Inspection on 03/06/05 for The Knoll Private Residential Care Home

This inspection was carried out on 3rd 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 Private Residential... 15/05/07

The Knoll Private Residential... 27/11/05

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 Joe Kenny Unannounced 3 June 2005 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 Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Knoll Private Residential Care Home Address 109 Church Road Urmston Manchester M41 9FJ 0161 755 3818 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) office@callaghansons.co.uk The Knoll Care Partnership Ltd Responsible Individual - Matthew James Callaghan Mrs Claire Louise Gardom CRH Care home PC Care home only 10 Category(ies) of OP Old age registration, with number DE(E) Dementia - over 65 of places The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 18 November 2004 Brief Description of the Service: The Knoll provides residential accommodation with personal care to ten (10) service users within the category of old age (OP), but up to four (4) service users may additionally have dementia (DE). The Knoll is a private residential care home that is owned by the Knoll Care Partnership Ltd. Mrs Claire Gardom is the registered manager. The home is located within a residential area of Urmston and it is within easy reach of local shops, public transport and the local motorway network. Landscaped grounds are located to the front and rear of the property. There is a seating area to the rear of the property and car parking space for visitors. The home has eight single and one double bedroom. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of the Knoll was carried out unannounced and took place over the course of six hours on Friday the 3 June 2005. During the course of the inspection time was spent talking to residents, members of staff and a relative of one of the residents to gain their views on the home. Time was spent examining records, residents and staff files and a tour of the home was conducted. The home had taken action to address requirements and recommendations made at the last inspection. The registered manager was on duty along with two care staff. There were 10 residents accommodated at the time of the inspection. Service users and relatives spoke positively about the care and support offered at the home. Residents commented that they or their relatives received information about the home prior to their admission which enabled them to make a decision about moving to the home. A homely atmosphere is maintained and this was borne out in discussions with residents, who confirmed that daily issues are discussed with them and they are free to organise how they spend their day. Residents were complementary of staff and catering arrangements at the home. The home continues to monitor and develop standards of care in line with National Minimum Standards for older people. What the service does well: The most positive aspect of the inspection was feed back from residents about life in the home. Discussions were also held with a relative, visiting at the time of the inspection, who confirmed that they were confident in the care and support offered to their mother. The home is in the process of reviewing and developing physical aspects of the service through development of ramped access to the rear of the building, construction of a conservatory area and development of an adapted shower facility and en-suite facility to an existing bedroom. Records relating to residents continue to confirm that the needs of residents were being met. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 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 F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 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 standard(s) 1,3 and 6 Residents are given appropriate information to assist them in making a decision about moving to The Knoll. EVIDENCE: During discussions with residents and a relative visiting at the time of the inspection, the inspector was told that residents had been supported by the home to make a decision about moving there. This was done by provision of literature about the home and the opportunity to visit before moving there. Three residents clearly stated that it was their decision to move to the home and that the support they received enabled them to come to terms with the decisions they had to make. The home’s statement of purpose clearly states that residents will be given the opportunity to take up trial visits to the home. Residents confirmed that this process happens. All residents are given a named member of staff to be their key worker. Care plans are developed on admission by the homes manager and reviewed on a monthly basis by the key worker. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 9 All service users are issued with a contract and statement of terms and conditions at the time of admission to the home and the document is held on their file. The home does not provide intermediate care as described in the standard above. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 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, 8, 9 and 10 Service users’ health, personal and social care needs were met and regularly reviewed by staff working in the home. EVIDENCE: Service users confirmed that their health care needs were being met and that they received regular support from their general practitioner when required. One service user spoke clearly of her understanding of fire risk assessments in relation to her choice to have her door held open as she chooses to use her room during the day and requests that the door is left open. Staff showed through discussion and from observations by the inspector that they enabled residents to be as independent as possible and that they supported residents in a manner which respected their rights to privacy and dignity. Care is offered in the privacy of service users’ bedrooms and all visiting professionals and relatives are offered the opportunity to meet residents in the privacy of their bedroom. The care plans for residents were clearly written to identify care needs and assessed risks. Four files were inspected as part of the inspection. Some were signed by residents to show their involvement. A daily record was kept of support provided. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 11 Care plans were being regularly reviewed and evidence was available to confirm this. Where required monitoring forms were used to record weight and other health issues, including visits by health professionals. It is recommended that staff sign the daily notes they maintain. None of the residents self medicated. All medication is administered by designated staff (five staff plus the manager) through use of a Monitored Dosage System. Medication was handled safely. The supplying pharmacist provides the home with back up support and will advise and conduct periodic inspections of how the system is being administered. Sample signature of all staff with responsibility for administering medication must be kept at the front of the medication administration records. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 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, 13, 14 and 15 The preferred daily lifestyles and social interests of residents is respected and responded to by the management and staff team working in the home. EVIDENCE: It was evident from discussion and records that there is a well-established link with relatives and the home. Arrangements for family contact in the event of an emergency are determined on admission and there is an open policy on visiting times to the home. Residents stated that they were appreciative of the support they received and confirmed that activities are held in the home. These included in house board/table games such as dominos and trips out to a local public house for meals and a drink. The manager stated that outings are carried out in conjunction with The Fairways, the second home owned by the partnership. Religious services are also held in house every month. Residents confirmed that they are directly consulted on all aspects of daily living such as time they get up, choice of breakfast in bed, choice at meal times and their social interests. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 13 A wholesome and balanced diet was provided. There was evidence of fresh fruit and vegetables available in the kitchen and shopping is carried out on a weekly basis at local supermarkets. The manager confirmed that all staff had received training in basic food hygiene. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 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 and 18 The home’s complaints procedures was known to residents and relatives who were aware of the process to raise concerns about the service. Procedures relating to protection of vulnerable adults protected residents from risk of abuse. EVIDENCE: The home’s complaints procedure contains information about who to contact if you have a concern about the service. The procedure required minor amendment to ensure that relatives and residents were aware that they could access the procedure at whatever level they choose. No complaints had been received by the home or by the Commission in the period since the last inspection. The home has a copy of the local authority guidelines relating to Adult Abuse procedures. The manager was advised to retain evidence that all staff had been given the opportunity to read the document and sign the tracking form to confirm they had read the document and understood its principles. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 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, 20, 23,24 and 26. The home is well maintained comfortable and provides residents with a safe environment in which to live. EVIDENCE: The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 16 The home continues to be well maintained in terms of décor, cleanliness and was free from offensive odours. The communal areas are suitably furnished, both lounges allow residents access to a television. Residents commented that they choose to use the front lounge as a quiet area. Bedrooms are suitably furnished and personalised by residents. There are plans to develop facilities to the rear of the property to include a conservatory area, additional shower facility and addition of an en-suite facility to one of the bedrooms. The proposal is to develop a ramped access to the conservatory area. The manager also indicated that a new boiler would be installed in the summer months. The home continues to operate a no-smoking policy. The kitchen is compact and suitably equipped to meet all catering arrangements. Ample provisions were available in the home at the time of the inspection. The floor covering in the kitchen required refitting as sections presented as a tripping hazard. A Glazing safety assessment is required on all glass panels and a risk assessment of all windows in terms of the need to fix restrictors to windows. A high number of windows are sash windows and do not have restrictors fitted. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 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 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, 29 and 30 The home was well managed and residents benefited from a staff team that were skilled, trained and supervised. The staff team were stable and offered residents the support necessary to address and meet their needs. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 18 EVIDENCE: The staff team consists of a registered manager and ten care staff. No ancillary staff are employed at the home, care staff undertaken all catering and domestic arrangements. This arrangement has been in place since the home was initially registered. The manager stated that the arrangement was effective for a home of its size. Staff did comment that the mid day period can be demanding on their time as they support peoples’ care needs prior to meal times and are actively involved in the preparation of the same meal. The staffing levels for the period covering the inspection met with the guidance of the previous registration authority. Staff confirmed during discussions that they received planned supervision sessions and that the home had a structured programme of training and development. Staff at the home continued to work towards the NVQ qualifications at level 2 and above. Three staff hold NVQ level 2 and five staff are to complete NVQ training shortly. This is equal to 80 of staff attaining NVQ training and meets the national minimum standard. There was one waking night staff and an officer sleeping within the grounds of the Knoll, offering “on call” support. Training records showed that appropriate training was being provided. Examples were of medication, moving and handling and diabetes awareness The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 19 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) 33, 34, 35 and 38 The management and administration procedures were effective in maintaining the best interests of residents and promoting their welfare. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 20 EVIDENCE: The registered manager had the relevant qualifications and experience of care of older people, in a residential setting. The manager demonstrated a commitment to developing and keeping her knowledge current and to supporting staff on development issues. This was evident from supervision and training programmes. The financial affairs of residents remain the responsibility of their relatives. On admission all relatives are informed that this is the home’s policy. The home will support residents in accessing services such as hairdressing and will arrange for purchases on their behalf. The home will then invoice the family for purchases made. The home has developed a manual of policies and procedures specific to the home. Staff indicated that they were familiar with the content of the manual from induction, ongoing supervision and support by the management team. The home is managed by registered partners who also operate another care home. The home has access to bank staff shared between each home and further resources such as staff skilled in administration and financial procedures. The fire system is checked on a weekly basis. The manager was advised to keep a weekly record of tests and checks on the routes of evacuation. Monthly checks should be conducted in relation to the emergency lighting and fire extinguishers. The recording of a fire drill must be conducted on a six monthly basis, the manager was advised to request staff to sign the fire register to confirm their attendance. The last recorded fire drill was carried out on the 23 April 2004. The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 21 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 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 2 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 3 3 x x 2 The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 22 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. Standard 9 Regulation 13 (2) Requirement A sample signature of all staff with responsibility for administration of medication must be kept in the front of the medication administration records. The floor coverng in the kitchen required refitting as section presented as a tripping hazard. Timescale for action 1 August 2005 2. 19 13 (4) 1 August 2005 3. 19 23 A glazing safety assessment and 1 August assessemtn of need to fit window 2005 restrictors must be carried out. The home is requried to carry out and record, weekly checks on routes of evacuation and monthly checks on extinguishers and emergency lighting systems in home. 1 August 2005 4. 38 23 (4) The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 23 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 9 18 Good Practice Recommendations That all staff sign the monthly care plans they maintain. The home is advised to retain evidence tha all staff have read and understood the policy relating to adult protection procedures. That staff sign the fire register in person to confirm attendance at fire drills. 3. 38 The Knoll Private Residential Care Home F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 F55 F05 s61011 The Knoll v228540 310505 stage 4.doc Version 1.30 Page 25 - 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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