CARE HOME ADULTS 18-65
The Knowle 60/62 Carterknowle Road Sheffield South Yorkshire S7 2DX Lead Inspector
Mrs Janis Robinson Unannounced Inspection 29th November 2005 08:00 The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 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.V265777.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 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.V265777.R01.S.doc Version 5.0 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 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.V265777.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th July 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 DS0000002979.V265777.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours from 8.00 am to 12 noon. An inspection of the environment was undertaken. A proportion of records were checked, including staff recruitment, supervision, health and safety and fire records. Interactions between staff and residents were observed. Eight residents were spoken with. The member of staff on duty was interviewed. Discussions with the homes manager and deputy took place. What the service does well:
A service user guide had been provided to each resident to give him or her information about the home. Contracts were in place for each resident, to inform them of their rights. Trial visits took place, to enable prospective residents and their representatives to make informed choices. Staff undertook a range of training to keep them up to date and ensure they were able to meet residents’ needs. Residents were supported to make decisions. Risk assessments were undertaken. A policy on confidentiality was in place. Relationships with family and friends were supported. A varied diet was offered and individual preferences were respected. Residents’ personal care needs were met. A complaints procedure and adult protection procedure were in place, to safeguard residents. The home provided a comfortable clean and pleasant environment with individualised space for residents and a pleasant outside area. A thorough recruitment procedure was in place. Staff undertook training to equip them with the skills needed to carry out their duties. Staff supervision took place at the required frequency. The home was well run. A quality assurance system had been introduced, to monitor the service offered. A range of policies and procedures were in place. The Knowle DS0000002979.V265777.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 Knowle DS0000002979.V265777.R01.S.doc Version 5.0 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.V265777.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5 The service users guide/statement of purpose was complete and available. Staff undertook a range of training. Specialist services were provided and information on advocacy services was available. Prospective residents were able to visit the home prior to admission. Each resident had been provided with a contract. EVIDENCE: There was a service users guide/statement of purpose in place, which contained all of the required information. Residents had received copies of this. Staff training was undertaken on a regular basis, to ensure staff had the skills to meet residents’ needs. Learning disability awareness training for staff had taken 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. Prospective residents and their families were encouraged to visit the home to meet staff and residents before they decided to move in. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 9 All residents had been provided with a contract, which included information on the fee charged and the rights and responsibilities of the resident and the home. The residents had signed the contracts seen. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 7,9 and 10 Residents were supported to make decisions. Residents were encouraged to take responsible risks as part of an independent lifestyle, and the majority of risk assessments were in place. A policy on confidentiality was in place. EVIDENCE: Staff supported residents to make decisions, for example, during the inspection residents were observed choosing how to spend their day, what to eat and deciding to make an appointment for a dental check. 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. Risk assessments were in place for all residents. One risk assessment had been undertaken to advise on how to deal with potentially aggressive behaviour, and staff had received training on this. Staff had access to the policy on confidentiality. Records evidenced that staff had received training on expectations regarding confidentiality. The
The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 11 supervision records seen also evidenced that confidentiality was discussed during supervisions. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12,13,15,16,and 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. Residents’ responsibilities for some household tasks were identified. A varied diet was provided. 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.
The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 13 Residents spoken to said they visited relatives and friends on a regular basis, some residents were friends and went out together. Visitors were welcomed to the home. Residents rights were respected, staff were clear about supporting individual choice and preference. Residents were consulted about their food preferences. Since the last inspection a review of the food provided had taken place to ensure all residents needs were met. Most residents did not help with the preparation of food, although they did sometimes make drinks or help to tidy up. All of the residents spoken to said the food was good. Fruit was always available for residents and snacks and drinks were also available. Nutritional needs were monitored and reviewed. Residents were observed choosing different breakfasts on the morning of the inspection, including cooked foods. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 18,19 and 21 Residents at the home were supported in maintaining their personal care and environment. Appropriate healthcare was provided. Residents had not been specifically consulted regarding long-term care ageing and death. 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. Residents had not been individually consulted regarding long term care, dying and wishes regarding funeral arrangements. It is acknowledged that some residents may not have an understanding of these issues, or may become distressed if approached individually. The manager agreed to approach the subject in a general manner at the next residents meeting, inviting all residents to approach her individually if they had any worries, concerns or wishes about getting older. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home had a clear and accessible complaints procedure, to ensure residents’ rights were protected and any concerns listened to and taken seriously. An adult protection procedure was in place. 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 had taken place since the last inspection. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 A comfortable and safe standard of accommodation was provided for the residents. Extensive decorating and maintenance work had recently been completed. Damp in a resident’s room required attention and dining chairs required cleaning. EVIDENCE: The home was clean, well maintained, and well decorated. The building complied with the requirements of the fire service. 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. The settees in the lounge had been professionally cleaned. Residents’ rooms were mostly well decorated and individualised. Two residents rooms had recently been repaired and redecorated from damp damage. Further damp damage was apparent in one other bedroom. The outside garden area had been cleared of rubbish and some loose paving slabs made safe. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36. Staff undertook a range of training. A thorough recruitment procedure was in operation. CRB checks for staff were completed. Residents were consulted on the appointment of new staff. The staff-training programme met standards. NVQ 2 training had not commenced. EVIDENCE: The staff member was due to commence NVQ training. Recruitment files contained the information required by the standards and regulations. One file had been updated to include a full employment history. The existing member of staff had signed a health declaration. However, a health check had not been undertaken. The manager was in the process of recruiting a new member of care staff. Health checks must be undertaken for any new employees. 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. 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. Staff supervision took place at the required frequency.
The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42 and 43. The home was well managed. The manager’s leadership approach benefited residents and staff. A quality assurance system to monitor views of residents and their relatives or representatives required further development. A range of policies and procedures were in place. 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. EVIDENCE: The manager displayed a strong sense of commitment to residents and to ensuring standards were maintained. All of the residents and the member of staff said the manager was approachable and supportive. A quality assurance system had commenced. Monthly monitoring visits took place, however, these needed to be routinely undertaken by a person external to the home. No views of residents and relatives/representatives on the quality of care provided had been formally sought via questionnaires. Residents’ views were informally sought on a day-to-day basis. Regular The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 19 residents meetings took place, which enabled residents to express their opinions. For the protection of residents, the home had a health and safety policy in place. A staff member spoken to confirmed he had received some mandatory training, including first aid training. The manager had also undertaken first aid training. Records indicated that refresher training in food hygiene and moving and handling were required. 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. Fire equipment checks were routinely undertaken. Staff had been provided with fire training to ensure they knew how to respond in an emergency. The manager confirmed that notifiable incidents were appropriately reported. The Knowle DS0000002979.V265777.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 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 3 X 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Knowle Score 3 3 X 2 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 2 3 DS0000002979.V265777.R01.S.doc Version 5.0 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4 5 Standard YA21 YA24 YA24 YA34 YA39 Regulatio Requirement n 12 Residents must be consulted to ensure they have no worries regarding getting older. 23 The damp area in the resident’s bedroom must be resolved. The room must be redecorated. 23 The dining room chairs must be cleaned. 18 New staff must have a health check completed. 26 A person external to the home must undertake monthly monitoring visits. 24 The quality assurance system must be expanded to include residents, representatives and professional visitor questionnaires. These must be undertaken on an annual basis. The results of the questionnaires must be audited and the results made available to residents and their representatives. All staff must be kept up to date with all mandatory training. Refresher training in moving and handling and food hygiene must be provided.
DS0000002979.V265777.R01.S.doc Timescale for action 31/01/06 28/02/06 31/01/06 31/01/06 31/01/06 6 YA39 31/03/06 7 YA42 13 28/02/06 The Knowle 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. 1. 2. 3. Refer to Standard YA5 YA32 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 The registered manager should hold a level 4 NVQ in care and management or equivalent by 2005. The Knowle DS0000002979.V265777.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sheffield Area Office 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 DS0000002979.V265777.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!
