Inspection on 20/11/05 for The Knells Country House

This inspection was carried out on 20th November 2005.

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

The Knells Country House 25/05/06

The Knells Country House 26/04/05

The Knells Country House 10/11/04

The Knells Country House 26/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Knells Country House The Knells Houghton Carlisle Cumbria CA6 4JG Lead Inspector Mrs Margaret Drury Unannounced Inspection 20th November 2005 09.10 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 The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 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. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Knells Country House Address The Knells Houghton Carlisle Cumbria CA6 4JG 01228 526496 01228 514872 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) Mrs Amanda Farrer Mrs Amanda Farrer Care Home 23 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (23) of places The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 23 service users to include: - up to 23 service users in the category of OP (Older people, not falling within any other category) - up to 5 service users in the category of DE(E) (Dementia over 65 years of age) The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 26th April 2005 2. Date of last inspection Brief Description of the Service: The Knells House is owned and operated by The Knells Country House Ltd. and run on a day-to-day basis by Mrs. Amanda Farrer, a partner of the company. The home is situated on the outskirts of the village of Houghton, approximately seven miles from the city of Carlisle. The Home is an older property, which has been adapted for its present use. The accommodation for service users is on two floors and access between the floors is by passenger lift or stair lift, as well as a staircase. The bedrooms are mainly for single occupancy, but there are three bedrooms that can be used by two people sharing. There are two communal lounges and one dining room. There are toilets and bathrooms equipped to assist people with a disability. There are spacious, pleasant gardens surrounding the home with seating areas. There is a car park. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home and the second one this year, with the visit taking place over one morning. During the inspection, time was spent talking with the manager, care staff on duty and the cook. The inspector looked at the care plans, other documentation and records to do with the day-to-day running of the home and the care of residents. Time was spent talking with some of the residents in the lounge and in their own rooms. The inspector was also able to speak with family members who were visiting the home at the time of the inspection. What the service does well: The manager carries out in-depth assessments of people before admission to the home to ensure their individual needs can be met and the correct level of care given. The care planning systems are very good and all residents are given the opportunity to be involved in the care planning process if they wish. The care staff have all the information required to deliver a high level of care to the residents. All healthcare needs are met, with an up to date record of all professional healthcare visits and external appointments. The manager said the home has an excellent working relationship with visiting healthcare professionals, with district nurses visiting the home on a regular basis. There is a programme of activities and the home has it’s own transport for outings all year round although only a few residents want to go out during the cold weather. Residents said there was usually something going on but they did not have to join in if they did not want to. Efforts are made to ensure that a nutritious and varied menu is provided with a choice at each meal. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 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 The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 5 Residents benefit from a formal admission process with all prospective residents having a full assessment of need prior to admission. EVIDENCE: No resident is admitted to The Knells without a full assessment of need being completed. The registered manager, who ensures the home is able to deliver the correct level of care, carries this out. All residents have a contract and terms and conditions, which is issued when they are admitted to the home. Prospective residents and/or their families are encouraged to visit the home and meet the staff and other residents before deciding whether or not to move in. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 & 10 The healthcare needs of the residents are met, with evidence of a good working relationship between the home and the healthcare professionals. Residents benefit from a staff team that treats them with respect at all times. EVIDENCE: Discussions with the manager and care staff confirmed that the home has a good working relationship with the visiting healthcare professionals. The district nursing service is currently visiting the home on a daily basis and the local general practitioners visit whenever a request is made. Residents and family members who spoke with the inspector said the staff were “extremely polite” and all care was given in the privacy of the resident’s room and in a dignified manner. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 15 Links with the local community are good and residents benefit from an open door visiting policy with visitors welcome at any time. EVIDENCE: The residents who spoke with the inspector said their families and friends are welcome at any time and the visitor’s book confirmed this. The inspector was able to speak to a visiting relative who could not speak highly enough of the care her mother was receiving. She has recently become chairman of the residents’ and friends committee that has just been set up to raise funds and organise a Christmas Fayre for the residents. This also acts as a means of assessing the quality of care provided and gives the residents the opportunity to “air their views” without the staff being present. Any comments, which are kept anonymous, are passed to the manager for her to attend to. The home has a varied and nutritious menu giving a choice at each meal. Special diets and liquefied meals are available. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff understood adult protection issues, which protected residents from abuse. EVIDENCE: Residents are given a copy of the complaints procedure when they are admitted, but those who were interviewed said they “had nothing to complain about”. They were confident, however, that if they had any issue to discuss, it would be dealt with as soon as possible. There was an anonymous complaint made recently that was investigated by The Commission for Social Care Inspection and also the home manager. The registered manager has now resolved the issues raised by the complainant. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21, 22, 23 & 25 The continuing programme of refurbishment means the residents have a clean and comfortable home in which to live. EVIDENCE: There are sufficient communal bathing and toilet facilities and there are nine bedrooms with en-suite facilities. The home provides aids for those residents with a physical disability. These include assisted bathing, hoists and handrails on the corridors. The inspector examined a sample number of bedrooms and found them to be satisfactory although some were a little small. All the rooms were personalised with items brought from their own homes. Domestic arrangements in the home mean the home was clean, pleasant and hygienic on the day of the inspection. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30 Residents benefit from a trained staff group who are employed following a thorough recruitment process. EVIDENCE: There is a full recruitment and selection policy in place that ensures no member of staff is appointed without all the legal checks being completed. The inspector was able to speak with the care staff that were on duty at the time of the inspection. They were appreciative of the support they received from the manager and the training that is organised. There are a number of staff who have completed the NVQ level 2 and others who are currently working towards the award. All mandatory training is up to date and this includes, first aid, manual handling and food hygiene. Staff are also trained in medication, infection control, fire awareness, dementia care and protection of vulnerable adults. Residents and relatives said that the manager and staff were “very kind” and “looked after them well”. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 36 There is clear leadership, guidance and direction to staff to ensure residents receive consistent good quality care. Residents benefit from a relaxed style of management and approach. EVIDENCE: Discussions with the registered manager confirmed her commitment to giving the highest level of care to the residents. She works closely with the staff team to ensure all the assessed needs are met. She is a qualified nurse, and has experience in the care of older people. During the inspection she demonstrated clear lines of responsibility and some delegation to the senior carers but also provided a “hands on approach” when necessary. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 15 There is a system that is followed when looking after money on behalf of residents that safeguard people’s personal finances. The inspector did, however, recommend that two people sign the records as a further safeguard. Staff are supervised every two months and health and safety policies and procedures ensure the residents and staff have a safe place in which to live and work. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 16 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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X 3 3 3 X 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X x The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 17 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 OP35 Good Practice Recommendations It is recommended that two members of staff sign the residents’ personal monies records. The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 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 The Knells Country House DS0000059723.V266151.R01.S.doc Version 5.0 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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