Inspection on 27/11/05 for The Knoll Private Residential Care Home

This inspection was carried out on 27th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Knoll Private Residential... 15/05/07

The Knoll Private Residential... 03/06/05

The Knoll Private Residential... 18/11/04

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 Knoll Private Residential Care Home 109 Church Road Urmston Manchester M41 9FJ Lead Inspector Kathleen Mcall Unannounced Inspection 27 November 2005 11:25 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 Knoll Private Residential Care Home DS0000061011.V257291.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 Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Knoll Private Residential Care Home Address 109 Church Road Urmston Manchester M41 9FJ 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) 0161 755 3818 0161 747 2513 The Knoll Care Partnership Ltd Mrs Claire Louise Gardom Care Home 10 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 10 service users to include: up to 10 service users in the category of OP (Old age, not falling within any other category) up to 4 service users in the category of DE(E) (Dementia over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3rd June 2005 2. Date of last inspection Brief Description of the Service: The Knoll is a residential care home that is registered to provide care for up to 10 residents whose primary care needs are due their old age, including four residents who may have a diagnosis of dementia. The Knoll is one of two care homes owned by the Knoll Care Partnership Limited, the other being The Fairways. Mrs Claire Gardom is the registered manager at the home. The home is situated in the Urmston area of Manchester and is within easy reach of local shops, public transport and the motorway network. Accommodation comprises of eight single occupancy bedrooms and one shared bedroom. None of the bedrooms have en suite facilities, however all bedrooms have a wash hand basin. Three bedrooms are situated on the ground floor and all others are on the first floor. There is an assisted bathroom on the first floor and a shower room on the ground floor. The home has plans to install a shower room on the ground floor in Spring 2006. Other plans include building a conservatory with ramp access to the back of the home. There are two large lounge/dining rooms on the ground floor and a stair lift to assist residents to their bedrooms on the first floor. The home is suitable for wheelchair users. There are gardens to the rear and front of the property with car parking to the front and rear of the home. The home operates a no-smoking policy. The Knoll Private Residential Care Home DS0000061011.V257291.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 that took place over the course of a Sunday afternoon. The registered manager accompanied the inspector throughout the inspection process. Care plans, assessment documentation, medicines and their storage were examined. The inspector spoke with several residents who were in the home at the time of the inspection and spoke with members of staff. Residents told the inspector that they were very happy with the care they received. One resident told the inspector ‘I’m very well cared for, I have regular baths, the staff are very approachable. I’m very satisfied with all.’ One resident said the home was ‘very good the staff are brilliant’. Another resident said that ‘staff are committed’ and one resident said that staff at the home were very approachable. The inspector met two care workers, one deputy manager, and one senior carer who was previously the registered manager of the home. Care staffs’ approach towards service users was observed to be sensitive and caring at all times. What the service does well: The Knoll is a fairly large home that offers comfortable and homely accommodation. A number of residents told the inspector that they liked living at The Knoll and that they felt well cared for. The atmosphere of the home is relaxed and friendly with a flexible routine based around the needs of residents. Residents spoke positively about the food and were pleased with the choice and variety on offer. Care staff are able to incorporate time to sit and talk with residents during their working day and two residents told the inspector that they appreciated this although they knew that care staff were sometimes very busy. There have been no complaints at the home since the last inspection and one resident told the inspector that she had no need to complain. Residents appeared to be well cared for and were supported by a trained and competent staff group. The Knoll Private Residential Care Home DS0000061011.V257291.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 Knoll Private Residential Care Home DS0000061011.V257291.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 Knoll Private Residential Care Home DS0000061011.V257291.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): 1, 3, 4 and 5. Service users were given appropriate information to assist them in making a decision about moving to The Knoll and their care needs were fully assessed before admission. EVIDENCE: The home had a Statement of Purpose and a Service User Guide in place. This information was given to new service users before their admission. One service user who had recently been admitted to the home confirmed that she had received information, which had assisted her in making her decision to move into the home. It was the practice of the home that prospective services users visit the home prior to their admission. A service user recently admitted to the home had been unable to visit but was happy for her relatives to visit on her behalf. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 9 A selection of service user files were examined. It was observed that they contained a sufficient amount of assessment information in respect of a service user. Service users admitted to the home had been assessed prior to their admission. Assessments were obtained from social workers and health professionals if they had been involved in the admission. Service users recently admitted to the home told the inspector that they were happy with the way in which the home was meeting their needs. Care staff demonstrated a good understanding of service users care needs. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10. Service users health and personal care needs were identified and met. EVIDENCE: Each service user had a care plan. The registered manager reported that service users were actively involved in the formulation of their care plan with a member of staff. Care plans included health needs, personal care needs, mobility, social interests, and risk assessments and were reviewed on a monthly basis and any changes needed were included. Care plans seen were individualised to each service users care needs and all information was stored in one accessible document. The Knoll had specialist equipment in place to meet the needs of service users living there. Service users confirmed that they had access to GP support, district nursing services, optician and chiropody services when required. Medication was provided in the monitored dose system; this was stored appropriately. The home had a secure dedicated refrigerator for the storage of medication requiring refrigeration; the temperature of this refrigerator was monitored and recorded on a daily basis. Staff with responsibility for medication administration had updated their training and the registered The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 11 manager had provided written information for care staff on how different medicines interact with each other and how these may affect a service users health. None of the service users managed their own medication. Service users told the inspector that staff treated them well and they were very satisfied with the care they received. Care staffs’ approach towards service users was observed to be respectful, sensitive and caring at all times. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 the following standard(s): 12, 13,14 and 15. The day-to-day routine of the home was relaxed and informal and met service users’ needs. Mealtime arrangements were well managed and satisfied service users’ expectations. EVIDENCE: The day-to-day routine of the home was relaxed and flexible with some service users preferring to spend time in their rooms and others using the lounge facilities. Service users said they could get up and go to bed at times that suited them. The home had an activities programme, which was sometimes shared with service users from The Fairways residential care home. At The Knoll a member of staff had been given specific responsibility to organise activities. Service users told the inspector that they had played bingo, darts, and various board games. Care staff told the inspector that they try to encourage service users to remain as independent as possible. One service user told the inspector that staff encouraged her to do as much as possible for herself and that she understood this was to enable her to remain independent for as long as possible. Meals were served at regular intervals and were usually taken in the dining room areas. The lunchtime meal was the main meal of the day and the teatime meal was lighter with a hot and cold option. Service users told the The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 13 inspector that they had enjoyed their lunch and that the meals provided were very good and, that a wide choice was available. All the food provided was home made. The home does not employ cooking staff and it was the responsibility of care staff on duty to prepare all meals. Visitors were made welcome at the home and service users kept in touch with family and friends. Service users confirmed that they could have visitors at all times. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18. Service users felt confident that their complaints would be taken seriously and acted upon. Staff had undertaken appropriate training in adult protection. EVIDENCE: The home had a detailed complaints policy and procedure; there had been no complaints since the last inspection. Service users told the inspector that they knew who to complain to and felt that their complaint would be dealt with in a suitable manner. One service user told the inspector that she had no reason to complain and that she was quite satisfied with the care provided. The home had a procedure for responding to allegations of abuse. The majority of care staff had completed training in adult protection and further training was planned for January 2006. Care staff on duty at the time of the inspection demonstrated a good understanding of issues around adult protection. However staff were less clear in their understanding of ‘whistle blowing’ and their responsibilities with regard to reporting abuse and poor practice. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 the following standard(s): 19, 24 and 26. The home was well maintained and provided comfortable living accommodation for service users. EVIDENCE: The home was well maintained throughout and provided comfortable accommodation. The grounds of the home were well kept and attractive. The home was clean, tidy, bright and airy throughout and was free from any unpleasant odours. At the previous inspection the home had been given a requirement in respect of loose floor covering in the kitchen, which required refitting as sections presented as a tripping hazard. At the time of the inspection the flooring remained in the same condition, though the registered manager said that there were plans to fit floor tiles imminently. Since the last inspection a glazing safety assessment and a risk assessment had been undertaken in respect of windows in the home and all necessary The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 16 actions required had been undertaken. Similarly all windows had been fitted with restrictors. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the occupants, with many of the service users being quite self contained in their own rooms. Service users were offered a key to their bedroom so they can lock their rooms. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 17 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): 27, 28, 29 and 30. The home was sufficiently staffed with a staff group that was trained to undertake their duties, and recruitment procedure ensured that service users were protected. EVIDENCE: At the time of the inspection the home was sufficiently staffed. A staff rota showing which staff were on duty and in what capacity, was kept at the home. No ancillary staff were employed at the home, care staff were responsible for all catering and domestic arrangements at the home. This arrangement has been in place since the home was initially registered. Care staff on duty at the time of the inspection confirmed that they had undertaken further training to assist them in their role as carers. Staff had undertaken training in optical awareness, diabetes, and two staff were in the process of completing a long distance training course in dementia. 80 of the current staff group held an NVQ qualification. All new staff had completed a period of induction at the commencement of their employment and individual staff training files contained evidence of the induction programme. Since the last inspection three new members of staff had commenced employment at the home; the registered manager had followed appropriate recruitment procedures with regard to newly appointed staff. However staff files did not contain a photograph of the employee. The registered manager was informed that these need to be put in place. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35, 36 and 38. The home had a qualified and competent manager, who supported and directed her staff. The health and safety of staff and service users was not fully safeguarded. EVIDENCE: The registered manager has been at The Knoll for approximately four years. She holds the registered managers award. Other qualifications held included a HNC in health and social care. The registered manager demonstrated a clear commitment to meeting the needs of service users by ensuring that staff were supported in their work and were provided with regular training. Staff told the inspector that they found the registered manager both supportive and approachable. Two members of staff who had previously worked at other homes felt the level of training offered at The Knoll was exceptional. All staff were contracted at the commencement of their employment to commit to undertaking NVQ training. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 19 Staff received regular supervision to support them with their work. Evidence of supervision records and discussions with staff confirmed that this was the practice. The home does not have any involvement with service user finances; these remain the responsibility of the service user or their relatives. The home does access services such as hairdressing, service users are then invoiced for the cost. Staff had updated their training in safe handling and moving procedures, food hygiene and health and safety. A certificate confirming the maintenance of the stair lift was seen on inspection. Records of weekly checks to the fire alarm system were undertaken and these were made available at the time of the inspection. The registered manager said that weekly examinations of the means of escape within the home were also undertaken on a weekly basis, as were weekly examinations of the emergency lighting systems. A contractor examined fire extinguishers every six months. Records to confirm that these tests were undertaken were not available at the time of the inspection. At the previous inspection the registered manager was required to carry out and record, weekly checks on routes of evacuation and monthly checks on extinguishers and emergency lighting systems in home. In addition to this the registered manager was required to provide evidence that staff had attended fire drill practice and that they signed to confirm attendance at a fire drill. Previously it had been observed that the last recorded fire drill was carried out on the 23 April 2004. At the time of this inspection no progress had been made in respect of this requirement though the registered manager said that fire drills had taken place and that annual fire training for all staff was planned for the 6th February 2005. The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 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 3 X 3 3 3 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 2 2 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 X 2 The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 13(4) Requirement The registered manager must ensure that floor covering in the kitchen is repaired or replaced and ensure that the area is free from hazards to service users and staff. (Timescale of 01/08/05 not met.) The registered manager must obtain a recent photograph of each employee working at the home. The registered manager must take adequate precautions against the risk of fire, including reviewing, maintaining and testing fire equipment within the home. (Timescale of 01/08/05) The registered manager must ensure that all staff receive training in fire drills and practices and that these take place at suitable intervals. (Timescale of 01/08/05) Training must be provided to staff on the Whistle Blowing policy Timescale for action 27/12/05 2 OP29 Schedule 2. 23 (4) 27/02/06 3 OP38 27/11/05 4 OP38 23(4)(c) 27/11/05 5 OP18 13(6) 27/12/05 The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 22 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 The Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Knoll Private Residential Care Home DS0000061011.V257291.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!