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Inspection on 08/04/10 for Knoll House

Also see our care home review for Knoll House for more information

This is the latest available inspection report for this service, carried out on 8th April 2010.

it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: Knoll House The quality rating for this care home is: The rating was made on: two star good service 2 9 0 1 2 0 0 9 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Elizabeth Dudley Date of this annual service review: 0 5 0 3 2 0 1 0 Annual Service Review Page 1 of 8 Information about the service Address of service: Ingram Crescent West Hove East Sussex BN3 5NX 01273267588 01273267589 annie.hampson@brighton-hove.gov.uk www.brighton-hove.gov.uk Brighton & Hove City Council Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : physical disability Conditions of registration: Number of places (if applicable): Under 65 Over 65 20 0 The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category/ies of service only: Care home with nursing - N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical disability - PD Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Knoll House is an Intermediate Care Service residential unit that provides rehabilitation services for up to twenty residents with an average stay of between seventeen and twenty six days following discharge from hospital or to prevent admission to hospital. There is no charge to the resident for the service. The home has been purpose built and refurbished to comply with the National Minimum Standards. It is owned by Brighton and Hove City Council and managed by Brighton and Hove City Council and South Downs Health NHS Trust. Knoll House is situated in Hove, East Sussex, close to local transport and amenities. Accommodation is provided in twenty single en-suite Annual Service Review Page 2 of 8 2 9 0 1 2 0 0 9 rooms, all of which include a shower or bath. Separate assisted bathing facilities are also located throughout the home. Rooms are fitted with a telephone, television, and lockable facilities. Accommodation is provided over two floors, separated into three units, each providing accommodation for six to eight residents. There is a passenger shaft lift providing access to all levels. The staff team includes Rehabilitation Assistants, Registered Nurses, Physiotherapists, Occupational Therapists and Social Workers. The home has a range of specialist facilities; aids and adaptations for meeting intermediate care needs, including a physiotherapy room and a rehabilitation kitchen. There is communal seating and a dining area on each of the three units. A local General Practitioner visits the home weekly, and can be contacted by staff whenever medical treatment is required. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received or asked for, since the last inspection. This included: The Annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being attained for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened to the service users. We refer to these as notifications and it is a statutory requirement for the registered persons to inform the Care Quality Commission within 24 hours of their occurrence. Monthly reports the provider is statutorily obliged to make and, if required, to submit to the Commission. The registered provider can undertake these, but more likely this is fulfilled by an appointed person with no connection to the home. We refer to these as Providers reports. The previous key inspection and the results of any other visits that we have made to the service in the last twelve months. Relevant information from other organisations. The last key unannounced inspection took place on the 29th January 2009. What has this told us about the service? The registered manager returned a comprehensive Annual Quality Assessment Review (AQAA) when we asked for it. This gave us sufficient information to enable us to review what has occurred in the home in the past twelve months. A telephone discussion was also held with the manager to identify any changes that may have taken place during the period between the receipt of the AQAA and this Annual Service Review. The Care Quality Commission did not send out questionnaires to residents prior to this Annual Service Review on this occasion, as the AQAA identified that questionnaires have been given to residents by the home and the Intermediate Care Service. The last inspection report was positive and showed that outcomes for residents were good across most areas. Four statutory requirements were made and these required the manager to ensure that all prospective residents have sufficient information about the home and the home to provide written confirmation to the prospective resident that the home is able to meet their needs. The second requirement was that sufficient leisure activities were provided for residents following discussion with them and a third requirement asked the home to ensure that robust recruitment processes prior to employment of new staff were in place. The home was also required to ensure that Annual Service Review Page 4 of 8 adequate quality monitoring systems were in place to ensure that the services provided met the needs and wishes of the residents. The manager has given assurances that all of these requirements have been met. The AQAA tells us that the home has produced a new brochure which is given to prospective residents by staff at the hospital to ensure that people know about the home before they come to live there. The home ensures that written confirmation that the home can meet their needs, is also given to prospective residents prior to admission. Preadmission assessments are currently undertaken on prospective residents by Intermediate Care Service Staff at the residents current hospital but the manager retains the right to refuse admission should the home not be able to meet the individuals needs for whatever reason. The manager assured us that all people have a care plan following admission which is completed initially within twenty four hours of the person being admitted to the home, and updated and reviewed at a minimum of monthly intervals. Care plans are formed in consultation with the resident or their representative. The AQAA informed us that people can keep their own GP if within the distance covered by that specific practitioner, otherwise they receive these services from a practice which is dedicated to the ICS and this specific home. Other health care professionals such as Occupational therapists, Physiotherapists and Registered Nurses form part of the staff in the home. The home is proactive in accessing various other health care professionals such as Tissue Viability and Infection Control specialist nurses, and the home has its own infection control champion ( a member of staff who has undertaken specific training in this area and liaises with the Health Protection Agency). Comments from residents during the last inspection showed that they were happy with the standard of care provided. The manager informed us that the provision of leisure activities for residents has increased, with the home now having specific staff responsible for providing leisure activities and volunteers helping out with providing an art group and a Pat a Dog scheme. Activities now take place three or four times a week. At the last inspection the residents in the home had varied opinions about the menus and food provided. Since this time resident satisfaction with the food has been surveyed and this forms part of the homes quality monitoring process. An Environmental Health Authority inspection took place in January 2009 and the home was awarded 5 stars in the Scores on Doors initiative for cleanliness and food preparation systems in place. The AQAA informs us that the home has had five complaints in the past twelve months of which two were substantiated, it also informs us that there have been seventeen adult safeguarding alerts raised. The commission has only been informed of six of these and this was discussed with the manager as informing the commission of any incident that affects residents is a requirement under regulation. The manager gave Annual Service Review Page 5 of 8 assurances that the commission would be informed as soon as she is aware of any alerts being made. Information that staff have received ongoing and thorough training in adult safeguarding gives us confidence that staff are aware of their responsibilities and that the home is being proactive in dealing with any issues that arise. The AQAA showed us that staff have received training in both the Mental Capacity Act and Deprivation of Liberty Safeguards. The AQAA states that numbers of staff employed is in relation to the needs of the residents in the home at any specific time. The commission has not been made aware of any concerns regarding the numbers of staff on duty at any time during the past twelve months; although some comments that there were sometimes staff shortages were received at the last inspection. The manager assures us that robust recruitment procedures are now in place and all staff receive the checks as required by regulation prior to commencing work at the home including a criminal records bureau check at enhanced level. The manager assured us that she is aware that any people volunteering their services for non care work must have the same checks as employed staff and this is being carried out. The manager was unsure as to whether new care staff continue to have an induction course comparable to the Skills for Care common induction standards, although the manager confirmed that all staff have a induction course specific to this home. The last inspection report showed that the amount of staff training given was variable and staff attendance was dependent on whether staff could be released from duty. The AQAA states that Both the City Council and the Trust provide training opportunities for staff. Staff development is held as a high service priority and training programmes for staff are robust. Of the twenty one care staff or rehabilitation assistants employed in the home, eight have attained the National Vocational Qualification in Care at level 2 or above. The home should continue to be proactive in encouraging staff to attain this qualification. The manager has been in post for five years and is registered with the commission. We are informed that during this time she has kept herself updated both managerially and clinically. Staff meetings are held at frequent intervals and the staff receive regular formal supervision. The AQAA confirmed that all utilities and equipment used in the home have been serviced on a regular basis and that policies and procedures used in the home have been reviewed. Staff undertake mandatory health and safety training and the manager told us that fire drills now take place at intervals. All the records available provide enough evidence to suggest the home is continuing to look at ways to improve the delivery of care, and how this can be better accomplished to ensure that the residents enjoy their stay in the home and are rehabilitated to either Annual Service Review Page 6 of 8 return home or go onto other care establishments. What are we going to do as a result of this annual service review? The Commission is reasonably confident that the service is continuing to provide high standards of care, and will continue to monitor the service through ongoing processes. A key inspection will be carried out by 30th January 2012 The Commission has the power to inspect the service at any time particularly if there are concerns about the quality of service, or the safety of the people using the service. Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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