Inspection on 12/07/05 for The Knowle

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 14 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Knowle 02/07/07

The Knowle 29/11/05

The Knowle 19/01/05

The Knowle 02/06/04

The Knowle 30/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 The Knowle 60/62 Carterknowle Road Sheffield South Yorkshire S7 2DX Lead Inspector Claire McAuley Unannounced 12 July 2005 09:15 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Knowle Address 60/62 Carterknowle Road Sheffield S7 2DX 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) 0114 258 3201 0114 258 3201 None Mr Michael Thomas Kelly Mrs Ann Patricia Bolger PC Care home only 13 Category(ies) of LD - Learning Disability (13) registration, with number of places MD - Mental Disorder (13) The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19 January 2005 Brief Description of the Service: The Knowle is a family run home supporting thirteen people who have mental health problems or learning disabilities. All service users have their own single room. There is a communal lounge, a small dining room and shared bathroom facilities. There is a small garden to the rear of the building. The Knowle is based in the Nether Edge area of Sheffield, close to shops, banks, pubs, public transport and health facilities. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five hours from 9.15 to 2.15. Previous requirements were checked and a number of key standards assessed. Areas of the home were inspected and four residents were asked their opinions of the quality of the service offered. Two staff members were interviewed and a number of records were checked. Discussions with the manager took place. What the service does well: 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 Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 3 The service users guide/statement of purpose was complete and available. Learning disability training was due to take place in July. Specialist services were provided and information on advocacy services was available. EVIDENCE: There was a service users guide/statement of purpose in place which met the standards. Residents had received copies of this. Learning disability awareness training for staff was to take place on July 28th 2005. Specialist services were provided for residents, including community psychiatric nurse, psychiatrist, social worker, and day centre and work placements. Information on advocacy services was available for residents. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 9 Plans of care met residents needs. The residents were involved in reviewing their plans. Residents were encouraged to take responsible risks as part of an independent lifestyle, and the majority of risk assessments were in place. EVIDENCE: Plans of care contained the required information. There was evidence that these had been appropriately reviewed with the individual residents who had also signed their plans of care. The manager gave an example of how health services had been accessed to ensure that a particular service users needs were met. These were fully recorded in their plan of care. Daily recordings of health professionals visits, activities, visits of friends or relatives, and food choices were also in place. Residents were supported to take responsible risks as part of an independent lifestyle, for example independently travelling, visiting friends, shopping and attending support groups, day activities and work placements. One plan of care did not have a risk assessment completed for a resident who had shown potentially aggressive behaviour, and there had been no guidance for staff on handling this. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 13 15 17 Residents were encouraged to maintain independence. Preferred daily routines were supported. The majority of residents had well established links with the community, were involved in social activities, and saw friends and relations. The food provided was generally good, although one resident was not satisfied. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 10 EVIDENCE: Residents were encouraged to be independent, and the majority of residents were out of the home during the day, some attending day centres and work placements, or going out shopping. Some older residents preferred to stay at the home during the day, and had established their preferred routines with staff support. The majority of residents were able to travel independently and had good links with the local community, including attending St Wilfred’s church and day centre, and going to cinemas and pubs. The manager said that they had a good relationship with local neighbours. Residents spoken to said they visited relatives and friends on a regular basis, some residents were friends and went out together. Two residents were having a camping holiday together, and visitors were welcomed to the home. Residents were consulted about their food preferences. Most residents did not help with the preparation of food, although they did sometimes make drinks or help to tidy up. The majority of residents spoken to said the food was good. One resident said that there were too many chips and he would like a curry sometimes. Fruit was always available for residents and snacks and drinks were also available. Nutritional needs were monitored and reviewed. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 20 Residents at the home were supported in maintaining their personal care and environment. Appropriate healthcare was provided. Medication systems were in good order. EVIDENCE: The manager confirmed that residents were mostly independent and needed little input from care staff in relation to personal care. However they did need support and prompting to maintain their care and physical environment. Residents confirmed they were able to register with a GP of their choice and had appointments with a range of healthcare professionals e.g. – dentists, opticians, chiropodists etc. One resident was assessed to manage his own medication and this was safely stored. The medication systems checked were in good order and staff were trained by the manager. The local pharmacist regularly checked the systems and gave the manager and staff helpful advice. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 23 Procedures and policies in place for protecting residents, and responding to any complaints were satisfactory. Staff had not yet received adult protection training. EVIDENCE: There was a complaints procedure in place. Residents said they could talk to staff if they were unhappy, and knew how to make a complaint if necessary. No complaints had been received. There was an adult protection procedure and policy in place, including the Department of Health guidance ‘No Secrets’. Adult protection training for staff had been arranged to take place in October 2005. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 A comfortable and safe standard of accommodation was provided for the residents. Extensive decorating and maintenance work had recently been completed. Damp in a residents room required attention and lounge settees required cleaning. The garden area required some maintenance, tidying and planting. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 14 EVIDENCE: The home was clean, well maintained, and generally well decorated. The building complied with the requirements of the fire service and environmental health department. The owners had recently decorated several rooms, hallways and stairs and the outside of the building. Some guttering had been replaced. The home was suitably furnished. Residents rooms were mostly well decorated and individualised. There was a damp area in a residents room, and the settees in the lounge required cleaning. The outside garden area would benefit from the removal of some rubbish and cigarette ends, and the areas around the paving slabs require weeding and planting. One of the paving slabs was uneven, presenting a tripping hazard. There was a mobile phone available for residents to use, however one resident said that he had been denied this by a member of staff who had told him that the bills were too high. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 35 Recruitment files required completion. CRB checks for staff were completed. Residents were consulted on the appointment of new staff. The staff training programme had improved. NVQ 2 training had not commenced. EVIDENCE: Recruitment files contained the majority of information required by the standards and regulations. One file did not have a full employment history or health check in place. CRB checks were in place for all staff. Staff had received the GSCC code of practice. Residents were consulted on their opinions, when interviews for new staff took place. Information on staff files, including supervision records, training, and development was difficult to access as it was not kept together. There was an induction programme in place at the home and new staff were sent on an induction course which met the Sector Skills workforce training targets. A staff development programme identified training needs. NVQ2 training had not been commenced. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 42 A quality assurance system to monitor views of residents and their relatives or representatives required further development. There was a health and safety policy in place. Staff had received the majority of mandatory training. Risk assessments and appliance servicing and monitoring was in place. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 17 EVIDENCE: The quality assurance system required development, as no information of views of residents and relatives/representatives on the quality of care provided had yet been published. Regular residents meetings took place which enabled residents to express their opinions. An informal system of auditing the physical environment was in place. For the protection of residents, the home had a health and safety policy in place. A staff member spoken to confirmed he had received mandatory training, with the exception of first aid training. The manager’s first aid training was also due for renewal. This has been arranged for September 2005. There were procedures in place to prevent infection. Boilers and central heating systems had been serviced. COSHH risk assessments were in place. Fire doors were closed. The manager confirmed that notifiable incidents were appropriately reported. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 2 Standard No 31 32 33 34 35 36 Score x x x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Knowle Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 19 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 YA3 Regulation 18 Requirement Learning disability awareness training must be provided for all staff. (Previous timescale of 31st May 2005 has expired). A risk assessment must be completed on how to prevent and deal with residents potentially aggressive behaviour. Staff must be trained and supported on dealing with aggressive behaviour A review must take place of all residents food preferences and alternatives offered. All staff must be provided with adult protection training.(Previous timescale of 31st May 2005 has expired). The damp area in the residents bedroom must be resolved. The room must be redecorated. The lounge settees must be cleaned. Rubbish and cigarette ends must be removed from the garden area and the garden must be kept tidy. The areas around the paving slabs must be weeded and planted. J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Timescale for action 28th July 2005 30th September 2005 2. YA9 13 18 3. 4. YA17 YA23 16 13 30th September 2005 31st October 2005 30th September 2005 30th September 2005 30th September 2005 30th September 2005 Page 20 5. 6. 7. YA24 YA24 YA24 23 23 23 8. YA24 23 The Knowle Version 1.40 9. 10. YA24 YA24 23 16 The uneven slabs must be made safe A phone must be available at the home for residents to use in private at all times. Staff members must not refuse the use of the phone to residents. Staff files must contain all of the information required by the regulations. Including a full employment history and health check. (Previous timescale of 31st May 2005 has expired). the home must ensure that there is an effective quality assurance and quality monitoring system in place.(Previous timescale of 31st May 2005 has expired). The managers training in first aid must be updated (Previous timescale of 30th March 2005 has expired). All staff must receive first aid training. 30th September 2005 31st August 2005 11. YA34 19 30th September 2005 12. YA39 24 30th September 2005 30th September 2005 30th September 2005 13. YA42 13 14. YA42 13 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. 3. 4. Refer to Standard YA5 YA32 YA34 YA37 Good Practice Recommendations All service users should be offered a paid 7 day annual holiday 50 of care staff should have an NVQ 2 or above qualification by 2005 All information on staff files should be kept together. This would allow the manager to keep track of training and supervision of staff more easily. The registered manager should hold a level 4 NVQ in care and management or equivalent by 2005. The Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Ground floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Knowle J55 S2979 The Knowle V237978 12.7.05 UI Stage 4.doc Version 1.40 Page 22 - 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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