm atmosphere and respectful interactions. People were supported at their own pace and could spend time privately if they wished.
“The atmosphere in the home was relaxed and people were supported in an unhurried manner.” from the report
Personalised activities and relationships
Staff knew what people enjoyed and supported them to take part in activities, go on trips, maintain relationships and work towards personal goals.
“People were supported to follow their interests and take part in a range of activities, trips and holidays.” from the report
Visible management
The manager was accessible and knew people's needs and preferences well. The provider used regular audits and reviews to check the service.
“The registered manager was very visible in the home and it was evident that people were comfortable in their presence.” from the report
Inspectors raised no specific concerns in this report.
- 01How are medicines currently labelled, stored, transported and administered, and how do you prevent staff being distracted?
- 02What training and supervision do staff receive for the complex needs of people living here?
- 03How are each person's health appointments, hospital passport and health action plan kept up to date?
- 04How are activities, family visits and personal goals recorded and reviewed with each person?
- 05What were the results of the most recent quality checks, satisfaction surveys and complaints since this 2017 inspection?
This was an unannounced comprehensive inspection covering all five questions, and the report says the overall rating remained Good after the previous inspection in April 2015. This explanation was written from the published report of 17 May 2017 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 Knowls
3 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Registered with the Care Quality Commission on 20 June 2014.
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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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.