CARE HOMES FOR OLDER PEOPLE
The Knowle Care Home 5 - 7 Egerton Road Ashton Preston Lancashire PR2 1AJ Lead Inspector
Mrs Felicity Lacey Unannounced Inspection 17th January 2006 9.30am X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Knowle Care Home Address 5 - 7 Egerton Road Ashton Preston Lancashire PR2 1AJ 01772 727485 01772 731670 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) The Knowle Care Home Ltd Mrs Susan Burns Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home may accommodate up to 23 persons in the category OP (older persons). 18th October 2005 Date of last inspection Brief Description of the Service: The Knowle is registered as a care home providing accommodation and personal care for up to 24 older persons of either sex aged 65 years and over. There are 21 service users presently accommodated. The home is situated in a residential area on the outskirts of Preston. The Knowle is a large Victorian property that is in keeping with the surrounding area and it has retained many of its original features. Service users accommodation is provided on ground and first floor and access is provided by a passenger lift. There are fourteen single and five double bedrooms, five of which have on-suite facilities. Communal areas comprise of two lounges, a dining room and a conservatory, these are situated on ground floor. There is a pleasant secluded garden at the rear of the home with ramped access. The Knowle is reasonably close to shops and local amenities, and has excellent transport links for the city centre. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced. The inspection included discussions with residents, members of staff and the manager. Daily notes, care plans and information gathered regarding the clients were looked at. Time was spent observing the workings of the home and how residents were supported by staff members. What the service does well: What has improved since the last inspection?
All appropriate checks are now being completed before staff commence work at the home. Individual records of medical visits and treatment have been established since the last inspection visit. This system allows an individual to read the record without having access to any other confidential information about another person. The home have complied with recent health and safety requirements. In line with a recommendation made at the last inspection the stairwell leading to the front door has been risk assessed to minimise the hazard posed to residents. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 6 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 Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the announced inspection in October 2005. EVIDENCE: The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were assessed at the announced inspection in October 2005. EVIDENCE: The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The gathering of information of the life experiences of residents would ensure that the service offered is in line with their cultural and social expectations. EVIDENCE: As recommended at the last inspection the homes approach to providing recreational and social activities could be improved by highlighting the previous life experiences of the residents in the care plan, for example recording jobs held and significant events. By gathering information, with the consent of the resident, regarding life experiences before moving to the home, staff will gain a valuable insight into the social and cultural needs of the individual. A format has been developed for this however has not yet been used. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The residents are protected by procedures for the protection of adults. EVIDENCE: Staff members spoken with were aware of the procedures in place to ensure that clients at the home are protected from abuse. All members of staff are required to sign to acknowledge that they have read and understood the ‘No Secrets’ guidance. Staff members receive guidance and training concerning adult protection at the time of their induction and through undertaking further training, such as National Vocational Qualifications. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The environment will be improved by the redecoration of the downstairs shower room and the repair of the shower tray. EVIDENCE: As recommended at the last inspection the downstairs shower room would benefit from redecoration. The broken edging to the shower tray should be repaired to prevent any accidental injury. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staff receive induction training and have access to on going training opportunities which ensures that the practice of the home is based on a good understanding of the needs of the clients, and how these can be best met. EVIDENCE: The home is staffed to the requirements of the care needs of the residents. Comments from residents indicated that staff were available at all times, and were friendly and polite. All members of staff are working towards National Vocational Qualifications. Appropriate checks are sought for all new employees. The home has recently recruited staff from Eastern Europe, and all the necessary checks have been completed, including a POVA First check. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 Residents views are respected and their financial interests are safeguarded by the practices at the home. EVIDENCE: The manager of the home is continuing to work towards completing her NVQ 4 award. Residents have regular contact with the manager and staff and felt that they were encouraged to make their views known. There have been regular attempts to hold residents meeting, however interest in these meetings has fluctuated. The manager is planning to hold another meeting in the near future, as there are a number of new residents who may be interested in discussing the home in a group setting. The home does not act as agent for any resident. The residents maintain control of their own finances or have a relative act on their behalf. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 15 The record keeping practices of the home have been improved by the development of individual records of medical visits and treatment; this system respects the need to maintain confidentiality. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X 3 X The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 17 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. Standard Regulation Requirement Timescale for action 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 OP12 OP26 OP28 OP31 Good Practice Recommendations Social histories should be gathered to ensure service meets cultural and social expectations of residents. The shower tray in the downstairs bathroom should be repaired. 50 of staff should achieve an NVQ in Care. The registered manager should achieve a NVQ level 4 in Care and Management. The Knowle Care Home DS0000062611.V278482.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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