Inspection on 02/07/07 for The Knowle

This inspection was carried out on 2nd July 2007.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Knowle 29/11/05

The Knowle 12/07/05

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 Miss Pam Dimishky Key Unannounced Inspection 2nd July 2007 10:00 The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 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 Knowle DS0000002979.V329359.R01.S.doc Version 5.2 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 Adults 18-65. 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 Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Knowle Address 60/62 Carterknowle Road Sheffield South Yorkshire S7 2DX 0114 258 3201 0114 258 3201 none 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) Mr Michael Thomas Kelly Mrs Sarah Bernadette Kelly Mrs Ann Patricia Bolger Care Home 13 Category(ies) of Learning disability (13), Mental disorder, registration, with number excluding learning disability or dementia (13) of places The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 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 home’s fees are £293.00 per week with additional charges for hairdressing (£5.00), activities, toiletries (£2.00). The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection site visit was undertaken with the home’s manager. The visit took place over a period of 3.25 hours and included a tour of the premises, examination of resident files and records relating to the service. Only one resident was available to talk to at the time of this inspection, but five resident survey forms were completed answering questions about the service and these comments have been reflected throughout the report. Two survey forms were returned from a health professional and a social service reviewing officer, and from two members of the care staff. What the service does well: What has improved since the last inspection? The home is very much family run and the manager’s husband has recently obtained a Registered Manager’s Award qualification; two members of staff now have certificates in first aid, food hygiene and moving and handling. The home has been redecorated throughout, including outside, and the dining table and chairs have been replaced. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 6 The annual quality assurance system developed to review and improve the quality of care and services provided is ongoing. Advice is being sought with a view to increasing the number of people the home is registered to care for. 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 summary of this inspection report can be made available in other formats on request. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home’s assessment procedure ensures prospective residents individual aspirations and needs can be met by the service. EVIDENCE: Three residents have been admitted since the last inspection and their case files were examined. Full needs assessments involving families and health care professionals were in evidence and signed contracts in place for two of the residents, one contract being unable to be found at the time of this inspection. A care plan has been developed from the assessment with risk assessments also in place. Prospective residents and their families are encouraged to visit the home before deciding whether to move in. The service user guide is given to all residents, however, the manager said not everyone wishes to have a copy and in this instance it is read to the resident and a copy given to the family and/or social worker. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care plan reflects residents individual needs and personal goals and they are given support in making decisions about their life, including following an independent lifestyle, therefore maximising their quality of life. EVIDENCE: Three care plans were examined at this inspection for new residents admitted since the last inspection; the case records included the needs assessment from which the care plan has been developed. Information in the care plan indicates it has been drawn up with the resident’s involvement, their family, relevant agencies and specialists and is regularly reviewed. Arrangements are in place for support and advice from health service professionals and all residents receive an annual optical check; four residents have spectacles prescribed. At the time of this inspection only one resident was in the home and available to talk to reflecting the degree of independence the residents have in what they do and how they spend their lives. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 10 The provider/manager acts as appointee for some residents and the arrangements for banking monies do not follow good practice guidance. However, the manager is to make arrangements for a separate bank account to be set up which provides the resident with interest on their monies. The balance of two other accounts, and the records, were checked and found to be correct. Residents receive their full personal allowance daily, but one resident expressed their dissatisfaction, as the amount of money provided was not considered to be sufficient. However, the manager stated the amount received is outside her control and agreed to explain the matter to the resident. The case records included risk assessments eg for going out of the home alone, which have been developed to support the resident in having an independent lifestyle. Risks are assessed prior to the resident coming to live in the home and are discussed with relevant professionals as part of the risk management strategy. A policy and procedure is in place for anyone missing from the home. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their lifestyle and are supported to develop skills which maximise their quality of life EVIDENCE: Residents are encouraged to be independent and the majority were out of the home for the day, some attending day centres and others shopping, only returning home for lunch and tea and retiring for the night. Links have been established with the local churches including Anglican, Roman Catholic and Methodist. According to the manager two residents who stated in their comment survey they are of other faiths/beliefs, are not practising and are well able to choose their food according to their wishes. The home is situated in a multicultural area of Sheffield with shops providing food for people of all religions. The manager stated she would ask residents of different faiths, and their families, about their food choices and how their food should be prepared and served. One resident spoken to stated he was very happy since coming to The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 12 live in the home and when asked about how he preferred to spend the time of day, stated he enjoyed watching television but often went out to the shops, visiting friends and for a walk; he also said “the food is very good”. On the day of inspection soup and tuna sandwiches were being prepared for those residents choosing to return for lunch, and for the evening meal residents had chosen to have fish and chips followed by rice pudding, mousse or yoghurt. The manager, a resident and a member of staff said that although a menu has been devised people choose what they want to eat and when, and if they want something different to what is offered, a local supermarket is nearby and someone will go and purchase whatever the resident chooses. The manager and a member of staff, stated crisps, biscuits, fruit and drinks are available at any time; residents make their own tea or coffee whenever they wish. Visitors are welcome to visit at any reasonable time and the manager stated those people in the community who support the home also drop by occasionally. Five residents completed survey forms and all responded positively about life in the home and the ability to make their own decisions about what they do each day. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents health and personal care is provided based on their individual needs. However, staff must receive proper training in medications to safeguard the residents. EVIDENCE: A requirement made at the previous inspection for residents to be consulted to ensure they have no worries regarding getting older has been met in a sensitive way. The manager said the issues were discussed in an informal way at a residents meeting to determine whether they had any views about getting older, however, residents responded by saying they were all “spring chickens”; this opportunity was also taken to discuss the procedure for writing a will. Almost all the residents are self-caring and personal support is provided as required to meet the individual assessed needs. None of the residents is self-medicating other than for the use of creams. Each has a locked cupboard for safe storage in accordance with the home’s policy and procedure. All residents’ bedroom doors are self-closing ensuring The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 14 any medicines kept in their rooms are secure. Care staff have not received accredited medication training. The manager stated she has given in-house training and the visiting pharmacist does not feel it is necessary for staff to have further training as residents are on the same medication. However, there is a need for staff training to ensure they have a basic knowledge of how medicines are used and how to recognise and deal with problems in use. The manager stated the pharmacist visits the home every three months, the last visit being March 2007; however the visitors book indicates the pharmacist visited during August 2005. The home’s pharmacist indicated that the home has not been visited by them since late 2006. Records and medications are checked at these visits and a discussion is held with individual residents regarding any medications bought over the counter; no report is made following these visits. The home operates the Nomad monitored dosage system for medication and these were checked along with the medication returns records and medicine administration sheets for three residents. All were found to be in order. Medications are stored in a locked box, which is kept in the office, which is always locked when not in use and the manager stated the visiting pharmacist is happy with this arrangement. Two questionnaires completed by health and social care professionals stated the home appropriately manages residents’ medications. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this serviced experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. The home’s policies and procedures for safeguarding adults and staff awareness training ensure residents are protected. EVIDENCE: The complaints book was examined which shows one minor complaint was received and satisfactorily investigated and resolved since the last inspection November 2005. The complaints procedure has been given to all residents who are encouraged to talk to staff and the manager if they have any concerns. The home has a policy and procedure for safeguarding adults and two members of staff have had training for safeguarding adults. The manager is to consider sourcing managers’ awareness training and obtaining a video for inhouse training. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of the environment in this home is good providing residents with a comfortable and homely place to live. EVIDENCE: All residents have a key to their room and as all but one were out at the time of this inspection only one bedroom was seen. The resident was proud to show the inspector the attic bedroom he occupies. The room was very spacious and had been personalised with items of the resident’s own choosing and decorated according to his choice of colour; the room is accessed by way of a very steep and narrow staircase and the manager confirmed a risk assessment has been undertaken. Two residents who smoke have chosen to share a bedroom with a second bedroom used as their own lounge. The fire officer has visited and given advice with regard to the area being used for smoking; the carpet has been removed and replaced with wooden flooring. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 17 A requirement made at the last inspection for a damp patch in a resident’s bedroom to be resolved, has been actionned and the room redecorated to the resident’s own choice of colour scheme. The manager stated that a leaking gutter has been identified and repairs are planned once the weather allows. Communal areas were clean and tidy and the laundry has floor and walls, which can be easily cleaned. Despite the best efforts of staff one staircase carpet is badly soiled and must be shampooed or replaced. Since the last inspection the home has been redecorated both internally and externally and the dining room chairs and table have been replaced. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home operates with sufficient staff who have the necessary skills to support residents assessed needs at all times EVIDENCE: Thirteen residents are living in the home. They are able to come and go as they please and only one resident was in during the time of this inspection. Two members of the care staff are employed by the home and the rest of the staff team, including the manager, are part of the registered provider’s family. Some discussion took place regarding the number of staff needing to be on duty at any time and the manager was advised that at all times there must be sufficient staff on duty to meet the assessed needs of the residents. When the residents go out during the day then there should be sufficient staff on duty to meet the remaining residents’ needs and if those who go out have been assessed as needing to be accompanied then they should be supported to do so. One senior carer and his wife live on the premises and sleep in covering the night shift; two members of the provider’s family are on call during the night. The wife is not employed by the home or had a recent Criminal Records Bureau The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 19 check. The manager agreed to rectify this shortfall without delay and to ensure she is included on the duty rota as a member of staff or volunteer. Since the last inspection the two members of the care staff have qualified in basic food hygiene, first aid and had safeguarding adults training. All the current residents are ambulant and do not need assistance with moving, but staff have received refresher training in moving and handling. The senior carer has received training for caring for people with learning difficulties and mental health. The manager is awaiting information regarding the two members of care staff taking a qualification at NVQ level II. Staff have annual appraisals and regular supervision. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 20 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager has a good understanding of the importance of maintaining a continual improvement of the home and there is evidence of residents being consulted in these developments. EVIDENCE: This is a home, which is family owned, and is run with the involvement of family members from two generations. The manager was able to demonstrate a strong sense of commitment to residents and to ensuring standards were met and maintained. Her husband assists in the management of the home and has obtained the Registered Manager’s Award. The manager herself stated she plans to enrol for NVQ level IV in care and management, or equivalent. In conversation with one resident, and from completed questionnaires, it is evident residents feel the home is well run and that they are consulted and The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 21 their views listened to. An annual survey is undertaken and summarised for inclusion in the service user guide. Residents meetings are held bi-monthly and regular, informal individual discussions also take place. A requirement was made at the last inspection for Regulation 26 visits to take place and someone not connected with the home has been recruited to do these and make a report. The pre-inspection questionnaire indicated maintenance and associated records are up-to-date. Evidence was seen that fire equipment was checked during March 2007, the landlord’s gas safety certificate is dated 17/08/06, and the emergency lighting periodic inspection was dated 18/08/07; fire alarms and emergency lighting is checked weekly. The manager stated her husband received a distinction award for fire training and staff have in-house training every six months. A policy and procedure for emergencies and crises is to be developed and as a result of the recent flooding in the area, the manager had bought two generators in case of need. The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 x The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA7 YA23 Regulation 20 Requirement Residents for whom the manager acts as appointee must have a bank account separate to the home’s business account The staircase carpet which is badly soiled must be cleaned or replaced Ensure people working in the care home have had the necessary criminal record checks prior to commencing work in the home Timescale for action 31/07/07 2. 3. YA30 YA34 23 19 31/08/07 02/07/07 The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 24 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. Refer to Standard YA20 YA32 YA37 Good Practice Recommendations It is good practice to have up-to-date training for staff administering medications and for the home to have evidence of the training and its content 50 of care staff should have an NVQ 2 or above qualification The registered manager should hold a level 4 NVQ in care and management or equivalent The Knowle DS0000002979.V329359.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000002979.V329359.R01.S.doc Version 5.2 Page 26 - 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!