Inspection on 17/07/07 for Knowle House Nursing Home

This inspection was carried out on 17th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Knowle House Nursing Home 19/04/06

Knowle House Nursing Home 30/11/05

Knowle House Nursing Home 23/06/05

Knowle House Nursing Home 05/01/05

Knowle House Nursing Home 06/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Knowle House Nursing Home Lingfield Road East Grinstead West Sussex RH19 2EJ Lead Inspector Mrs J Aston Unannounced Inspection 09:30 17th July 2007 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 Knowle House Nursing Home DS0000031332.V341069.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. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knowle House Nursing Home Address Lingfield Road East Grinstead West Sussex RH19 2EJ 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) 01342 317740 Yourcare Ltd Bernadine Victor Dias-Jayasinghe Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2006 Brief Description of the Service: Knowle House is registered to provide personal care and nursing for 35 residents aged over 65 years in the category of older persons (OP). Knowle House is a large detached three-storey house situated in a residential road near the town centre of East Grinstead. Accommodation is provided in 19 single bedrooms, 12 of which offer en-suite facilities, and 8 shared bedrooms, 2 of which offer en-suite facilities. A passenger lift provides access to most of the bedrooms. There is a lounge and conservatory, which is also used as a dining room situated on the ground floor, and there is a small lounge on the second floor. Yourcare Ltd owns Knowle House and Dr Sivasubramanian is the Responsible Individual for the company. The Registered Manager responsible for the dayto-day running of the home is Mr Victor Dias. Fee levels for the home From: £488 - £547 Knowle House Nursing Home DS0000031332.V341069.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, uses the term ‘service user’ to describe those living in care home settings. The Inspector however for this report has referred to those living in the home as “residents”. This inspection is called a key inspection as only the key standards determined by the Commission have been assessed. This inspection will determine the frequency of inspections hereafter. Planning for this inspection took place prior to the visit to the home. An Annual Quality Assurance Assessment form was received prior to the inspection and information from that will be referred to in this report. The Manager of the service was also asked to distribute a number of surveys to people living in the home, relatives, advocates and Health Care Professionals. Prior to the inspection sixteen surveys were received in total. • • • Four were received from people living in the home. Ten from relatives. Two from Health Care Professionals. Information and comments obtained from the surveys will also be referred to in this report. An unannounced visit to the home took place on the 17th July 2007. Just over seven hours were spent in the home. The Inspector looked around the home, spoke with six people living in the home, five members of staff and three relatives. A sample of records relating to residents, members of staff and the safety of the premises was examined. What the service does well: The information received whilst undertaking this inspection provides evidence that Knowle House provides a good standard of care. Residents and relatives spoken with during the visit to the home told the Inspector that members of staff were friendly and respectful, the Manager is very approachable, professional and caring and the food was very good. Residents spoken with said that members of staff respect their wishes and they are pleasant and caring.” Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 6 Comments received from relatives; “The carers are kind to the residents. They are patient and do not hurry them.” There is a friendly greeting when visitors come. There are a variety of activities going on.” “The staff are very friendly and always appear happy.” “They treat patients as individuals.” A Health Professional commented that, “The Manager Victor is a strong influence in the overall leadership team that appears to offer a dedicated service they are a hardworking bunch.” What has improved since the last inspection? The last key inspection was undertaken on 19th April 2006 and a number of requirements for improvement were made. A Random inspection was undertaken on the 29th November 2006 to follow up on compliance to the requirements. Improvements had been made in the recording of complaints, individual staff supervision and the contracts between residents and the service. Since the random inspection all hot water outlets have been fitted with thermostatic safety devices to prevent residents from scalding. Self-closure door devices have been fitted to some residents’ bedroom doors so that the doors can be safely left open without affecting fire prevention measures. The Manager confirmed that there is a continual programme to fit these within the home. Pre-admission assessments are being undertaken by the Manager prior to a resident being admitted to the home. Improvements have been made in the recording of information about residents, ensuring that the needs of each resident are reviewed, that the needs and wellbeing of residents are monitored regularly during the day and that members of staff have a clear direction of how to support each resident. From training records examined and from speaking with members of staff it was demonstrated that the training provided for members of staff has improved and they now receive a good level of training appropriate to the needs of the residents. Weekly training is provided and recent training sessions have been in nutrition, incontinence, infection control and pressure area care. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this 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. Knowle House Nursing Home DS0000031332.V341069.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 Knowle House Nursing Home DS0000031332.V341069.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): Standards 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of a prospective resident are assessed appropriately before admission to the home. EVIDENCE: During the visit to the home a sample of records relating to five residents was examined. This included a resident who had been admitted to the home in March this year. The needs of each resident had been assessed prior to admission to the home and the assessment had been recorded. The assessments covered all the needs of each resident and were dated, however where the assessment took place was not recorded. It was noted that copies of assessments undertaken by other professionals for example a Care Manager or Continuing Health Care Assessment had been obtained for most residents in the sample. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 10 A further assessment of a resident’s needs had been undertaken on admission and recorded on a care plan. Members of staff spoken with during the inspection said that they usually receive good information about the needs of a new resident. This enables the Manager to be confident that the residents’ needs are met and provides good information to members of staff before the resident moves in and on admission. A contract and terms and conditions had been agreed and signed for all residents in the sample of records examined. Intermediate care is not provided in this setting. Knowle House Nursing Home DS0000031332.V341069.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal care and health needs and wishes are recorded appropriately and are met well. The administration of medicines is managed safely and is well organised. Residents feel they are treated with respect. EVIDENCE: The needs of each resident and the support they require are recorded on a care plan. During the visit to the home five care plans were examined. Each care plan stipulates clearly the different needs of each person. A nursing care plan had also been compiled for each resident that had been signed by the resident or relative to say they had read the care plan or it had been explained to them. The care plan stipulated each need for a resident, the aim of the support and the nursing action required to ensure the resident was supported appropriately. Care plans recorded personal care needs, health needs, nutritional assessment, moving and handling assessments and risk assessments. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 12 There was evidence of daily recording on the nursing care plan and the basic care plan and they had been reviewed regularly. Where Care Managers are involved or there has been a Continuing Health Care Assessment a formal review of the needs of the resident and the placement had been undertaken. Each care plan documented health checks for each resident, health professional’s visits and any treatment or advice given. There was evidence of consultation with diabetic nurses and letters to Doctors asking for a review of medication. Residents spoken to during the visit to the home confirmed that they see their Doctor when they wish, see a chiropodist regularly, have visits from an aroma therapist and are supported to see opticians, dentist and have hearing tests. There was clear recording (including photographs) of any wound or pressure area care. These were also included in the records for administration of medication. It was noted that these had been regularly updated so the information was current. It was noted when looking around the home that equipment is in place and used to prevent residents developing pressure areas. A member of staff is allocated to each resident as their key worker. It was noted during the visit to the home that they Key worker’s name and nurses name is written on residents bedroom doors. In each room there was a Key worker review folder that recorded information about the support being provided to the resident and any changes or progress. There was also a room check sheet in each room where staff had to record daily the times they had checked the room and any needs of the resident if they were in the room. There was evidence therefore from the sample of records examined that there have been improvements in the recording of information about residents, ensuring that the needs of each resident are reviewed, their wellbeing is monitored regularly during the day and that members of staff have a clear direction of how to support each resident. During the visit to the home the storage and handling of medication was examined. The administration of medication was observed over the lunch time period and was undertaken appropriately. The Inspector found that all medication was stored appropriately and securely. The records relating to the medication administered were in good order. It was noted during the visit to the home that a resident’s privacy and dignity is respected by using screens in shared rooms, members of staff were observed to knock on residents doors and signs are used to stop other staff entering where residents are being supported with personal care in bathrooms. Residents spoken with during the visit told the Inspector that members of staff were kind and friendly and moved them gently and in the correct manner. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 13 Relatives spoken with during the visit said they always observed members of staff speaking respectfully to residents and felt that the staff knew how to move residents safely. Knowle House Nursing Home DS0000031332.V341069.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): Standards 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. There are activities for those who wish to participate. Residents are assisted to maintain relationships with family and friends or representatives. The food provided is of a good standard and promotes individual choice. EVIDENCE: Knowle House has a dedicated activities organiser who works in the home on a daily basis. It was noted during the visit to the home that residents took part in activities during the morning. There is a programme of activities and trips out are organised. A party has been arranged for residents and relatives in July. A resident who due to disability remains in bed told the Inspector that staff have read to him on occasions but this hasn’t happened so much recently. This was mentioned to the Manager and has been addressed. There is a large garden that is easily accessible and is well maintained. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 15 Relatives spoken with during the visit said they felt they could visit at any time and are made welcome. The Manager promotes good relationships with relatives by holding a regular meeting with them to update them on any changes in the home and to ask for feedback about the service. Minutes of these meetings are kept and were seen during the visit. It was noted during the visit that personal possessions have personalised residents’ rooms. Residents confirmed that they are able to get up when they want to and spend time in their rooms if they so choose. There are routines within the home around mealtimes. The service does not manage money on behalf of residents’ only small amounts of money for hairdressing and chiropody. Where a resident cannot manage their financial affairs relatives are asked to take over through Power of Attorney. The Inspector ate lunch with the residents. The dining area is in the conservatory that is also used as a nurse’s station where records are kept. It was noted that there is not sufficient space in the dining area for all residents to sit at a dining table so quite a few residents ate in the lounge in their chairs with small tables. A relative and Health Professional both commented on the dining room and said, “The dining area could be improved.” The meal was cooked well, tasty and well presented. It was noted that the daily meal with an alternative was written on a board in the lounge. Dessert was served from a trolley by care staff that allowed residents to see what was being served. It was noted that care staff provided residents with support with eating in an appropriate and sensitive manner. There were sufficient staff on duty and the timing of the meals had been organised so that where residents ate in their rooms they also had support to eat their meal. The Chef was spoken to during the visit who confirmed the type of special diets he provided, that he used plenty of fresh vegetables, fruit and good quality meat and although had to stay within a budget this was reasonable and manageable. There is a sufficient number of kitchen staff to ensure the cleanliness of the kitchen and to provide suppers so that members of care staff are not required to become involved with preparation of food. The Chef confirmed that his food hygiene training is up to date. Knowle House Nursing Home DS0000031332.V341069.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are appropriate procedures for dealing with complaints. Through training the staff team have awareness about signs of abuse and know how to report any allegations. EVIDENCE: A complaints policy and procedure are in place. The material received prior to the visit to the home recorded that twenty complaints had been received in the last twelve months, all had been resolved within twenty-eight days and two were upheld. The complaints log was examined during the visit and it was noted that all complaints had been recorded appropriately with action taken to resolve complaint and the date the complaint was received and action taken. The Commission has not received any complaints in respect of this service. Residents spoken with said they would be happy to speak to the Manager if they were dissatisfied with anything. Relatives spoken with also had confidence in speaking with the Manager and that action would be taken. A relative who responded to the inspection through surveys said, “There is a meeting held every three months. We can speak to the Manager at any time.” Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 17 The West Sussex Multi-disciplinary Adult Protection Procedures are followed by the home. From training records it could be seen that members of staff have received training in recognising signs of abuse and this is updated as required. Members of staff spoken with during the inspection confirmed that they have received training in recognising signs of abuse and how to report this. Knowle House Nursing Home DS0000031332.V341069.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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The property is well maintained, safe and provides a homely environment. EVIDENCE: The Inspector looked around the home during the visit and identified that Knowle House provides a clean, comfortable and homely place to live in. All residents rooms had been personalised and the dining area, lounge and conservatory all looked clean and homely. The garden is attractive and well kept. The home is also a safe place for residents as all radiators had been covered, the Manager confirmed that all hot water outlets in residents’ rooms and bathrooms had safety thermostatic valves fitted, safety checks and maintenance visits are kept up to date on equipment and utilities. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 19 Procedures and measures are in place to prevent infection in the home. There is a dedicated staff team for care, laundry, cleaning and working in the kitchen. There were adequate sluicing facilities situated on each floor. Since the last inspection a nurses’ station has been situated in the conservatory area. Although there are advantages to this as the Manager or nurse on duty can observe members of staff and residents this infringes upon communal space available for residents and detracts from the homely feel and atmosphere in the home. This was discussed with the Manager who made the Inspector aware of a programme of improvements that will address this matter. The Manager agreed to consider how this area could be made less like an office and that information about residents was kept confidential. Knowle House Nursing Home DS0000031332.V341069.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): Standards 27, 28, 29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home’s recruitment procedures do not safeguard residents. Members of staff receive training appropriate to the needs of the residents. EVIDENCE: The staff team consists of the Registered Manager, Group Care Manager, six trained nurses, six Senior Care assistants, four care assistants, two domestic staff, two kitchen assistants and two laundry assistants and four members of staff who are available to cover leave or sickness. The care staff team currently consists of eleven female and two male members of staff and there is a mix of ages, different nationalities and levels of experience. The numbers of staff employed in the home and the mix of staff meets the needs of the residents well. The Annual Quality Assurance Assessment form confirmed that there have been no agency members of staff employed in the home in the past three months. The information provided in the Annual Quality Assurance Assessment form confirmed the staffing levels within the home. On the day of the visit to the home there was an appropriate number of staff to meet the needs of the residents. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 21 Members of staff spoken with confirmed that the staffing levels allowed them to do their job well and have time to sit and talk with residents or support them with an activity. Residents spoken with during the visit said the staff were respectful, kind, friendly and felt they knew how to move and assistant them. Relatives who responded to the inspection through surveys said, “The carers are kind to the residents. They are patient and do not hurry them.” “Treat patients as individuals.” The records relating to seven new members of staff employed in the home since the last inspection were examined. National Minimum Standards and Regulations require that any member of staff recruited must have all the necessary checks in place before working in the home. The criminal record bureau guidance states that where a Manager feels that they need to start a member of staff working in the home before a criminal record check is received, as not to would leave the home understaffed, then a check against the register of Protection of Vulnerable Adults (POVA first check) must be in place along with all other checks before that person is undertaking training or works in the home. They must be supervised at all times. It was found from the records examined that there was a lack of recruitment checks in place. For one member of staff who had started working in the home in May of this year there was no evidence of references, POVA first check or a criminal record check. This person was asked to leave after working in the home for two days. Another member of staff who started working in the home in June this year had no written references, only a record that a verbal reference had been received but no details of this were recorded. A member of staff who started working in the home in January of this year, a CRB was received but there was no POVA first check and no references on file. This was discussed with the Manager during the inspection and an explanation given however it is the responsibility of the Registered Manager to ensure the fitness of the person before allowing them to start training or work in the home. The lack of good recruitment procedures leaves residents at risk. Therefore a requirement has been made for the Manager to adhere to the regulations and CRB guidelines. The Annual Quality Assurance Assessment form confirmed that all permanent care staff are supported to achieve National Vocational Qualifications (NVQ) Level 2. Currently out of the thirteen permanent care staff employed in the home seven members of staff have achieved NVQ level 2 and two are working towards this. Members of staff spoken with confirmed that the management of the home have supported them well through their NVQ training. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 22 From training records examined and from speaking with members of staff it was demonstrated that members of staff receive a good level of training appropriate to the needs of the residents. Weekly training is provided and recent training sessions have been in nutrition, incontinence, infection control and pressure area care. A training session was held in the home during the visit. Other training that has been provided was confirmed by members of staff in moving and handling, infection control, dementia, understanding strokes and diabetes, fire and recognising signs of abuse. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 23 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): Standards 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Knowle House is managed by an experienced Manager and is well maintained. The Manager however needs to safeguard residents through appropriate recruitment procedures. Relatives manage residents’ finances where a resident lacks the capacity to do this. EVIDENCE: Mr Victor Dias was appointed in March 2006 and approved for registration as the Registered Manager in April 2007. Mr Dias has a nursing qualification, at least two years management experience and is working towards the Registered Managers Award. Many changes have been made in the home that has improved the quality of the care provided to residents. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 24 The Registered Manager ensures that there is a good communication system and quality monitoring system in the home through handovers after each shift, regular meetings with nursing and care staff, meetings with relatives. A quality assurance exercise is undertaken on an annual basis and the questionnaires have been recently updated to ensure they are user friendly. A business plan is in place for 2007 and the Annual Quality Assurance Assessment form confirms that the development plan will be reviewed for the next twelve months. Relatives who responded to the inspection through surveys said, “I have regular contact with Victor Dias and the other staff.” “The staff are always friendly and approachable. The Manager is always around or easily contacted.” “There is a meeting held every three months. We can speak to the Manager at any time.” The policy of the home is not to handle large sums of money for the residents and records showed that small amounts of spending money are held and accurate records and receipts are kept for all transactions. The residents who have chosen and are able to manage their own money are supported to continue to do so. Records seen on the day of the inspection and information provided prior to the inspection demonstrate that annual safety inspections are undertaken on equipment and utility supplies and maintenance systems are in place to ensure the safety of residents. It was noted that accidents and incidents are recorded appropriately and the Manager monitors these. A record of falls is kept and an analysis of falls within the home is undertaken. On the day of the visit to the home the call bell system although ringing the panels located throughout the home were not displaying the number of the room where the call alarm had been activated. When the call bell had been activated members of staff had to visit each room to see which resident was requiring assistance. This was discussed with the Provider and Registered Manager and an explanation for this given. Written confirmation was received from the Registered Manager the day after the visit to the home confirming that the call alarm system would be checked again and brought up to its fullest working capacity and that a new system would be installed in September 2007. Training records demonstrated that members of staff received training in mandatory topics such as moving and handling, infection control, first aid, safeguarding adults and fire as part of the induction programme and as refresher training. Training needs are assessed as part of the individual supervision with members of staff. It was confirmed by members of staff spoken with that individual supervision is provided on a regular basis and regular staff meetings are held. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 25 A requirement has been made under Standard 29 in respect of recruitment checks. As this is a management issue and therefore this outcome area has been rated as adequate. Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 26 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 27 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. 1 Standard OP29 Regulation 19 Requirement The Registered Provider must not employ any member of staff in the home unless the full recruitment checks have been undertaken and there is evidence of this kept in the home. This must include POVA first checks where a member of staff might start induction training or supervised work in the home before the criminal record check is received so a Timescale for action 17/07/07 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 Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 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. Extracts may not be used or reproduced without the express permission of CSCI Knowle House Nursing Home DS0000031332.V341069.R01.S.doc Version 5.2 Page 29 - 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. 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