This inspection took place on 21 December 2016. The inspection was unannounced. When the service was last inspected in February 2014 there were no breaches of the legal requirements identified.

The Knole is a home run by a Christian charity working with men who have offended or at risk of offending. Their aim is to provide assistance and support for people so that they can lead crime free lives. The service is registered to provide care and accommodation for up to 9 people. At the time of our inspection the service was providing support to 8 people.

A registered manager was in post at the time of inspection. 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.

Risks to people were assessed and where required a risk management plan was in place to support people manage an identified risk. People were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines.

Safe recruitment procedures ensured all pre-employment requirements were completed before new staff were appointed and commenced their employment. Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. People received effective support from staff who had the skills and knowledge to meet their needs. Staff demonstrated a good understanding of abuse and knew the correct action to take if they were concerned about a person being at risk.

People's rights were being upheld in line with the Mental Capacity Act (MCA) 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. Where appropriate people's support plans held information about their mental capacity and Deprivation of Liberty Safeguards (DoLS) being applied for.

People were supported to maintain good health and had access to external health care professionals when required. People’s care records demonstrated that their healthcare needs had been assessed and were kept under review.

People were supported by a small experienced team. Enabling relationships had been established between staff and the people they supported. Support plans were in place to enhance people’s independence and this ethos was promoted by the service and staff members.

A number of positive comments were provided by people about the level of care they received; “I was wary at first as it was a new environment. This location is a transition and is helping me to adjust. I have no problems with the staff. They listen and do not rush you”; “All the staff are good. I felt welcomed. I’ve been given a second chance”; “We’re well looked after”; “They help me with my finances. I’m motivated and they encourage me. We can go to the staff anytime. They give us something to look forward. They’re always here for us 24/7.”

People received care that was personal to them and staff assisted them with the things they made the choices to do. People told us they were content living in the service and received the support they required.

The registered manager was passionate about their role. They played an integral role in promoting the provider’s ethos of establishing positive foundations so that people can lead crime–free lives and become contributors to society. There was a positive culture within the service between the people who lived there, the staff and the registered manager.

To ensure continuous improvement the registered manager conducted regular compliance audits. They reviewed issues such as; health and safety, client file and risk management and client activity. The observations identified compliance rates and areas where improvements were required.

An adult social care inspector carried out this inspection. This was a follow up inspection to check on a compliance action for the management of medicines. We did not speak with people who used the service.

When carrying out inspections five key questions are asked: is the service safe, effective, caring, responsive and well led? As this inspection was following up non-compliance in one area, the question we asked was, is the service safe?

Below is a summary of what we found. The summary describes what the staff told us, what we observed and what the records told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found that the service was safe in terms of how staff gave people their medicines. Staff had received annual medicines training to ensure they were up to date with current practices. A member of staff we spoke with was able to describe how they would follow safe procedures for giving people their medicines. In addition photographs were used to help staff identify a person when giving them their medicines.

People told us they were happy with the care they received at the Knole. We spoke with four people who told us they felt they were treated with respect by staff. One person said; “all staff treat us equally, no one gets superior treatment, we are all treated the same way which is good.” People told us staff asked for suggestions about day trips and activities, which were then arranged. Staff were able to demonstrate how they treated people with dignity and respect and supported to maximise their independence.

The provider had systems in place to cooperate with other services and professionals. This enabled appropriate and safe care to be planned for people on admission to the service. Care records showed other professionals and services were regularly consulted when care was reviewed or risk assessments devised. People were supported to access appropriate health care service to meet their individual needs.

Staff told us they felt supported in their roles and managers were approachable. The provider had induction process which ensured new staff were supported to provide appropriate and safe care to people. Systems were in place for staff to access training, supervision and annual appraisals and to attend regular team meetings. There were opportunities for staff to gain additional qualifications relative to their roles.

We spoke to people and staff to see how safely medicines were managed in the home. Each person completed an assessment to see if they were able to safely self-medicate. During our visit we observed medicines being administered to one person. We found the providers processes and staff training needed improving. We saw medicines were stored safely and checked regularly.

People told us they knew how to make a complaint. The provider had suitable arrangements in place to process and monitor complaints. This included how people could make complaints to external agencies and processes to monitor complaints for potential service improvements.