Inspection on 14/11/07 for The Knowls

This inspection was carried out on 14th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Knowls 22/08/06

The Knowls 13/02/06

The Knowls 17/10/05

The Knowls 02/02/05

The Knowls 27/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Knowls 86 Trull Road Taunton Somerset TA1 4QW Lead Inspector Judith McGregor-Harper Unannounced Inspection 14th November 2007 09:30 The Knowls DS0000039960.V353447.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 Knowls DS0000039960.V353447.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 Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Knowls Address 86 Trull Road Taunton Somerset TA1 4QW 01823 327080 01823 353691 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) Home First & Foremost Ltd Miss Sarah Louise Fry Care Home 14 Category(ies) of Learning disability (14) registration, with number of places The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: 2. Learning disability - (Code LD) The maximum number of service users who can be accommodated is 14. Key unannounced. 22nd August 2006. Date of last inspection Brief Description of the Service: The Knowls is a large semi-detached Victorian house situated close to Taunton town centre. The home is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation for up to fourteen people with learning disabilities. Two of the fourteen people live separately in an area of the house, known as Lomond House. An Art Room is located in the grounds of the home. The gardens have been well maintained and are accessible to service users. The Registered Manager is Miss. Sarah Fry. The Registered Provider is Voyage Ltd. Voyage (formerly Home First and Foremost) achieved Investors in People status in December 2001. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over the course of one day and was carried out by one inspector. Due to the complex needs of people living at the home we telephoned in advance to announce our intention to carry out an inspection visit. The registered manager Miss Fry, her deputy and staff on duty were available and assisted during the inspection. The operations manager was also available for comment at times during the visit. There were no vacancies at the home. Two people were away on holiday with staff support and three other people were planning to go on holiday with staff support later that day. We had brief contact people who live at the service and some people showed us into their personal rooms. Prior to the inspection the manager submitted the required Annual Quality Assurance Assessment, which is the home’s self-assessment of the quality of the service. We also sent surveys about the service to people who live at the home, their relatives and advocates, staff working at the home and visiting health and social care professionals linked to the service. A total of thirty surveys were completed and returned to the Commission. Overall the responses were positive with replies noting improvements in changing the practices and attitudes at the home away from what was perceived as somewhat institutional to a service that is better responding to individual needs and encouraging people living at the service to express choices and take up opportunities for greater community leisure involvement. Some relatives did not feel that the home communicated with them either with the desired frequency or via a medium that they preferred. The manager is recommended to consider how communication with relatives can be improved. We inspected care, staff training and health and safety records. Information provided about the service to prospective admissions and contracts for current admissions were inspected. We toured the home with the manager and observed practice at different times of the day. This report should be read together with that of the previous key inspection of August 2006 and random inspection reports form the 23rd January 2007 and 23rd May 2007. As a result of this inspection no requirements but six recommendations for good practice are made. These can be found at the end of the report. The fees levied at the home range from approximately £1500 - £2100 per week. What the service does well: The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 6 People’s care and support plans are individual, regularly reviewed and updated. Staff are familiar with the residents health care needs and how these should be met. Parents are provided with copies of the care and support review notes. Staff continue to be supported both formally and informally by the supervisory team and care practices are reviewed to ensure that the standard of care provided at the home is good. The management is committed and is able to demonstrate a drive to provide more individual choices and ranges of social opportunities for people living at the service to enable them to live with greater self-esteem and sense of achievement. What has improved since the last inspection? What they could do better: The Knowls is a large house that does not best lend itself to providing accommodation for fourteen people with complex and challenging needs as this would be better manager in smaller units. However, the home is managed in a way that tries to minimise the environmental constraints. As a result of survey response the service is recommended to review methods of communication with relatives of people who live at the service. The manager is advised to seek advice from the Health Protection unit regarding infection control practice in the laundry. The company needs to review whether it should be producing contracts in easy to read formats, as they do for the Statement of Purpose and Service User’s Guide. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 7 The service is advised to avoid writing individual service plans in the first person, as this can be misleading to authorship. The management carry out workplace clinical supervisions. They are recommended to record this. The manager’s office used to be a bedroom for a service user. The carpet is worn and stained. The carpet would benefit from being replaced. The manager is recommended to review how the home’s ‘communication book’ meets criteria of Data Protection legislation. 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 Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 8 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 Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 9 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): We inspected Standards 1, 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is produced in easy to read formats in order to provide people with clear details about the service that will inform any decision to move into the home. Once settled in the home contracts are issued in long written text documents. This seems at odds with the Company’s ethos of inclusiveness. The service obtains a full history before offering a place in order to ensure that the service has the skills to meet a person’s needs. EVIDENCE: In 2007 the Statement of Purpose and Service User Guide were reviewed, published in easy to read formats with pictorial aids. This is good practice. There has been one admission to the home in 2007. This was an emergency admission but the service took sensible steps to obtain a good history of the person. These documents were inspected. There was also evidence of the continuing involvement of the placement officer to monitor the appropriateness of the admission to the home. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 10 Contracts have been issued to people living at the service for 2007-2008. These documents were inspected. The contracts are 17 pages long and are not available in an easy to read or pictorial format. The manager reported that staff had explained contracts to people living at the service as best as they could. People who use the house vehicles contribute £75 per month toward the running costs of the vehicles. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 11 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): We inspected Standards 6, 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care and support plans are individual, regularly reviewed and updated. The format has been reviewed and is clearer in presentation. In the wording of plans it is not always evident to the degree that people are voicing their views about the way they want to be cared for. People are assisted in making decisions about matters that affect them, are given responsibilities explicitly based on trust and assisted to take risks within a framework of support. EVIDENCE: We examined three care and support plans. Care, risks and support needs are comprehensively detailed and there is a behaviour management plan for each person. Monthly summaries are prepared and inform reviews. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 12 The format used for care and support plans had been reviewed and the staff are in the process of updating all plans into a clearer system that makes the centred approach more explicit. There was evidence in the care notes of access to social and health care services. The revised individual support plan format is at times written in the first person, as if the resident were dictating how they would want to be supported to meet their care needs. On discussion with the manager it is evident that people using the service have not always made their feelings or thoughts explicit to how they want to be supported. It is therefore misleading to write support plans in the first person and it is recommended that this practice be reviewed. Discussions with staff and observation of practice on the day evidenced that people living at the home are encouraged to express choices and are consulted in their activities of daily living. Staff were sensitive to each individual’s needs and preferences and actively assisted and encourage daily living skills, both in the home and while accessing services in the community. The manager introduced resident meetings this year. So far one was held in April. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 13 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): We inspected Standards 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Since the last key inspection there has been improved access to daily leisure and holiday facilities. Bedrooms are also more individualised. Meal planning and variety of menu choice has improved. There are now resident meetings, enabling people to make more informed choices and have greater control. EVIDENCE: The service has two vehicles for transporting people to leisure or learning events. Risk assessments for individuals travelling in the cars have been completed. The service has achieved greater community access for people living in the home since the last key inspection. There is also now better use of the home communal and private space in providing opportunities for social interaction. There is a useful art room at the service that is also accessed by people at The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 14 other Homes First and Foremost services. Examples of expressive and creative artwork in a variety of medium were on display in the art room. Monthly care and support summaries note improved behaviours over the last year. There was a relaxed atmosphere in the home throughout the day. The manager acknowledged that there could be more work done to address cultural needs of people living at the service. The home is taking steps to liaise with families and specialists in the community to find out how or if any unmet cultural needs may be met. The majority of people living at the service are reported to have close relations with relatives and visit them. People have one week paid holiday per year and they are asked to contribute if the holidays chosen are abroad or they take more than one holiday. On the day of the inspection two people were returning from a short break to a holiday parc in Wiltshire and three people were getting ready to go away to the same parc for a few days. A varied menu is prepared taking into consideration needs and preferences. Specialist suppliers are used to cater for health, cultural and religious diets. Some people have chosen to be ‘rewarded’ for adhering to weekly behaviour management agreements by getting to choose a takeaway meal once a week. This ‘reward’ agreement is documented in an individual’s care and support plan. The kitchen was inspected. It was clean and suitably equipped. Records were maintained for hot foods and food cold and frozen storage. The kitchen access is restricted as there is a risk of injury not to do so. However, this does not prevent people who live at the home getting engaged in food preparation with staff escort and assistance. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 15 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): We inspected Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are working to meet people’s psychological and support needs with improved outcomes. Social and health care specialists are engaged in the management of meeting these needs. Trained staff appropriately and safely carried out the medication storage, recording and administration. EVIDENCE: Care and support records evidence that staff have a good knowledge of each person’s needs and preferences and also evidence plans made to meet individual needs. Staff were observed confirming with people that they agreed with whatever they were doing and staff also described how they assisted people to choose appropriate options when out of the home. Good outcomes were reflected, as people seemed relaxed and apparently contented. Where necessary the home works with other professionals. There were recent records of visits to dentist, chiropody and opticians by the individuals whose records were inspected. Psychiatric nursing support and clinical psychologist support is accessed and records evidenced the continuing input of social The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 16 workers. Surveys received from visiting professionals acknowledged improvements in the service in providing more opportunities for life skills and that the service maintained appropriate links with community health support services. Medication reviews have taken place. There has been a reduction in the use of psychotropic medication with greater reliance upon robust behaviour management plans and consistency of staff deliverance of agreed management plans. The medication storage, recording and administration were well managed. A list of trained staff signatories was maintained with notes for when training updates needed to be booked. There is a corporate tool for assessing and recording staff competencies. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 17 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): We inspected Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home works to protect vulnerable people living at the service through following policies and procedures in relation to adult protection and investigating concerns. EVIDENCE: The home has complaints procedure entitled ‘Letting us what you think’. This includes details of external agencies that may be contacted. There is available an easy to read version of the ‘Letting us know what you think’ procedure, with ‘help’ cards. Within the surveys received relatives confirmed that they would know how to raise a complaint. Where completed surveys from people living at the service indicated that they would raise any problems with staff at the home. There are currently two internal investigations taking place at the service. The manager has shared to details of the allegations with the Commission. Cash held at the home for people living at the service was not audited during this visit but staff were observed checking with a senior staff balances as they re turned from trips out. People living at the home have individual accounts. Good behaviour management programmes were part of the care and support plans seen, with primary and secondary strategies detailed to manage risks. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 18 Staff had received training in appropriately managing behaviour and aimed not to have to use physical intervention (PI). The service has recently been using expert guidance of a clinical psychologist to improve upon the emotional support that staff can provide people at the home. There is a corporate policy for the protection of vulnerable adults. Staff surveys indicated that they were aware of Whistle Blowing processes and had received training in the protection of vulnerable adults. There have been four scheduled staff training events in the protection of vulnerable adults available for staff during 2007. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 19 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): We inspected Standards 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although the building was not purpose built for housing several people with complex needs the home is generally homely, safe and comfortable. Some bedrooms are attractive and nicely personalised with personal equipment reflecting the preferences of the persons living in them. EVIDENCE: We conducted a tour of the building, gardens and outbuildings. Most areas of the building, shared and private, were attractive and well maintained. The nature of the service is that damage to décor requires on-going maintenance. The manager has a sound system for reporting maintenance issues and following up on work in progress. There was an odour in the manager’s office (previously a resident’s bedroom) from the carpet. This carpet is secured in areas with masking tape. As a public area by invitation it is recommended that the carpet be replaced. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 20 Two bedrooms have key locks where people hold keys to their rooms, other bedroom have code combination locks on them. The home’s AQAA reports that some people are provided with the number combination to their bedrooms. The reason for maintaining coded locks on some doors is that some people regularly enter other people’s room without permission causing distress to the person whose room has been entered. During the inspection we witnessed people asking staff if they could go to their rooms and staff obliging their wishes by providing access to the rooms. One person was aware of a restriction to access to their room during certain times of the day and the reason for this. This was recorded as part of a behaviour management process in their individual support plan. Two people showed us their rooms, which were personalised and roomy. Other rooms had recently been upgraded with people choosing colour schemes. Each bedroom has an en-suite facility. All people living at the service are independently mobile around the building. Equipment for sensory stimulation was observed in some areas. Communal spaces are large and people were observed moving freely between communal spaces. The home is a secure unit due to the risk of absconding or poor road safety awareness. The home is situated on a busy town road. The security measures at the building have been risk assessed. The home provides equipment and materials for the control of infection. New laundry equipment was installed in the summer providing good resources for managing laundry requirements. There is only one sink on the laundry, however, doubling as a route for disposing of waste in mop buckets and for hand washing. The manager is recommended to seek professional advice from the Health Protection Unit to the adequacy of cross infection prevention in the laundry and the need to install a ‘clean’ sink dedicated to hand washing only. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 21 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): We inspected Standards 32, 33, 35 and 36. Records were not available at the home to make a judgement against Standard 34. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a core of experienced staff achieving good outcomes for service users, however staff recruitment has been problematic. This has affected the number of NVQ qualified staff at the home. New staff receive appropriate induction training and on-going training updates Staff are supported to perform their roles effectively. EVIDENCE: The manager is supported by an experienced deputy and supervisory staff. Areas of managerial responsibility are shared by the senior team, some of whom had received training in supervisory roles. There is a core of staff who have been in the home for a number of years and know the residents well. The home staffs the service with 7 – 9 day staff and 3 waking and 1 sleeping staff member at night across the main home and the flat housing more independent people. The manager reported there had been difficulty in The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 22 recruiting staff into vacant posts but that agency staff were not used and the existing staff team covered vacant shifts. Less than 50 of the staff team hold an NVQ at level 2 as staff leaving the service and new staff needing to complete the induction process before embarking upon an NVQ qualification has hampered this. The staff induction is comprehensive and includes specialist training to equip them in their roles, such as LDAF, NVCI, communication techniques such as II and TC and for specific purposes such as rectal administration. The manager has an annual training matrix for the team of staff. We were supplied a copy of the staff training record. There is good follow up of staff mandatory training requirements and service specific training. Staff training requirements are discussed at individual supervisions approximately every two months. It is recommended for good practice that when a practical supervision of clinical work takes place that this be recorded and signed by both parties as evidence of good practice in workplace supervisions. Staff meetings are scheduled bi-monthly. Most staff recruitment records are held centrally at the Company’s head office. Staff surveys indicated satisfaction with the level of support and training provided by the company and home management. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 23 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): We inspected Standards 37, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The experienced registered manager has a positive and open approach to lead the home’s team. Internal quality assurance systems are in place to audit and review the quality of service provided by the home. Contact with families should be reviewed to ensure that parents feel that their needs to have updates regarding their children are being met. EVIDENCE: The registered manager Sarah Fry has completed the registered Manager’s Award and is a NVQ assessor. She has substantial experience and is positive and inclusive in the approach to her role. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 24 Feedback from surveys regarding the management style of the home was positive. Many parents reported that the home communicated well with them, some parents of people living at the home said they did not feel that contact with them was frequent enough or in the manner that they wanted to be contacted. The manager is recommended to contact parents to ascertain their wishes further. The organisation undertakes yearly internal quality audits in which the views of some stakeholders and advocates are sought about the services the home provides. We discussed with the manager issues around maintaining confidentiality in the home where records are written and the impact of the data Protection Act and Freedom of Information Act. As a result of this discussion the manager said she would review how information is recorded in the home’s communication book. Accident records examined were recorded appropriately and the manager analyses all accidents and incidents in the home. The manager is advised to complete a Regulation 37 notification for the Commission for all aggressive incidents in the home that trigger a behaviour management review, whether someone is injured or not. A company has a contract to check the water quality in the home and staff also perform checks to ensure that the mixing valves do not fail and hot water outlets exceed 43 degrees Celsius. Staff records indicate all received an update in health and safety training within the last 2 years. The home has a moving and handling trainer on staff and all staff updated a moving and handling refresher update during 2007. Staff records indicate that all staff have completed a food hygiene training day within the last 2 years. The home has use of a laptop computer (EL Box) with training courses loaded onto it so that staff can learn on the company premises. Staff received fire training and conducted a practice fire drill either in October or November 2007. Records for equipment servicing were inspected and were satisfactorily maintained. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 X 4 X 5 3 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 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 26 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. 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 Refer to Standard YA5 YA6 Good Practice Recommendations The provider should consider producing service user contracts in easy to read formats. The service should review the practice of writing individual support plans in the first person, if this is not a direct quotation, as it is misleading to the plan’s authorship. The carpet in the manager’s office should be replaced. The manager should solicit advice from the Health Protection unit regarding the appropriateness of installing a hand washing only sink in the laundry. As evidence of good practice it is recommended that workplace clinical supervision feedback records be competed and signed by both parties. It is recommended that the manager seek feedback from DS0000039960.V353447.R01.S.doc Version 5.2 Page 27 3 4 YA24 YA30 5 YA36 6 YA39 The Knowls parents of people living at the service to ascertain if the service is communicating with them in a manner and with frequency that they would like. 7 YA41 The manager is recommended to review the recording format in the staff ‘communication book’ to ensure that written records meet Data Protection guidelines. The Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Knowls DS0000039960.V353447.R01.S.doc Version 5.2 Page 29 - 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!