Inspection on 17/05/07 for Thomas Knight Care Home

This inspection was carried out on 17th May 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

Thomas Knight Care Home 16/06/08

Thomas Knight Care Home 29/08/06

Thomas Knight Care Home 16/05/06

Thomas Knight Care Home 27/01/06

Thomas Knight Care Home 12/09/05

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Thomas Knight Care Home 1 Beaconsfield Street Blyth Northumberland NE24 2DN Lead Inspector Janet Thompson Unannounced Inspection 10:30 17 May and 21st June 2007 th 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 Thomas Knight Care Home DS0000060989.V334771.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 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. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thomas Knight Care Home Address 1 Beaconsfield Street Blyth Northumberland NE24 2DN 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) 01670 546576 01670 546823 Mr Sewa Singh Gill Position Vacant Care Home 54 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (35), Old age, not falling within any other of places category (17), Physical disability (1) Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2006 Brief Description of the Service: Thomas Knight was opened in 2005, it is situated in the centre of Blyth. The home is close to local shops and amenities. The accommodation is located on three floors and all rooms are single with en-suite facilities. The ground floor of the home accommodates residents with general nursing needs. The second floor accommodates residents with nursing and mental health needs. There are sitting areas and a dining room on each floor. A passenger lift connects all floors. There are small gardens to the front and side of the home. The garden at the front is not suitable for use by those residents with any degree of confusion as it leads directly onto the main road. The fees for the home range from £355.97 to £376.31 per week. Further information can be found in the statement of purpose for the home and previous inspection reports. These are available in Thomas Knight. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home opened in 2005. There have been several changes of manager since the opening of the home. Standards in the home had improved at the last inspection but the manager of that time subsequently left. Standards deteriorated again and Northumberland County Council suspended contracts with the home. The current acting manager, Carol Spence has been at the home for three months. She has managed, in that time, to improve the home enough for reinstatement of contracts. This inspection was unannounced. It took place over two visits. Mrs Spence was present for both visits. Information about the home, in the form of a self-assessment document was requested before the inspection. The manager returned this. Resident questionnaires were also distributed. Five were returned and all commented positively on the home. During the inspection a range of records were examined and time was spent with residents and staff. What the service does well: What has improved since the last inspection? Social activities have been reviewed to cater for residents’ individual needs. More residents go out of the home for visits to local facilities. There have not been any complaints since Mrs Spence took over. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 6 There have not been any issues requiring the intervention of the adult protection team since Mrs Spence took over. The manager regularly consults and updates residents, relatives and staff about matters arising in the home. Staff training has been reviewed and staff brought up to date. The premises have improved. The bathrooms have been redecorated with colourful schemes to give them a more homely feel. Pictures and ornaments have been bought to decorate the corridors and public rooms. The home clean and smelled fresh. Staff spoken to were very positive about the new manager. They confirmed that she provided them with the correct equipment to carry out their job and had residents’ best interests at heart. This was the first time, since opening, that the inspector had visited the home and not received any complaints or criticisms from staff. In questionnaires residents and relatives said things had improved greatly with this manager. 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. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 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 Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have their needs assessed before moving into the home. This ensures that the home can meet individual needs. EVIDENCE: Three resident’s care plans were examined. They all contained adequate preadmission information. The assessments had taken account of information from health professionals. All aspects of care were covered. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are not always clearly set out in a plan of care to support staff to care for residents. Resident’s health needs appeared to be met. The medication procedures in the home are adequate in protecting residents. Residents felt they are treated with respect and have privacy. EVIDENCE: Four plans of care were examined. Two were case tracked to people the inspector had met or identified. These were residents with complex physical and psychological needs. Most of the care plans contained enough information about residents but the planning and evaluations were a little muddled. For example one care plan dealing with the management of diabetes had more information regarding poor appetite than regulation of blood sugar. Another plan for urinary incontinence contained in depth detail of how to transfer the resident, which should have been in a plan for mobility. One plan that was case tracked showed that the resident had a wound on an ankle. There was no body map or formal grading or measuring for this. The acting manager was aware of the need for care Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 10 planning to be improved. She has commenced a system of auditing care plans and some staff training. Residents looked clean and well cared for. All residents spoken to, or who responded to the questionnaires, said they were well looked after. There was evidence in care plans that residents can see a doctor when they need to. Other health professionals such as psychologists had been involved in the care of residents. Medication administration records were examined. Medication management was satisfactory. The acting manager audits medication practices. Resident’s spoken to confirmed that they were treated well in the home and they felt that staff treated them respectfully. On resident questionnaires comments were made such as: “the staff work hard and are very nice” “I am treated well”. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s lifestyles do meet their social needs. Resident’s are helped to maintain community links and to exercise choice and control. Residents do receive an adequate diet to maintain their health and wellbeing. EVIDENCE: An activities co-ordinator is employed for 30 hours per week. The acting manager reported that the level of activities is slowly improving. She is very keen to engage residents in activities that will benefit their mental and physical health. Pictures have been purchased that are based on times past and help to prompt reminiscence. Several residents are now going out of the home on a daily basis to local shops and cafes. As yet there is no system for recording the level and benefit of activities people have participated in. Families and friends do visit residents in the home. Several relatives commented in questionnaires that they were happy with communication in the home since the appointment of the new manager. The acting manager has had a lot of input into the management of the kitchen. This has resulted in changes to the menu and better standards of hygiene and cooking. The acting manager is planning to print a daily menu for residents to Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 12 remind them what they are eating that day. The food on the day looked good. It was well presented. Pureed diets had separated ingredients. The assistant cook was baking cakes and does a lot of home cooking. The dining areas look a lot better as they have had some homely touches such as ornaments and dressers added. Dining tables were clean and nicely presented. Staff were observed to be polite to residents and offer them choices about where to sit, what to eat and how to spend their day. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ are confident that their complaints will be listened to. Good systems are in place to ensure that residents are protected from harm. In the past these systems have not been followed. EVIDENCE: There have not been any complaints since the acting manager took over. The residents are given the complaints procedure in a welcome pack on admission and a laminated version is in the entrance hall. Residents know whom to complaint to. In questionnaires, residents said the complaints procedure was “always available”. There were a number of complaints in the recent past. The documentation relating to this is not all available due to the change in manager. Adult Protection procedures are available in the home. All staff have now received training in adult protection. There have not been any incidents requiring the intervention of the adult protection team since the acting manager took over. Prior to this there were numerous incidents, one of which is still ongoing. This prompted Northumberland County Council to restrict new admissions to the home for the second time. This suspension of admissions has just been lifted. The change in staff practice and attitude happens over a period of time. This will be reassessed again in the near future and continues to be part of a monitoring process with other agencies. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 14 Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were safe and well maintained. The home was clean and pleasant for residents to live in. EVIDENCE: All of the public areas, bathrooms and toilets were examined. Some of the bedrooms were examined. Resident’s bedrooms were clean, tidy and well personalised. Bathrooms have just been redecorated and are more colourful and homely. The entrance hall, corridors, dining rooms and lounges have been improved with the addition of pictures and ornaments. External grounds are limited. On the day of inspection they were tidy and free from rubbish. There were no obvious trip hazards. Fire exits were clear. Hazardous substances were locked away. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 16 There were no offensive odours in the building. The laundry was well organised and clean. The home was very clean and all areas were tidy. The acting manager reported that the home has been provided with a handyman. A book is kept of repairs and these are now carried out promptly. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were enough staff to meet the needs of residents. Residents are protected by good recruitment procedures. Staff have up to date statutory training to enable them to do their jobs safely. EVIDENCE: There were sufficient numbers of staff on duty. The current staffing for the home is: Ground floor: One RGN at all times. Two carers through the day and one at night. Middle Floor: Two care staff throughout the day. One carer at night. Second Floor: One RMN/RGN at all times. Four carers throughout the day. Two carers at night. 51 of care staff have been trained in NVQ2 or above. More staff are currently training for this and some staff are now progressing to level 3 NVQ. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 18 Four staff recruitment files were examined. These were from staff that had been employed by the acting manager. They contained all the required information. All files showed that employment history had been checked. References have been obtained. Criminal records checks have been carried out. The manager has used an interview form when interviewing staff, which is good practice. A staff-training plan is now used to identify training needs at a glance. Staff also have an individual file to record courses undertaken externally and inhouse. The acting manager has ensured that all statutory training is up to date and has now started sending staff on vocational training and courses that they have requested. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a manager in the home who has not yet been assessed as “fit” to run the home. Residents do benefit from the manager’s leadership. The home is run in the best interests of residents. Resident’s financial interests are safeguarded. The health and safety of residents and staff may not be fully protected. EVIDENCE: The acting manager has been at the home for three months. She is not yet registered with CSCI. The acting manager is a first level nurse with 25 years experience, 12 of which have been in care homes. The inspector had no cause to doubt that the manager would be successfully registered by CSCI, following which this standard would be met. The acting manager has made numerous improvements to the home. These have already been detailed in the body of this report. This has resulted in Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 20 residents living in a more pleasant environment with a better lifestyle. Staff spoken to say that they are happier at work and feel the home is well managed. Staff said the manager “listens to you and gives you what you need to do your job”. They said, “She is all for the residents” and “she should have been here from the beginning”. This is the first time that the inspector has visited the home since it opened and not heard adverse comments from staff. The atmosphere in the home was relaxed and happy. Staff were cheerful and friendly. All resident/relative questionnaires returned commented that the home had improved since the acting manager took over. The home is run in the best interests of residents as they are now formally consulted about the running of the home. Finance records for all residents were examined. Monies are held individually and receipts kept for amounts spent. Staff are up to date with statutory training relating to the health and safety of themselves and residents. There were no obvious health and safety issues in the home. Fire checks and tests were up to date. Staff had been trained in fire protection. A health and safety audit has been carried out. Some minor issues were identified and dealt with. It is good that a more proactive approach to management of the home is now underway. Two documents relating to safety could not be found. These were, the hot water checks carried out by the handyman and the electrical safety certificate. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 X 3 X X 2 Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 22 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. 2. 3. Standard OP7 OP31 OP38 Regulation 15 8 13(4)(a) Requirement Care plans must fully reflect residents care needs. Provide a registered manager for the home. Provide CSCI with evidence that the electrical system has received a certificate of safety and the hot water checks are carried out. Timescale for action 01/08/07 01/09/07 01/08/07 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. Refer to Standard OP12 Good Practice Recommendations Provide a record of social activities. Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Thomas Knight Care Home DS0000060989.V334771.R01.S.doc Version 5.2 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. 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