The inspection took place on 15 June 2017 and was unannounced. A registered manager had recently left the home. A new manager had been recruited by the provider and was in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Knowle Gate Care Home provides accommodation and personal care for up to 60 older people who live with dementia. 46 people were living at the home at the time of our inspection and most of those people lived with dementia.
The home is situated in Solihull, West Midlands. Communal areas in the home included large spacious lounge areas, dining rooms, a room where people could follow their interests and hobbies, a bistro and a cinema room. The home also had large well maintained gardens.
A month before our visit the provider of the home had changed. A plan was in place to manage the change. People were satisfied with home was run. Some staff told us they were looking forward to working with the new provider. Others felt apprehensive about the changes. The future leadership at the home had been discussed with staff and they assured us they had had the opportunity to attend team meetings and ask questions which had made them feel more supported and involved.
People felt safe and were happy living at the home. Procedures were in place to protect people from harm. Staff understood their responsibilities to keep people safe and were confident to raise any concerns with their managers. They understood the risks to people's individual health and wellbeing and risks were clearly recorded in people’s records. Our discussions with staff demonstrated a consistent approach to the management of risks. Detailed plans were in place to ensure people would receive continuity of care if an unexpected event occurred such as, fire.
Accident and incident records were completed. The provider had implemented a new system to analyse the records each month to identify any patterns or trends to reduce further incidents occurring. Equipment was checked by staff and external contractors to make sure it was safe to use.
The provider's recruitment procedures minimised, as far as possible, the risks to people safety. There were enough qualified, skilled and experienced staff to meet people's needs.
New staff were provided with effective support when they first started work at the home. People and their relatives told us staff had the skills and knowledge they needed to care for them. Staff completed training and demonstrated an in-depth knowledge of people’s care and treatment needs. They were skilled and confident in their practice. We saw staff put their learning into practice and offered reassurance and comfort to people throughout our visit.
The staff demonstrated an understanding of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) so that they could ensure peoples' rights were being protected. The managers understood their responsibility to comply with these requirements. For people who were assessed as not having the capacity to make all of their own decisions, records showed their families and health care professionals were involved in making decisions in their best interests. Staff always obtained people's consent before they provided care and support.
Most of the people we spoke with provided positive feedback about the food and dining experiences at the home. Mealtime experiences were enjoyable for people and they received a varied and nutritious diet. Staff demonstrated good understanding of people’s nutritional needs and people had opportunities to plan food menus in partnership with the chef. Medicines were stored safely and people received their medicines as prescribed. The provider and staff team worked closely with external healthcare professionals to ensure people's health and wellbeing was promoted and maintained.
People spoke positively about the staff that provided their care. Staff we spoke with showed concern for people's wellbeing and demonstrated they knew the people they cared for well. Several people had recently moved into the home from a nearby home run by the same provider. Some staff had also moved with the people to ensure they received care from staff they knew.
People and their relatives worked in partnership with the staff to plan their care which meant staff had an in-depth knowledge of people's preferences and support needs. Most care plans provided personalised information about people’s their preferred routines, likes and dislikes. The new provider was in the process of implementing a new care plan document which would be written from the person’s perspective. Training to ensure the staff had the skills they needed to write the care plans had begun to take place.
A keyworker system was in place. This meant people were supported consistently by a named staff member. People told us staff involved them in decisions about their care and staff knew the importance of people being involved in these decisions. People were encouraged to be as independent as they wished to be. People were treated with respect and were cared for in a dignified way.
We received positive feedback about how the service was personalised and responded to people's individual needs. People received care which was in line with their wishes and preferences. We saw throughout our visit staff responded quickly to people’s request for assistance.
People were encouraged to maintain relationships important to them. Relatives were encouraged to be involved in their relatives care and there were no restrictions on visiting times. Overall, people spoke positively about the varied social activities that were available to them to occupy their time.
People and their relatives were invited to attend regular meetings so they could make suggestions about how the home was run. People and their relatives knew who to speak with if they had any concerns or complaints about their care and all felt confident concerns would be dealt with appropriately and fairly.
Staff told us they enjoyed working at the home, they felt supported by the management team and they received regular supervision of their work. The new provider and the managers promoted an open culture by actively encouraging feedback from people, their visitors and staff to put forward their suggestions to make continual improvements at the home.
The provider took action to ensure the home was run in-line with people’s wishes. We saw good examples of team work and communication between the staff and their managers during our visit. The provider had a staff awards scheme that recognised contributions from staff, and recognised outstanding skills in caring for people at the home.
There were systems to monitor and review the quality of the home. There was an emphasis on continually looking for ways to improve the service people received, and also looking at learning if care fell below the standards the new provider expected.