Inspection on 31/07/08 for Knellwood

This inspection was carried out on 31st July 2008.

CSCI found this care home to be providing an Good service.

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.

Other inspections for this house

Knellwood 01/08/07

Knellwood 29/11/06

Knellwood 30/01/06

Knellwood 18/08/05

Knellwood 27/09/04

Knellwood 06/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Knellwood 83 Canterbury Road Farnborough Hampshire GU14 6QN     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter McNeillie     Date: 3 1 0 7 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Knellwood 83 Canterbury Road Farnborough Hampshire GU14 6QN 01252542169 01252541153 knellwood@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Janet Gover Type of registration: Number of places registered: Farnborough (War Memorial) Housing Society Limited care home 52 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 52. The registered person may provide the following category/ies of service only: Care home with nursing only - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Knellwood is a large home situated in its own extensive grounds located in the North Hampshire of Farnborough and within easy access to shops, local amenities, the railway station, bus routes and the M3 motorway. The home is owned and managed by a non profit making charity and provides accommodation for up to 52 residents over Care Homes for Older People Page 4 of 28 Over 65 0 0 0 0 Brief description of the care home the age of 65 some od whom may have nursing needs or dementia. Responsibility of the day to day running of the home is with the registered manager who is responsible to the homes board of management. The home charges between 389 pounds and 453 pounds a week for residential care and 815 pounds for nursing care exclusive of personal items such as hairdressing, chiropody, newspapers, escort duties and toiletries. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, previous reports, residents records, staff training and recruitment records and responses to an in house satisfaction survey by residents and their representatives. We talked with residents, staff and management and received a response by the manager to a pre inspection Annual Quality Assurance Assessment. (AQAA). This inspection took place on 31/07/08 between the hours of 8.45am and 1.45 pm during which all of the key standards for older persons and any previous requirements were inspected. The results and findings contained in this report will determine the frequency and type Care Homes for Older People Page 6 of 28 of future inspections. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well-developed system of planning and reviewing care, which reflects residents, wishes, and aspirations and ensures residents needs are met within a risk management policy involves residents and residents representatives or relatives in decisions that affect them. Evidence: Samples of four residents pre admission assessments were viewed. These were produced in a format that took into consideration the needs, wishes, choices and aspirations as well as any risks to the potential resident and were in accordance with the homes pre admission policy and procedure. The procedure requires that a detailed written assessment of need and risk by a member of the homes management team being carried out in consultation with the Care Homes for Older People Page 10 of 28 Evidence: prospective resident. The procedure allows for a trial admission followed by a review before a permanent place is offered. This ensures the resident is happy with the placement and the home is sure they can meet the assessed needs. As part of the admission process management also liaise with external health and social care professionals regarding any care needs, risks, equipment and aids, that need to be taken into consideration when developing a plan of care. Records viewed also confirmed ongoing assessments of need and risk for all residents are carried out on a regular basis and care plans (Section 7-11 of this report refers) updated to reflect any changes. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well-developed system of planning and reviewing care, which reflects residents, wishes, and aspirations and ensures residents needs are met within a risk management policy involves residents and residents representatives or relatives in decisions that affect them. Evidence: At the last inspection the following requirements were made. 1) Care plans must set out in detail the action which needs to be taken to ensure that all aspects of care needs are met. Residents must be involved in reviewing care plans.2)The home must refer residents to the appropriate health care professionals when residents health is deteriorating and 3) Medication records must be correct so that an audit trail can be followed. As part of or inspection we viewed a random sample of four residents care plans and other records.. Care Homes for Older People Page 12 of 28 Evidence: All of the care plans which were reviewed at least monthly were based on pre admission assessments to identify what help and support individuals needed and any attendant risks. (The previous section of this report; standards 1-6 refers). Some residents verbally confirmed they were consulted about and participated in the production of the plan, others could not remember. All of the residents spoken with confirmed they were very satisfied with the care and support they received. They advised us they were contented, liked the staff and management and were treated with respect. They felt wanted and would recommend the home to anyone. Individual residents responses to our questions about how they were cared for, liked living in the home and the quality of the service included comments such as Its lovely here I am very content and want for nothing, Well satisfied, Care is very good The staff are very kind and look after us all very well A1 hotel service especially the food.. Resident also confirmed that their privacy was respected and that staff always knock on their bedroom door and wait before entering, a practice we observed during this visit. Residents right, and the opportunity to take risks is seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. This process identified individual risks and how they were to be managed. Staff who had a good understanding of the contents of the care plans and risk assessments and were able to explain how the care plan was put into day-to-day practice. Residents informed us were able to see the doctor of their choice(currently approximately thirty doctors from seven practices visit) or any other health and social care professional when they needed to. The records viewed indicated that apart from doctors, district nurses, physiotherapists, occupational therapists, other specialists had been consulted when required. Records were kept of appointments with all health and social care professionals, these included details of any advice and treatment given. To ensure equality and diversity are promoted within the service the home informed us in their Annual Quality Assurance Assessment completed by the manager ( In the Care Homes for Older People Page 13 of 28 Evidence: AQAA): Policies and procedures adopted within the Home. The staff handbook highlights the requirement for anti-discriminatory practice. Religious needs are met through the local community, either by Residents attending a place of worship, or an appropriate member of religion being welcomed into the Home. Care of the dying policies and procedures take into account both the wishes of the Resident and any religious observations of their religion. Ageist attitudes are not tolerated within the Home either by staff working in the Home or by visiting professionals. We pride ourselves by having a mixed workforce with members of the team coming from various backgrounds. Medication records confirmed that all prescribed drugs, which are securely stored, are dispensed by a pharmacist into a blister pack system. These are administered in accordance with a medication policy and procedure by staff all of which have received training in the administration, recording and the security required when handling resident’s drugs and medication. All staff handling medication told us they were aware of and had read the procedure. The record of drugs and medicines administered to residents and unwanted drugs disposed of were complete and accurate. A procedure was in place to enable residents who wish to assume responsibility for their own medication. At the time of the inspection no resident was managing his or her own medication in accordance with a risk assessment. In the light of our findings we were satisfied all the previous requirements had been complied with Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Family contacts the provision of varied and nutritious meals and the availability of social activities were well managed and reflected residents interests and choices. Evidence: Following the last inspection a requirement was made that: The activities programme for residents with dementia must be reviewed and specific activities accessed as necessary to ensure residents with dementia can benefit. A varied social activities calendar, which is regularly updated was available. whilst some residents residents expressed how important the activities were and how much they enjoyed them others took the opposite view and said all they wanted was to be left alone. This mirrors the findings of the homes manager in responsed to an in house quality audit.( Standards 32 to 38 0f this report refers). All confirmed that participation was up to the individual; no one was forced to join in. The manager informed us that the local Alzheimers society was being consulted and their advice sought to ensure that the needs of residents with dementia were also being addressed. In the light of our findings we are satisfied the previous requirement Care Homes for Older People Page 15 of 28 Evidence: has been complied with. The home has regular visits from local Church of England and Methodist clergy who conduct services and communion in the home. The needs of members from any other Christian denominations and faiths would, if required be catered for but at the time of this visit no members from other faiths were residing in the home. Visitors are always welcome, and can share a meal in private with the person being visited if they wish. All are encouraged to feel at home and if required overnight on site accommodation can be made available. Residents said they were fully consulted and were able to exercise choice in all aspects of their lives for example; when to get up and go to bed, mealtimes and where meals are taken, visiting times, the right to receive and converse with visitors and to make and receive telephone calls in private either by using a telephone installed in a private booth or a phone in their own room. We were informed that about 50 of residents had had a private phone installed. A written daily menu based on residents likes and dislikes was displayed. We highlighted the need to ensure that the menu was displayed in format that all residents would understand. This is of prime importance for persons with dementia who may find the addition of pictures would be beneficial to understanding the daily menu and when making choices. The manager gave a verbal undertaking he would look into the way menus were displayed in future. All of the residents spoken with expressed in glowing terms total satisfaction regarding the quality, quantity, choice and presentation of food served. We were invited to share the midday meal with residents and are able to confirm the quality ,choice and presentation of the food was as described by residents. Special diets can be catered for. Residents appreciated helping themselves from serving dishes on the table another example of them being in control and exercising choice. From records seen, the inspector also noted, that apart from attending a number of training courses, the home’s cook also holds a diploma in nutritional health. Whilst there are set meal times advertised service users confirmed these are flexible Care Homes for Older People Page 16 of 28 Evidence: and changed to meet service users wishes/appointments etc. Those responsible are to be congratulated for the excellent manner in which this most important area of day to day living is managed. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure was satisfactory with evidence that residents feel their views will be acted upon . The home has clear policies and procedures in place which ensures residents are protected from abuse. Evidence: Following the last inspection a requirement was made that: All staff must understand protection of vulnerable adults procedures. From discussion with management and records viewed we were satisfied that the home has an Adult Protection policy and procedure that operates in tandem with the policy and procedure produced by Hampshire County Council that is designed to safeguard residents from abuse. Records and staff spoken with also confirmed they had received training in recognizing various types of abuse. All were able to demonstrate they knew the procedure to follow should they witness or suspect the abuse of any resident. In view of these findings we were satisfied the previous requirement had been complied with. The homes complaints procedure, which included information on how to contact The Care Homes for Older People Page 18 of 28 Evidence: Commission for Social Care Inspection (CSCI) was seen, as was a record of complaints. The procedure, which was included in the service users guide was also displayed within the home. No complaints had been received by CSCI since the last inspection. Residents spoken with said they felt comfortable in raising any concerns they had with the homes management or any member of staff and were confident any matters raised would be dealt with fairly and promptly. Staff also confirmed they felt confident in raising any matter or complaint with the homes management on behalf of a resident. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: All areas of the home were clean and free from unpleasant odors and obvious hazards. Residents confirmed the home is always clean and smells fresh. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs. All rooms were decorated to a high standard and well maintained. Residents commented how satisfied they were with their accommodation. All communal areas were accessible by residents including the well-tended established and safe garden. Apart from personal mobility aids a number of communal aids had also been provided to assist residents, these included special beds, lifts, hoists, grab rails, and ramps. There is a rolling programme of maintenance to ensure that the building is well maintained, decorated and kept safe for residents and staff. The manager informed us any new furnishings and decorations will take into Care Homes for Older People Page 20 of 28 Evidence: consideration the particular environmental needs of persons with dementia. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The staffing rota viewed confirmed the planned daily staffing levels for the home each day is: 8am–2.30pm: The Manager,a qualified nurse shift leader six carers, a cook, kitchen assistant, five cleaners, two laundry assistants,a gardener, a handyman and an administrator. 2.30pm- 9pm: The Manager (for part) a qualified nurse shift leader, six carers and a kitchen assistant. 9pm to 8am; A qualified nurse shift leader, four carers plus an on call member of the management team o for advice and emergencies etc. At the time of this visit, in our view the number of management, care and support staff available met residents needs, a view supported by the staff and residents who informed us there were always enough staff on duty and they rarely had to wait for attention. We viewed four staff recruitment and training files selected at random. All files included evidence that staff are employed in accordance with a robust recruitment, equal opportunities and selection procedure, which is designed to protect Care Homes for Older People Page 22 of 28 Evidence: residents. This involves the completion of an application form, the signing of a rehabilitation of offender’s declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed that all staff are subject to an in house/corporate induction and compulsory training programme that include first aid, handling medication, food handling, moving and handling, POVA, infection control and dementia in compliance with a previous requirement.On completion of their induction all staff are expected to undertake a National Vocational Qualification N .V. Q.) training course. Information provided by the Registered Manager in the AQAA indicated that 65 of permanent staff has been trained to at least NVQ level two, with a further 10 currently on a course leading to a level two qualification. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents, whose views about living in the home are formally sought. Evidence: The Registered Manager who, since the last inspection has ensured all previous requirements have been complied with has had experience in managing resources for older persons for many years. She is is a qualified Registered Nurse and has Registered Managers NVQ level four qualification and has recently been involved in a training initiative leading to a Diploma of Higher Education in Health Care. In talking with staff we were satisfied that the home has a clearly defined management structure. Staff were aware all of their responsibilities and the limits of their authority. Care Homes for Older People Page 24 of 28 Evidence: Staff described the management as approachable and accessible and willing to listen to any ideas they may have for the improvement of the service. As part of the homes quality monitoring system, residents and their relatives and staff are invited to participate in satisfaction surveys however, currently the views of health /social care professionals involved with the home are not sought a verbal undertaking was given by the manager this group would be included in future surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health/ safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents, procedures to follow in the event of fire (including evacuation) and ensuring of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and radiators and hot pipes were covered to prevent a resident or staff being burnt. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!