This inspection took place on the 13 December 2016. Our visit was unannounced.

Kibworth Knoll provides accommodation for up to 36 people who require personal care and support. There were 31 people using the service at the time of our inspection.

The service had a registered manager. 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.

People told us they felt safe living at Kibworth Knoll. Relatives we spoke with agreed with what they told us. The staff team were aware of their responsibilities for keeping people safe from avoidable harm and knew to report any concerns to the registered manager.

Risks associated with people’s care and support had been assessed. These assessments provided the management team with the opportunity to reduce and properly manage the risks presented to both the people using the service and the staff team.

There were suitable numbers of staff deployed to meet the current care and support needs of the people using the service and to keep them safe. People we spoke with felt there were currently enough members of staff on duty each day because their care and support needs were being met.

People were receiving their medicines as prescribed by their doctor. Medicines were being appropriately stored and the necessary records were being kept. Systems were in place to regularly audit the medicines held at the service.

People received support from a staff team that had the necessary skills and knowledge. New members of staff had received an induction into the service when they were first employed and training relevant to their role had been provided to enable them to meet people’s needs.

The staff team supported people to make decisions about their day to day care and support. Where people lacked the capacity to make their own decisions, we saw that decisions had been made for them in their best interest. Where people required additional support to make decisions, advocacy support was available to them.

People told us the meals served at Kibworth Knoll were good though people’s dining experience varied. People’s nutritional and dietary requirements had been assessed and a balanced and varied diet was being provided. For people assessed to be at risk of not getting the food and fluids they needed to keep them well, records showing their food and fluid intake had been kept.

People were supported to maintain good health. They were supported to access relevant healthcare services such as GP’s, community nurses and dieticians and they received ongoing healthcare support.

People told us that the staff team were kind and caring and they were treated with respect. The relatives we spoke with agreed with what they told us. Throughout our visit we observed the staff team treating people in a kind and considerate manner.

People’s privacy and dignity was respected and promoted by the staff team.

People had plans of care that reflected their care and support needs. These provided the staff team with the information they needed in order to properly support the people using the service.

A complaints procedure was in place. Although not everyone we spoke with remembered seeing this, they all knew who to talk to if they had a concern of any kind.

Relatives and friends were encouraged to visit and they told us that they were made welcome at all times by the staff team.

Staff meetings and meetings for the people using the service and their relatives were being held. These provided people with the opportunity to have a say and to be involved in how the service was run. Questionnaires were also being used to gather people’s feedback.

The staff team felt supported by the registered manager. They explained that they were given the o

This inspection took place on the 13 and 14 January 2016 and was unannounced.

Kibworth Knoll provides accommodation for up to 36 older people who require personal care including people living with dementia. There were 33 people using the service at the time of our inspection.

The service had a registered manager. 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.

People told us they felt safe living at Kibworth Knoll. Their friends and relatives confirmed this.

Although the staff team knew their responsibilities for keeping people safe from harm, we found that a safeguarding incident had not been passed to the registered manager for their attention or action. This was immediately addressed following our visit.

People received their medicines as prescribed by their doctor though the paperwork held was not always accurate. Protocols for medicines prescribed to be taken as and when required where not in place and medicines had not always been stored appropriately. Actions were taken following our visit to remedy these issues.

People’s needs had been assessed prior to them moving into the service and plans of care had been developed from these. The plans of care seen during our visit did not always include people’s personal preferences in daily living or provide specific information as to how a person’s care and support needs should be met.

There were systems in place to monitor the service being provided, though these had not always been effective in identifying shortfalls, particularly within people’s care records and the medicine records held.

People’s consent to the care and support they were to receive had been obtained when they first moved into the service and the staff team involved them in making decisions on a daily basis. For people unable to give consent, decisions had been made in their best interests by someone who knew them well. The registered manager was working in line with the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards.

People using the service had access to the required healthcare services, were supported to maintain good health and received on going healthcare support.

The majority of risks associated with people’s care and support had been assessed and actions had been taken to minimise such risks. However, not all of the risk assessments seen during our visit were effective or reflective of people’s current situation.

The provider’s recruitment procedures had been followed, with the required checks being carried out prior to new members of staff commencing work.

People liked the meals served at Kibworth Knoll and mealtimes were relaxed. People’s nutritional and dietary requirements were assessed and a balanced diet was provided, with a choice of meal at each mealtime. Monitoring charts used to monitor people’s food and fluid intake were not always clear.

Throughout our visit we observed the people using the service being treated in a caring and considerate manner. They were involved in making choices about their care and support and when they made their choices, these were respected by the staff team.

Staff meetings and meetings for the people using the service and their relatives had been held and surveys had been completed. This provided people with the opportunity to be involved in how the service was run.

The staff team felt supported by both the registered manager and the providers of the service.

Prior to our inspection we reviewed all the information we had received from the provider. We spoke with four people who used the service, a relative and visiting dentist, for their views and experiences about the service.

We spoke with the acting manager, the proprietors of the service, the housekeeper, two care staff and a senior member of staff.

We looked at some of the records held in the service, including the care files for four people who used the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found.

Is the service safe?

People told us they felt safe with the staff team and with the environment. They also told us that staff sought consent before care and support was provided. People said they felt there were enough staff to meet their needs and that staff treated them with dignity and respect.

Comments from people included, “I feel safe knowing there is always someone around to support me.”

We found that staff were knowledgeable about people’s needs, and what was required to meet people’s needs and keep them safe.

The cleanliness of the environment was good. Infection control policies and procedures in place, meant people were protected from risks associated with infections and cross contamination.

We found there was sufficient staff employed at the service to meet people’s needs and keep them safe.

Is the service effective?

People told us that they thought staff knew and understood their needs, and appropriate action was taken when their needs changed.

Comments received from people included, “I’m happy with how I’m cared for, they (staff) look after me very well.”

People had their needs assessed, monitored and reviewed. This showed people could be assured there were systems in place that monitored their needs.

We saw the provider made appropriate referrals to health care professionals, and records demonstrated they worked together in a person centred and coordinated way.

Is the service caring?

People spoke highly of the staff that supported them. They described staff as kind, caring and compassionate.

Comments received from people included, “The staff are polite, respectful and are good natured.” And, “The staff treat you properly, are kind and caring. Nothing is too much trouble.”

Our observations found on the whole that staff were caring, thoughtful and supported people appropriately.

Is the service responsive?

People told us they had not had to make a compliant but felt confident to do so if required. They also told us they had opportunities to attend ‘residents meetings’ where they were asked for their views and opinions about the service.

Comments received from people included, “We have residents meetings where we talk about different subjects.”

We saw the provider had a complaints policy and procedure that informed people of their rights.

Is the service well-led?

People told us they thought the home was well run. Comments included, “The managers are very sociable. I think they do a good job.”

The provider had quality assurance procedures in place that monitored the quality of the service provided.

We saw accidents and incident were recorded and analysed to look for lessons learnt to reduce further incident.

We spoke with six people who used the service and a relative of another person who used the service. The relative told us that they and the person that used the service had been "very involved in decisions about the care provided." They added that they had regular contact with the manager and staff at the home and felt "very confident" about the care provided. They described the staff as "respectful and kind" and added that they "trusted staff completely."

People who used the service told us that they liked living at the home. One person told us, "I like it here. It's very pleasant. I enjoy it. I'm made to feel very welcome." All of the people we spoke with were complimentary about the quality of food at meal times. People had a variety of activities to choose from. One person told us, I can relax here. We have lots of interesting things to do." We found that the service respected people's choices of what they wanted to eat at mealtimes and about how they spent their time.

All of the people we spoke with told us that they felt that they had been well looked after. One person said, "We are very well looked after here." A relative told us, "The care is fantastic, brilliant here. I feel very confident about the care my mother receives."

We found that the home had effective recruitment procedures and that the induction new staff had received had prepared them well to be able to support people who lived at the home.

The home was exceptionally clean.

We spoke with two people who used the service and a relative of another person who used the service. All of the people we spoke with were complimentary about their experience of living at the home. One person who used the service told us that they liked living at the home because, "It's very good. It's free and easy and not restrictive." Another person told us, "It's a friendly home. I picked the right place when I was looking for a home." One person told us about resident's meetings where people had opportunities to make suggestions about aspects of living at the home. People told us that they were satisfied with the quality of care they received and activities and entertainments that the home had organised. A relative told us, "I'm perfectly happy with the level of care my mother is receiving." That relative told us about activities the home had organised, such as excursions and entertainments. The relative told us that they knew how they could raise concerns and that they felt their mother was safe at the home.

A health professional who visited the home to attend to people's nursing needs told us, "The quality of care here is fantastic. The service is very well organised and there are always staff available when I need to speak to them. I've no concerns about the health welfare of people living here."

During our visit we saw people making use of communal facilities at the home and taking part in social activities. We found that people were well cared for.

During this visit we observed people having breakfast and interacting with staff. People told us they are well cared for and happy at the home. They told us they received good support from staff and managers. People were offered a hot or cold breakfast, and three people said they enjoyed the porridge. People told us they liked having their hair done each week by the mobile hairdresser. Visitors told us they had confidence in the running of the home and are kept informed about their relative’s wellbeing.