We inspected Knowles Court care Home on the 28 November and the 20 December 2017. The first day of inspection was unannounced. This was the first inspection of the service since it changed legal entity in January 2017.

Knowles Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Knowles Court Care Home has five individual single storey houses and is situated in Holmewood, a residential area on the outskirts of Bradford. At the time of the inspection only four of the five houses were occupied. Headley House provides care and support to people living with dementia. Ryecroft House provides nursing care for older people, Fairfax House provides care and support to older people and Rosewood House provides support to people with learning disabilities.

Overall we found the accommodation at Knowles Court provided people with a pleasant and comfortable environment. However, we found attention was needed to the décor and furnishings on Rosewood House especially in the communal areas. We have therefore asked the registered manager to discuss the plans for Rosewood House with the new registered providers and provide us with a written response.

There was a registered manager in post. 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.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff told us they had regular safeguarding training, and they were confident they knew how to recognise and report potential abuse. Where concerns had been brought to the registered manager’s attention, they had worked in partnership with the relevant authorities to make sure issues were fully investigated and appropriate action taken to make sure people were protected.

Overall we found there were sufficient staff on duty to meet people’s needs. However, we recommended that the registered manager kept staffing levels under review.

Staff had undertaken training relevant to their roles and there were clear lines of communication and accountability within the home.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act 2005 (MCA).

The relatives we spoke with told us they were made welcome and encouraged to visit the home as often as they wished. They said the service was good at keeping them informed and involving them in decisions about their relatives care.

People told us they enjoyed the food and we saw a wide range of food and drinks were available and people’s weight was monitored to ensure they had sufficient to eat and drink.

There was a range of activities for people to participate in, including activities and events in the home and in the local community. However, we concluded that more could be done to provide people with a stimulating environment on both the dementia care and learning disability units.

We saw the complaints policy had been available to everyone who used the service. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

The care plans in place were person centred and contained individual risk assessments which identified specific risks to people health and general well-being, such as falls, mobility, nutrition and skin integrity. However, we found some care plans had not been updated following significant changes in people’s needs.

We saw arrangements were in place that made sure people's health needs wer