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Inspection on 30/01/07 for Knowle Park Nursing Home

Also see our care home review for Knowle Park Nursing Home for more information

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 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.

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

What the care home does well

The home has a stable staff team who demonstrated to the inspector that they knew the service users well and good interaction between them was noticed on the day. They were enthusiastic with the training that takes place and certificates were displayed in the laundry room for all the housekeeping team. One relative told the inspector that `I visit at all different times of the day and I am always treated the same the staff are very caring. I cannot fault it here`. A service user stated `I am very happy here the staff are wonderful`. Another told the inspector `everybody is so good and patient with us`. One service user told the inspector `weather permitting I walk in the grounds everyday they are beautiful`.

What has improved since the last inspection?

All requirements from the previous inspection and the recommendations have now been met. The manager now carries out pre-admission assessments prior to service users moving into the home. The home`s statement of purpose has been amended and all employment checks are now carried out prior to any person working at the care home.

What the care home could do better:

One recommendation was made for the manager to seek the views of stakeholders to the home to further improve the quality of the service and to feed back the results to the service users.

CARE HOMES FOR OLDER PEOPLE Knowle Park Nursing Home Knowle Lane Cranleigh Surrey GU6 8JL Lead Inspector Lesley Garrett Key Unannounced Inspection 30th January 2007 10:00 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 Park Nursing Home DS0000017621.V325441.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 Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knowle Park Nursing Home Address Knowle Lane Cranleigh Surrey GU6 8JL 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) 0208-547 2640 netra.longhurst@slnh.co.uk www.slnh.co.uk South London Nursing Homes Limited Mrs Netra Louise Longhurst Care Home 49 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (49), of places Physical disability (4) Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 4 service users from the age of 50 years within the category of Physical Disability (PD). Up to 2 service users may be between 40-50 years within the category of Physical Disability (PD). Up to 9 service users may be within the category of Dementia (DE(E)). Date of last inspection 4th October 2005 Brief Description of the Service: Knowle Park is a large country house surrounded by extensive grounds on the outskirts of Cranleigh. The home is owned by South London Nursing Homes Limited, which has its offices, in the grounds, in an adjacent building. The home provides accommodation and nursing care for up to forty-five residents, the majority of whom are over the age of 65 years. The house has been adapted to provide good-sized en-suite bedrooms and many communal areas throughout the home. The home is approached via a long driveway and there are small visitors parking lots to the front of the home and a larger parking area to the rear. The fees for the rooms are between £70 to £170 per day Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit formed part of a key inspection and took place over six hours commencing at 0950 and finishing at 1530. Mrs L Garrett regulation inspector completed the visit. The registered manager assisted the inspector with the inspection process and members of staff were interviewed. A tour of the premises took place and the inspector spoke to some service users and viewed their bedrooms. A pre-inspection questionnaire has been completed by the service and the information provided will assist with this report. Feedback has also been received from comment cards completed by service users and their relatives. Records were sampled as part of the inspection process including care plans, policies and procedures and employment records. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this site visit. What the service does well: What has improved since the last inspection? All requirements from the previous inspection and the recommendations have now been met. The manager now carries out pre-admission assessments prior to service users moving into the home. The home’s statement of purpose has Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 6 been amended and all employment checks are now carried out prior to any person working at the care home. 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 Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 7 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 Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 8 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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission assessment that is undertaken ensures that service users can be confident that their health care needs will be met. The home does not provide intermediate care. EVIDENCE: The registered manager stated that she or her deputy carries out all preadmission assessments prior to service users moving into the home. The manager also stated that all of her senior registered nurses have also been trained in this procedure. Two individual plans of care were sampled on the day of the site visit that demonstrated that the assessments had been completed. The home does not provide intermediate care. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have individual plans, which reflect the care, and support they require and their health care needs are fully met. The medication policies and procedures that are in place and implemented by staff protects service users during this procedure. The privacy and dignity of the service users is respected. EVIDENCE: Two individual plans of care were sampled and they were found to contain detailed care plans, risk assessments and daily notes. The manager stated that the home has recently changed their system for documentation. The inspector observed that the home now has computer that will generate and store their documentation. The manager stated that every month when the nurses update the plans on the computer they are then printed into a paper format and these are kept in the service users bedroom where they then can be discussed and Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 10 the service user has access to them. The inspector saw evidence of service user involvement and in some cases their representatives had also contributed. The manager stated that service users have access to a local general practitioner (G.P.) who visits the home every week. A ‘comment card’ received from the G.P stated ‘first class nursing home. Staff are excellent and their care is exemplary’. The home also has the support of other specialist’s and the manager explained that the dietician’s will visit and speech and language specialist comes when required. The manager also stated that the tissue viability nurse and palliative care nurse have all visited various service users when the need had arisen. The inspector sampled three medication administration records (MAR) and found that they contained no gaps. The medication policy is available for all registered nurses that administer the medications and the inspector saw this policy. The inspector noted that blister packs are used for the administration of tablets and the home’s local pharmacist dispenses this. The manager stated that she caries out an audit every month on the medication procedures. The manager stated that the home has a privacy and dignity policy and this is discussed with all new employees at induction. All bedrooms are single ensuite so personal care is given there and visiting professionals can also be seen in the privacy of service users own bedroom. All rooms have a telephone so that service users can make calls as they wish. The inspector observed staff knocking on doors prior to entering and therefore promoting the privacy of service users. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 11 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with activities that match their expectations and preferences. They can maintain links with their families and friends and have access to the local community as they wish. Service users are helped to exercise choice and control in their lives and receive a wholesome balanced diet. EVIDENCE: The manager stated that the home has three part time recreational therapists to assist and provide service users with activities. She said that two carers also assist and the inspector spoke with one who enjoys providing activities in one to one or very small groups for service users with dementia. A programme of activities is available for all service users and the inspector observed this. On the day of the site visit the inspector observed service users in one of the lounges after lunch attending an art group. The inspector spoke with staff and all were very enthusiastic about the provision of activity in the home. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 12 Church services were observed on the activity programme by the inspector to be a regular feature with the Roman Catholic priest, Baptist Minister and Church of England vicar regular visitors to the home and church service or Holy Communion is held at the home regularly. The manger stated that other denominations could be catered for when the need arises. Family and friends are welcomed to the home and the manager said there are no restrictions to the visiting time. It was also stated that all visitors to the home could see their relative or friend in private if requested. The manager stated that service users are able to make choices in their daily lives. Service users stated that they are given a choice of meal and may choose the time they get up in the morning or go to bed. Observation of service users’ bedroom confirmed that personal possessions are permitted in the home. The inspector spoke with some service users about the provision of food in the home. One service user said that ‘the food is always good and if you don’t like it they will give you something else’. The inspector saw the tables laid in the dining room with tablecloths and napkins and juice or water was available. The staff was distributing the menus for the day and the inspector observed service users making their choices. The inspector met the head chef and was told that there had been a visit by the environmental health officer the day before and no requirements had been made. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 13 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives can be sure that any complaint will be taken seriously and acted upon. Service users are protected from abuse as staff had clear knowledge of the procedures for safeguarding their welfare. EVIDENCE: During this site visit the inspector saw, clearly displayed, the home’s complaint policy and this contained clear timescales for action. Comment cards received by the Commission prior to the site visit indicated that most of the respondents knew about the policy. The manager keeps a complaints log and all complaints received last year were resolved within the timescales and there are no on going issues. The home has a safeguarding adults policy and the manager stated that the home refers to the local authority policy. The staff has received training in the local authorities procedures for safeguarding adults. There was one referral made under the local authority procedures, last year, which has been satisfactorily resolved. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 14 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained, decorated and furnished to a good standard and the facilities are safe and clean. EVIDENCE: The inspector observed a well-maintained environment, which provides aids and equipment to meet service users care needs. All bedrooms meet the national minimum standards or are larger all with en-suite facilities. The communal areas allow service users to meet their relatives or friends in a variety of settings if they wish. The inspector spoke with the buildings manager who visited on the day of the site visit. He stated that he talks with the manager to compile a schedule of repairs and decoration. The home has a full time maintenance person and two gardeners. Service users have access to the grounds, which are kept tidy and Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 15 safe for their use. One service user told the inspector ‘I go for a walk every day weather permitting. I really enjoy the outside’. The home has a good sized laundry and on the day of the site visit the person operating the laundry had a good knowledge of infection control procedures and was pleased to show the certificates for all the training that has taken place for all the housekeeping staff. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 16 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff and the skill mix was adequate to meet service users assessed needs and training (including national vocational training) takes place to ensure service users are in safe hands at all times and that staff are competent to do their jobs. Service users are protected by the home’s recruitment policy and procedures. EVIDENCE: There were adequate numbers of staff on duty for the number and needs of service users, with a good skill mix. The manager stated that she has some empty beds but that staffing numbers had not been reduced. The inspector looked at the rotas and the staff rota sent with the pre-inspection questionnaire and found numbers were consistent. The manager stated that the home has the capacity to increase staff numbers if dependency levels or numbers increased. Four out of five ‘comment cards’ received from relatives indicated that they were satisfied with the staffing arrangements while one person stated that they felt staffing was insuffficent. National Vocational Qualification (NVQ) training takes place regularly and over 50 of staff has this certificate. The inspector met with the training coordinator who stated that she works with new staff on the induction programme, which is linked with the national induction standards for care. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 17 The inspector sampled three recruitment folders. The home had all the necessary documentation required including two references, application form and gaps in employment history, which had been explored. All applicants have had a criminal record bureau check prior to commencing employment. The inspector spoke with the training co-ordinator who explained that all mandatory training takes place and this includes fire awareness, protection of vulnerable adults and manual handling. A record was sampled of all training that has taken place and that which is planned. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 18 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 33 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a manager that is fit to be in charge and is run in the best interests of the service users. Service user’s financial interests are safeguarded. The health, safety and welfare of service users is promoted and protected. EVIDENCE: The manager has been in post for four years and has the required qualifications and experience and is competent to run the home. The manager stated that she has an open door policy, which allows service users and visitors to the home to see her at any time. On the day of the site visit several service users and visitors came to speak to the manager. Service users that the Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 19 inspector spoke with spoke highly of the manager telling the inspector that ‘she is lovely’. The manager has a strong staff team and this was demonstrated to the inspector, as they were all willing to speak openly and positively about their jobs and responsibilities within the home. The manager stated that she holds service user meetings every three months and relatives are also invited with minutes kept of the meetings. The manager has completed service user surveys but it is recommended that the home seek the views of other stakeholders also. Service users may keep some personal money with the home for safekeeping and the manager said that this is then kept in the safe and receipts and a record kept of all transactions. The inspector had the pre-admission questionnaire to check that certain health and safety checks and certificates were in place and these included the electrical certificate. The gas certificate and the lift have been checked as was evidenced by certificates that were also made available on the day of the site visit. The manager stated that fire alarms are tested weekly and the buildings manager said that the home is about to start some work on the water tanks therefore until this has been done the Legionella checks have not been completed. The buildings manager said that regular checks on the water takes place and has been satisfactory. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 20 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 X 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 3 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 Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 21 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. 1 Refer to Standard OP33 Good Practice Recommendations It is recommended that the manager seek the views of other visiting professionals to the home to improve the quality monitoring within the home. Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. Extracts may not be used or reproduced without the express permission of CSCI Knowle Park Nursing Home DS0000017621.V325441.R01.S.doc Version 5.2 Page 23 - 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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