Inspection on 21/06/05 for The Knoll Nursing Home

This inspection was carried out on 21st June 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 Knoll Nursing Home 28/10/08

The Knoll Nursing Home 14/11/06

The Knoll Nursing Home 20/08/05

The Knoll Nursing Home 14/02/05

The Knoll Nursing Home 11/10/04

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 The Knoll Nursing Home 196 Dover Road Walmer Deal Kent CT14 7NB Lead Inspector Susan Hall Unannounced 21.06.05 at 10.00 hours. 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 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 Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Knoll Nursing Home Address 196 Dover Road, Walmer, Deal, Kent, CT14 7NB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 374679 01304 374679 Raj & Knoll Limited Mrs. Amita Patel Registered Care Home 28 Category(ies) of Older People aged 65 or over registration, with number of places The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th & 15th February 2005 Brief Description of the Service: The Knoll Nursing Home is a large detached building, situated at the corner of two roads in a residential area of Walmer, Deal. it is near to local shops, Walmer Castle and the sea, and is within easy distance of the town of Deal. It is owned by Raj and Knoll Limited, and managed by one of the Providers, Mrs. A. Patel. Accommodation is mostly provided in ground and first floor bedrooms, although there is also a shared room on the second floor. All floors can be reached via a small passenger lift. A number of rooms have en-suite facilities. Outdoor space is currently limited to a small patio area, where Service Users are able to sit out in good weather. There is a large public park almost opposite to The Knoll, which is widely used for taking Service Users out for walks. The Providers have purchased the adjoining premises, and were in the process of finalising plans for extensive additional building work to increase the size of the Home. Plans also include some structural alterations and refurbishment of the existing building. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Lead Inspector carried out an unannounced inspection visit, following up the progress of the Home after the last inspection in February 2005. She was accompanied by a second Inspector, Mrs. Chris Randall, as this enabled them to converse more easily with a higher number of Service Users. The inspection took place in hot weather, and the Home was well ventilated with doors and windows open. The Inspectors were welcomed by the Deputy Manager, who informed the Manager of their arrival. Both of these staff were available for discussion throughout the visit, and assisted the Inspectors in looking round the premises, and in chatting with Service Users. The Inspectors were able to chat with a total of 11 Service Users and 3 relatives, who all made positive comments about the care given by the staff. They also talked with the cook, and briefly spoke with 1 cleaner and 2 carers. After looking around the Home, one of the Inspectors examined care plans, while the other Inspector checked the medication storage and administration. Documents for hoist servicing, fire records and gas and electrical servicing were viewed at the last inspection, and were not examined at this visit. The Inspectors talked with the Manager about the ongoing plans for the building development. These have been altered several times, but the Manager was confident that they are now ready to be viewed by CSCI, and sent to the planning department. What the service does well: Service Users and relatives spoke highly of the staff, and said that they “were all good”, and that “they looked after them well”. They felt that staff are friendly and caring, and that they are reliable in answering the call bells. Care plans contained detailed information, and recommendations given at the last visit had been acted on. This included making more specific reference to how personal care is given (eg: bath given, hair washed, shave given), and implementing turn charts for Service Users who are bed bound, and who are unable to move independently. Care plans confirmed that there is good input from other health professionals, including doctors, specialist nurses, dentist, physiotherapist and chiropodist. Records demonstrated that the nursing staff are quick to recognise when additional medical intervention is needed, and act accordingly. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 6 Several Service Users said that the food was good, that they were able to choose main meals from different options, and were able to change their minds about their original choice. The kitchen was clean and well organised, and the Inspectors were able to see evidence of the choices offered to Service Users. The Home has a very friendly atmosphere, and relatives said that they are always made to feel welcome, and can visit at any time. What has improved since the last inspection? What they could do better: It was evident that cleaning staff worked hard to keep the premises clean, and to reduce unpleasant smells in the building. There were a few areas which had some stale odours, and the Inspectors felt this was mainly due to recent “accidents”, and the general wear and tear of the carpets and furnishings. Some of the furniture was very worn. The Providers expect to refurbish the premises as needed after alterations are made, and the Inspectors recognised the difficulty in not wishing to replace carpets/furniture etc. which are scheduled for replacement in due course. There is an ongoing requirement for the Providers to keep CSCI informed of the future building and alteration plans; and there is a recommendation to keep the décor and furniture under review for refurbishment as indicated. The clinical room is far from ideal, as it is very cramped and has old cupboards which need replacing. This is another item which is included in new building plans. There is a requirement to fit a new lock on a specified medication cupboard. There is also a recommendation to review the way in which the MAR charts (Medication Administration Records) are filed, as they tend to fall out of the current file in use. Staff files were not available for viewing, as the Manager had taken them off The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 7 the premises to store safely in an office elsewhere. The Inspectors reminded her of the regulation (Care Homes Regulations 2001 No. 17) which specifies that these documents must be available for viewing by the Commission at all times. There is a requirement to file these on-site. Care plans are stored on a shelf in an office, which is locked when not in use. The shelf did not have any divisions on it, and files are liable to fall off the shelf. This could be hazard for people in the office, and also damage the files’ contents. There is a recommendation to alter the storage – either by altering the shelf, or by fitting new cupboards. 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 Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 (Standard 6 does not apply to this Home.) The Home has satisfactory procedures in place to ensure that Service Users (or their relatives) can make an informed decision prior to arranging admission. EVIDENCE: One of the Inspectors viewed 3 care plans which all included pre-admission assessments. These contained adequate detail, and included assessments for nutritional needs, continence, mobility, risk of falls, hygiene needs, pain assessment and medication. One of the care plans examined was for the most recently admitted Service User. The Manager ensures that Service Users are not admitted to the Home if they cannot meet their assessed needs. One of the Service Users stated that he is visited weekly by a physiotherapist; and other specialist services are discussed and arranged prior to admission if applicable to the Service User. The Manager stated that the Statement of Purpose and Service User Guide had not been altered since the last inspection. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7 - 10 There is a consistent care planning system in place, which adequately provides staff with the necessary information to meet Service Users assessed needs. Systems for medication administration are satisfactory, but the Homes clinical room is inadequate, with a lack of sufficient storage space. EVIDENCE: Care plans viewed included detailed records of medical input and nursing care given. Daily records were completed after each shift, and were accurately signed and dated. Data recorded included information about pressure area care, wound management, body maps for showing where bruises or wounds are situated, blood and urine tests, fluid and nutrition charts and weight records. Levels of continence and catheter care were included, and falls assessments and associated risks. Care plans are reviewed on a monthly basis. Some Service Users were being given personal care in bedrooms or bathrooms. The staff were careful to ensure their privacy, by informing the Inspectors where personal care was in progress. Staff were seen to be The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 11 interacting well with Service Users, and to treat them with respect. The Inspectors noted the care staff’s attention to detail – ensuring that Service Users had items within reach, and fresh drinks available. Medication is stored in a locked clinical room, which has bars at the window for added safety of storage. This room is inadequate for storage, as it is too small and very cramped for the amount of medication and dressings needed for this size of nursing home. The Lead Inspector was informed that a new clinical room has been identified on the new building plans. One of the cupboards had a lock which did not work properly, and there is a requirement to repair or replace this lock. Creams and external medication were stored separately from internal medication. Most administration is via the Boots Monitored Dosage System (MDS). Some items cannot be packaged in this way, and there was very limited storage for these items. The drugs fridge was at a safe temperature, and the Inspector viewed the daily records for recording the temperature. This was locked, and contained separate areas for storing liquid antibiotic medicines, insulin, and eye drops. All items had been dated on opening. The Deputy Manager is responsible for all medication ordering and returns, and documents receipt of medication on the Medication Administration Records (MAR charts). She carries out additional safe guards by checking the numbers of controlled drugs on a daily basis. These were recorded in a notebook. The Inspector checked the records in the controlled drugs register and counted the tablets for one entry, and these were correct. No out of date medications were found. MAR charts were examined, and had been accurately completed. They were difficult to manage as they kept falling out of the file. This would be a source of constant frustration for nursing staff, as they would easily get out of order, and could get mislaid. There is a recommendation to review the system for filing these, and for nursing staff to recognise the importance of maintaining these charts in good order. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 12 -15 The Home has improved the choice of in-house activities, and Service Users have more opprotunity to join in with others and to access the local community. EVIDENCE: The Manager had made arrangements for additional activities on 2 afternoons per week. One afternoon is for bingo, and the other afternoon is for a variety of activities. Two of the Service Users talked to the Lead Inspector about how much they enjoy taking part in these afternoons, and look forward to them. Activities include items such as musical movements, ball games, quizzes, balloon games, skittles, poetry, and reminiscing. A record is kept of which Service Users participate, and how they respond. The activities lady checks each week to ensure that she knows any reasons to take extra care with certain activities or prizes for individual Service Users. For example, she would be careful with ball games or musical movements for someone with arthritis or painful joints; and would not give sweets as prizes to a diabetic or someone with a swallowing difficulty. Service Users said that they are taken out into the nearby park by relatives or staff, and they enjoyed the opportunity of going outside. Visitors are welcomed at any time, and are able to take Service Users out if they can manage their care needs whilst out. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 13 Church services are held in the Home on a regular basis, and Service Users are assisted in attending churches if they are well enough to do so. Service Users said that they enjoyed the food, and one said the only problem was that “they give me too much!” The kitchen was viewed and was well organised. The cook has worked at the Home for many years, and has good systems in place. A cleaning schedule itemises duties which need to be done each day/ week/ month, and these are signed for when completed. Records are maintained for fridge and freezer temperatures, and these were up to date. There are 2 choices of main meals, and of desserts, and a soft option for those who need it. Some Service Users need their food to be liquidised, and this is presented as separate parts of the meal, and made to look as attractive as possible. Instructions for different Service Users were seen for breakfast choices, and for those who need fluids to be thickened to aid swallowing. A second cook works for the other 2 days each week. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 The Home has a satisfactory complaints procedure which is accessible to Service Users and visitors. EVIDENCE: The Inspector had taken part in an investigation as a result of a complaint made at the time of the last inspection. This investigation had been completed, and the investigating team had not found any evidence to uphold the complaint against the Home. The Inspector viewed the complaints record, which is documented in a hardback notebook. This showed a number of entries since the last inspection, which were mostly comparatively minor concerns which had been raised by Service Users or relatives. The Inspector was pleased to see that these had all been documented, and that the records showed that action had been taken to resolve these issues very quickly. No complaints had been made to CSCI. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19-26 The Home has been gradually becoming more worn over the years, although the Providers have taken some steps to improve some of the decor and carpeting over the last few months. Radical improvements are planned in the existing building, after extensive new building work is completed on the adjacent property. EVIDENCE: The Providers have been working on plans to change the premises over the last 18 months, and have completed purchase of the adjacent property during that time. Plans were drawn up last year, but have since been altered, and are in the process of being finalised. Service Users and relatives have been kept informed of the planned changes, and look forward to these becoming a reality. The plans include new building work, which would include new bedrooms, communal areas, and kitchen and laundry facilities. Service Users would be moved over to new rooms at the completion of this work, so that the existing rooms can be altered and refurbished. There is an ongoing requirement for the Providers to keep CSCI The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 16 informed about the new building plans. The Inspectors were shown around most of the building, but did not view all bedrooms or bathrooms as some were being used to give personal care. Two bathrooms had been painted since last year, and some carpeting had been replaced. Some of the bedrooms are now becoming very worn and décor and furniture will need to be kept under review. The Inspectors noted that the rooms and corridors were clean, and attention to detail was evident in polishing and dusting. Some of the carpets were stained and waiting to be cleaned. This is an ongoing situation, as some carpets need to be cleaned every week. There were unpleasant odours in some areas, but these were in specific areas, and not generally throughout the building. There is an ongoing recommendation (previously a requirement) for the Providers to keep all bedrooms under review, and be ready to change the décor and furnishings if they become unacceptable during the delay in waiting for new rooms to be available. Bathrooms were fitted with fixed hoists or with in-built lifting devices (eg : a “Parker” bath.) Other equipment available included 6 mobile hoists. There were 5 at the previous inspection, and the Inspector viewed all of these together on that visit. The 6th hoist had been recently purchased as it is lightweight and folds up for easy transfer to different areas. It is possible to use it to raise a patient from the floor if they have fallen, and also fits easily into the lift. Each Service User has their own lifting sling. The Manager has one bedroom still in use for 3 people to share. This has been discussed with CSCI, as there is an awareness that this does not meet the National Minimum Standards. However, the 3 Service Users in this room have shared for many years, and became distressed when one of them was moved to a single room. The Manager has an arrangement with CSCI that this room will revert to a double room when one of the current Service Users leaves, and there is a condition on the registration in this respect. There were previously 2 rooms in this category, but one of them has now reverted back to a double room. The laundry area was clean, and well equipped with 4 washing machines (one has a sluicing facility), and 2 tumble dryers. There is a red bag system in place for processing dirty linen. The Home has 3 sluicing disinfectors in different areas of the building. One of these was viewed and was acceptably clean and tidy. Clinical waste is stored in a locked container at the rear of the building, and is collected weekly. The outdoor communal area is currently limited to a small patio area, which had been made more attractive with tubs of flowers. It also had a homely atmosphere with washing hanging outside. This space is insufficient to meet The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 17 the National Minimum Standards, and the Lead Inspector looks forward to seeing this situation addressed on the new build plans. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 The Home has a stable staff team, with staff who show a consistency in providing good standards of care, and who clearly understand their roles. The Manager lacked awareness of the importance of keeping staff files available for viewing by authorised professionals. EVIDENCE: The Home has a trained nurse on duty at all times, and is supported by 4 care staff in the mornings, 3 in the afternoons, and 1 at night. A member of the day care staff commences each day at 06.00hrs, and another at 07.00hrs. This enables them to assist the night staff at a busy time when many Service Users require toileting, drinks, and medication. Some may be washed and dressed, but only if it is their specific choice to have personal care early in the morning. The Inspectors noted that Service Users were still being washed and dressed mid-morning, and one was having breakfast in bed at 10.30. This confirmed that their personal choice is taken into account. Care staff are supplemented by a cook and (usually2) cleaners on duty each day, and the Manager’s hours are additional. A number of staff were carrying out NVQ training, and the Home may achieve 50 of staff with this training by the end of 2005. The Inspectors asked to view staff files, but the Manager had moved these out of the premises to a secure office elsewhere. Staff files should be available for The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 19 inspection by authorised persons at all times, and there is a requirement for staff files to be made available on-site. The Manager informed the Inspectors that all CRB and POVA First checks were up to date, but they were unable to confirm evidence of this. A staff training matrix showed evidence of mandatory staff training, but the Inspectors were unable to check staff individual training records as these are stored in staff files. The induction programme was viewed at the last inspection and was seen to be satisfactory at that time. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-34 and 37 The Manager has a clear development plan for the Home, and has effectively communicated this vision to staff, Service Users and their relatives. EVIDENCE: The Manager is trained as a Registered Nurse, has a Diploma in Management, and has a BSc. (Hons.) in Rehabilitation Nursing. She is committed to implementing extensive plans for change, which includes alterations to the building, and additional registration for another client group. The building plans include a number of beds for younger adults with physical disability and who need nursing care, as well as beds for older people with nursing needs. Service Users had been kept informed of the proposed changes and were able to talk about the plans for building work. Their opinion is sought informally on a day to day basis, at occasional residents’ meetings, and via questionnaires. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 21 Service Users and relatives spoke positively about the amount of information made available to them. Records were seen to be in satisfactory condition. Care plans are stored in a shelf in the office, which is not divided into sections. This could cause files to fall off, with a risk of damaging the contents. There is a recommendation to alter the storage system for these files. The Inspectors did not check documentation for servicing records, building risk assessments or accident records at this visit, but will view these at the next Announced Inspection. Fire extinguishers had been appropriately serviced, and staff showed a general awareness of health and safety matters. The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 1 3 3 2 2 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 3 x x 2 x The Knoll Nursing Home H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 23 NO Are there any outstanding requirements from the last inspection? 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. 2. Standard OP9 OP19 Regulation 13 (2) 39 (h) Timescale for action To fit a new lock on the identified 31.07.05 medication cupboard. Ongoing requirement to keep 31.12.05 CSCI informed about the proposed alterations and new building work, and supplying CSCI with a new action plan with timescales once the plans are approved. To store staff files on the 31.07.05 premises, and ensure that they are available for viewing by authorised persons at any time. Requirement 3. OP29 17 (1-3) 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. 2. Refer to Standard OP9 OP24 Good Practice Recommendations To improve the system for filing Medication Administration Records which are currently in use. To keep the state of bedroom decor and furniture under review, implementing a programme of refurbishment prior to new building work completion if indicated. (This was previously a requirement.) To improve the system for storage of care plans. H56-H05 S26103 The Knoll V231934 210605 Stage 4.doc Version 1.30 Page 24 3. OP37 The Knoll Nursing Home Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. 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