Inspection on 30/01/07 for Knoll House

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Knoll House 29/01/09

Knoll House 16/11/05

Knoll House 04/04/05

Knoll House 22/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Knoll House Ingram Crescent West Hove East Sussex BN3 5NX Lead Inspector Linda Boereboom Key Unannounced Inspection 30 January 2007 13:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knoll House Address Ingram Crescent West Hove East Sussex BN3 5NX Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01273 267588 01273 267589 annie.hampson@brighton-hove.gov.uk www.fosteringinbrightonandhove.org.uk Brighton & Hove City Council Anna Hampson Care Home 20 Category(ies) of Physical disability (20) registration, with number of places Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Only adults aged eighteen (18) years and over on admission can be accommodated. A maximum of twenty (20) service users to be admitted. Only service users with a physical disability requiring Intermediate Care can be accommodated. 16th November 2005 Date of last inspection Brief Description of the Service: Knoll House is an Intermediate Care Service residential unit that provides rehabilitation services for up to twenty service users 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, completed in 2004 to comply with the National Minimum Standards. It is owned 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 rooms, all of which include a shower or bath. Separate assisted bathing facilities are also available. Rooms are fitted with a telephone, television, and lockable facilities. The home is on two floors, separated into three units, each providing accommodation for six or seven residents; there is a passenger lift 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. There is also a day service unit on the ground floor of the building with a communal canteen/dining area, which can be accessed by residential service users. A local General Practitioner visits the home weekly, and can be contacted by staff whenever medical treatment is required. Since 2006, Knoll House has become a non -smoking environment. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Knoll House will be referred to as ‘residents’. This inspection took place over a period of two days, with the Inspector visiting the home on the first day to look at the premises and talk to staff and residents; in addition she also attended a staff meeting to gain more understanding of the running of the home. On the second day the Inspector returned and looked through the homes administrative processes including staff and resident files and at the end of the inspection gave an overview of her findings to Mrs Annie Hampson the homes Registered Manager and Mrs Cheryl Burtenshaw the Assistant Deputy Manager. Twenty resident surveys and staff surveys were sent out at random by the Commission for Social Care Inspection prior to the Inspectors visit to the home, on the day of writing this report six residents and one member of staff had replied to the Inspector. The Inspector would like to thank all the staff at Knoll House for their contribution in making the inspection a pleasure to undertake. What the service does well: Knoll House continues to offer residents a caring, homely and relaxed environment that places their needs first. It provides short-term accommodation with physiotherapy, occupational therapy and nursing treatment in order to assist residents in maintaining or improving their independence to enable them to return home after a stay in hospital, or to prevent the need for a hospital admission. The home provides many aids and adaptations to enable service users to move around the home more independently, and also provides advice, assistance and equipment to help service users maintain their independence when at home. The management approach of the home is positive and supportive, taking into account the wishes and feelings of both residents and staff. Attention is paid to the training and supervision of staff enabling them to perform their duties with confidence. Quality assurance is a priority and management staff are Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 6 committed to ensuring that health and safety is maintained for the well being of both residents and staff. Comments received by the Inspector from residents included: ‘No-one could ask for more’ (relating to receiving care and support) and ‘I think we need more of these places which really help people to get back on their feet. They have certainly helped me!’ What has improved since the last inspection? What they could do better: There will not be any requirements made in this report, however two areas that could be improved are the provision of more activities should residents request them and for staff to ensure that residents are seated nearer to their telephones in the home. Comments were made by recent residents in the home and taken from two residents surveys relating to these issues. Please contact the provider for advice of actions taken in response to this Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in the home are provided with information about the service prior to admission and receive an information pack on admission. All residents are assessed for admission to Knoll House in their place of residence at that time and are made aware how Knoll House differs from hospital care. EVIDENCE: The Inspector spoke with the Deputy Assistant Manager about information available to residents in Knoll House as it differs from other residential care and is for rehabilitation of residents prior to going home or to prevent admission to hospital. The agreed target for Knoll House with the Primary Care Trust and South Downs Health Trust is that residents stay in the home for Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 10 a period of 17-26 days depending on their degree of disability and individual needs, in addition it is expected that Knoll House has 6 admissions and 6 discharges each week. A Nurse Assessor assesses prospective residents at their place of residence that is usually at home or hospital; occasionally in a residential care home. Referrals for admission are made through the GP’s or Community Nursing Teams across Brighton and Hove. Residents agree a package of care and are informed about the role of Knoll House as an Intermediate Care Home. The Inspector spoke with one resident who had been a patient in Knoll House twice and she confirmed having been provided with sufficient information on both occasions. There is a procedure in place for staff to record that each individual resident has agreed his/her treatment, these records were seen by the Inspector. Knoll House has a specialised team of staff from different disciplines within the National Health Service who are able to meet the needs of the residents, if at any time a resident needs additional care, steps are taken to move them to a hospital or other care setting that is more suitable. Trial visits to the home are optional and the choice of the resident, however as prospective residents are often already being cared for these visits do not often take place unless a relative or friend is able to visit for them. The home has specialised equipment and staff to deliver short-term intensive rehabilitation to enable residents to return home as soon as possible. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans belonging to residents include sufficient information to enable their care, rehabilitation and social needs to be met. The home has suitable medicine storage and administration system; care staff that administer medication are appropriately trained. Residents are treated respectfully and their privacy and dignity acknowledged. EVIDENCE: Requirements from the last inspection relating to recording of residents care needs, and risk assessment of residents had been addressed. The Inspector saw that each resident had an individual plan of care and those spoken with confirmed they are consulted about their care planning regularly throughout their stay in Knoll House. Care plans outlined the goals and Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 12 objectives for individual residents with details of their medical history, dietary status, skin integrity, any specialised assistance required and daily progress reports. There were also details of monitoring residents weight and daily exercises. Each care plan had a summary and information from planning and case meetings. The Inspector was shown a discharge-planning document, kept by the Registered Manager that outlined the progress of each resident from admission to the estimated date of discharge. In addition to the nurses, rehabilitation assistants, occupational therapists and physiotherapists within Knoll House, the home has access to specialists within the National Health Service Framework which includes chiropodists, dieticians, the Community Mental Health Team and hearing and sight specialists; there is a GP and hospital consultant also attached to the home, the latter of which was visiting on the day of inspection. On arrival in the home medication is checked by a qualified nurse and a rehabilitation assistant. Items are recorded and the medication re-assessed if necessary. On admission residents are risk assessed for being responsible for their own medication and throughout their stay steps are taken to help them to be as independent as possible with taking their medicines. Only trained staff and trained rehabilitation assistants give medication. Each room has a lockable facility for storage. Residents spoken with by the Inspector all said their medicines arrived on time and that staff were very helpful to them. Knoll House has a privacy and dignity policy which is promoted in the home and the Inspector noted that care staff knocked on doors before entering and were polite and respectful as well as sensitive and friendly in conversation with residents. Care staff spoken with by the Inspector said that confidentiality, and its importance is dealt with during the induction process. Residents praised care staff for their cheerfulness and manner when dealing with them with one person writing in a survey to the CSCI ‘They (the care staff) carry out their duties in a very cheerful and helpful manner’. The home has a policy in place outlining the procedure when a resident is nearing the end of life. Residents are admitted to Knoll House with a primary intermediate care need which does not preclude people with terminal illness, each situation is judged on its own merit and any resident who becomes terminally ill whilst in Knoll House is treated individually and if necessary would be moved to another caring environment e.g. the local hospice, who can fully meet their nursing needs. During this time families are welcome to stay and share the home’s facilities. The Inspector received an email from an NVQ Assessor (National Vocational Qualification) prior to the inspection that read; ‘I have been consistently impressed by the high standard of care and compassion demonstrated by staff at Knoll House. I find it a pleasure to Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 13 assess there, all staff are polite and show great respect and consideration to residents that I have observed them with’. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Knoll House are involved in daily routines and activities with encouragement from the care and rehabilitation staff although this is largely related to their exercise classes. Residents are able to maintain contact with their friends and relatives who are permitted to visit freely throughout the day. EVIDENCE: At the last inspection a requirement was made relating to more activities being available for residents. Following that staff in the home tried on several occasions to engage residents receiving the service in more social activities including art, cake making and reminiscence afternoons. A DVD player was also purchased. The Registered Manager told the Inspector that attendance had been varied and inconsistent depending on the people staying in the home at any one time, added to which most residents only stayed for a short while. The Inspector spoke with residents during the inspection who said they felt tired after the morning activities of exercises and working together with the Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 15 physio and occupational therapists and did not want to join any further activities; this was also reflected in some of the residents’ surveys received by the Inspector prior to the inspection. One resident told the Inspector that she had asked to see a vicar and staff had arranged for one to visit. The Assistant Deputy Manager confirmed that all new residents are asked about their normal social contacts and where possible arrangements are made to support this during their stay. Visitors to the home are made welcome and residents told the Inspector that they are either offered tea or able to make their own in the communal kitchen. Visiting is not restricted and all visitors are met at reception and asked to sign themselves in and out as a record of who is in the home. At the time of inspection the Registered Manager was arranging training for all staff in ‘restrictive practice’ to ensure that residents are allowed autonomy and choice, taking into account their individual capacity. Residents confirmed they are given a choice of meals and all said the quantity, quality and variety offered was good. The Inspector received a survey from one resident saying ‘the food is excellent and nicely served’ whilst others replied that they ‘usually’ liked the food on offer. All residents spoken with said their meals always arrived hot. During the inspection the Inspector noticed menus on view in the communal sitting/dining areas giving residents the menus for the day. At the last Environmental Health Inspection in March 2006 Knoll House was awarded the Clean Food Award. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 16,17 and 18. This judgement has been made using available evidence including a visit to this service. Knoll House has policies and procedures in place to ensure that residents’ views, concerns and complaints are listened to and they are protected from risk of harm, neglect and abuse. EVIDENCE: The senior management staff who work at Knoll House have ensured that the Commission for Social Care Inspection has been made aware of any serious concern or incident within the home. The Registered Manager is pro-active in encouraging staff to record all complaints and concerns no matter how minor and the Inspector, who attended a staff meeting, noted that the ethos of the home is to learn from any complaints made with a view to improving staff practice. All complaints are recorded and managed according to the policies and procedures as outlined by Brighton and Hove City Council and South Downs Health Trust. The Inspector saw up to date records of incidents, concerns and complaints and a record of any in-house investigation relating to the protection of vulnerable adults. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 17 The Inspector spoke with the Assistant Deputy Manager who said that Knoll House is registered for the postal voting system and staff would ensure that anyone wanted to vote would be assisted to do so. The Inspector looked at staff records and those sampled showed that staff are Criminal Records Bureau checked prior to working at Knoll House; staff also confirmed this during conversation. Staff said they receive training in the protection of vulnerable adults during their induction training with the opportunity to attend refresher courses at a later date. The Inspector presented staff with a scenario involving adult abuse and staff showed a common sense approach, all were aware of the different types of abuse and levels at which they would be investigated. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26. Quality in this outcome area is Excellent This judgement has been made using available evidence including a visit to this service. Knoll House is specifically designed to provide short-term intensive rehabilitation using fully trained staff and specialised equipment. The surroundings are warm, comfortable, safe, spacious and modern. EVIDENCE: Knoll House provides a well-maintained bright and cheerful environment for its residents. Accommodation is provided in twenty single en-suite rooms, all of which include a shower or bath. Separate assisted bathing facilities are also available. Rooms are fitted with a telephone, television, and lockable facilities. The home is on two floors, separated into three units, each providing accommodation for six or seven residents, and there is a passenger lift to all levels. Areas are named after flowers or colours and are reflected in the Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 19 decoration. 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. There is also a day service unit on the ground floor of the building with a communal canteen/dining area, which can be accessed by residential service users. The Inspector saw a works schedule for Knoll House relating to areas of work both internally and externally with dates for completion of work, these included improvements and repairs to the roof area and guttering and general internal maintenance and decoration. Laundry facilities are placed away from the communal and kitchen areas. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Knoll House employs a specialist team of workers from different disciplines to look after its residents and help them maximise their independence. Recruitment policies are thorough and care is taken in the selection of staff. Care is also taken to ensure all staff receive sufficient training to help them in their work. EVIDENCE: The Inspector spoke to residents in the home who said they felt the home to be well staffed and that staff responded very quickly if they pressed their call alarm. Knoll House employs a number of multi disciplined staff including social workers, qualified nurses, rehabilitation assistants, occupational therapy assistants catering staff and household staff to meet the full needs of the residents. The Registered Manager told the Inspector that she is currently recruiting nursing staff for an ‘outreach’ service that is being implemented to care for intermediate care patients in care homes locally. This is part of a new project organised by the Primary Healthcare Trust who fund a number of beds with Knoll House providing some specialised care. The home also has the support of district nurses and other healthcare professionals if necessary. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 21 Staff told the Inspector they have the opportunity to take NVQ (National Vocational Qualification) 2 and 3. At the time of inspection 10 rehabilitation assistants were undertaking one or the other. The managements staff at Knoll House encourage their staff to improve their working skills and knowledge and the Inspector was told that 2 staff had gone on to further training to become registered nurses. Having looked at the recruitment procedure and staff recruitment files the Inspector decided that the recruitment in the home is excellent with records being kept of CRB (Criminal Records Bureau) checks and references for each member of staff. Records also showed that CRB’s are renewed three yearly for all staff. In addition a professional register is kept of all professional staff working in the home. Staff from all disciplines confirmed receiving induction and the shadowing of existing staff. Staff training is encouraged and a bulletin is regularly produced and pinned to the staff notice board for staff to put their names forward for basic and refresher training. One new member of staff told the Inspector ‘As a newcomer I have found the induction course and training to be really well organised’ The Inspector received an email from the home’s NVQ Assessor prior to the inspection, part of which read: ‘I am an RGN and have a background in Nursing Home Management prior to becoming a Lecturer/Assessor for Northbrook College. I have observed and managed staff in a vast variety of care homes and feel the staff at Knoll House are amongst the best there are. I am also aware it is not often you as inspectors are given positive feedback, and this is well deserved’. Other parts of the email relating to care and respect of residents is included in this report under Health and Personal Care. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,24,25,26,27 and 38. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Knoll House is well managed and the Registered Manager and staff ensure that it is run to ensure the best interests of the residents; there are clear lines of accountability with staff being well supported and supervised; care is taken to ensure the residents are protected. EVIDENCE: Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 23 Knoll House is managed by a qualified registered nurse who, since the last inspection has been registered by the Commission for Social Care Inspection to manage the home. During the inspection the Inspector attended a staff meeting and included in the agenda were topics covering the care of residents, social setting, organisational issues, health and safety, and training opportunities for staff. During the meeting staff were encouraged to share their views. In October 2006 residents, their family and friends, and staff were given the opportunity to complete a quality questionnaire, the results of which had been collated into an improvement plan for Knoll House. The plan to make improvements included aspects of running the home, training for staff to support residents with mental health needs, more time for physiotherapy assessments for residents prior to admission, improvement to the level of night staff on duty, a directory of services for residents and improving the reliability of transport. Comments taken from the completed questionnaires included ‘I cannot fault the care I received from all the staff -110 !’ and ‘The accommodation and food was first class’. South Downs Health Trust and Brighton and Hove City Council jointly ensure that the home is covered by relevant insurance, the certificates are on view in the main reception area. The Inspector spoke to staff who confirmed they received supervision and appraisals, records of which are kept. Staff attend safety training during their induction period that is on going throughout their working life in the home. Moving and handling training is undertaken yearly with separate training to use the hoists. The Assistant Deputy Manager is a qualified moving and handling assessor. All records kept by the home are stored appropriately. The home has an Intermediate care policy for documentation and record keeping that supports records being clearly written, dated, timed and signed. Policies and procedures are reviewed regularly and where necessary in line with Brighton and Hove guidelines. The Inspector in the year prior to this inspection regularly received Regulation 26 reports on the home which are also discussed with staff at staff meetings; In addition Regulation 37 reports from the home have also been received relating to any accidents or incidents within the home; all are is stored on the home’s service file at the Commission for Social Care Inspection (CSCI). The Registered Manager has continued to promote good communication between Knoll House and the CSCI throughout 2005 to 2007. Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 24 The Home has health and safety policies and procedures in place relevant to the running of the service these include policies for the prevention of healthcare associated infections. To ensure resident safety a risk assessment policy and procedure is used that covers service delivery, staffing, facilities within the home as well as maintenance, and the environment. The Inspector looked at records that showed risk assessments take place on the building including the kitchen area, laundry, offices, all staff and public areas, the activities area, bedrooms bathrooms and treatment rooms; Regular checks are undertaken on the water system with shower heads being removed and thoroughly cleaned three monthly and annual samples of water tested from hot water outlets annually. Residents confirmed that the water temperatures in their individual bathrooms are checked weekly. All cleaning fluids are kept locked in designated storage cupboards. The lighting system is checked weekly and all equipment regularly serviced. Fire training is compulsory. The home’s fire safety policy had been completely revised to accommodate the new Government legislation. The Registered Manager told the Inspector that she was organising training for staff to be made aware of the new information. In addition Knoll House has become a No Smoking environment with a Smoking Cessation Advisor visiting weekly to support staff and residents in stopping smoking for life. There are appropriate health and safety signs on view in the home. . Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 3 4 3 4 3 3 4 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 3 3 3 3 3 Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Knoll House DS0000060589.V324770.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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