Inspection on 29/08/06 for Thomas Knight Care Home

This inspection was carried out on 29th August 2006.

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 17/05/07

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 Key Unannounced Inspection 29th August 2006 09:30 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.V302936.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.V302936.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 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.V302936.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: Thomas Knight is a newly built care home 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. The middle floor is currently unoccupied. There are sitting areas and a dining room on each floor. A passenger lift connects all floors. The lift is of a type not usually found in care homes and its approval is still under discussion with the fire department. The gardens are located to the front and side of the home. They are very small. 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.V302936.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. The home has had numerous inspection throughout 2005 and 2006 due to concerns about it’s management. This inspection was unannounced. It started in August and was suspended for two months whilst two adult protection investigations were taking place. Northumberland County Council suspended contracts with the home, which meant that new residents could not be admitted. The home submitted improvement plans to the council. All residents were reviewed and contracts were restarted. Information about the home was requested before the inspection. Resident questionnaires were also distributed. Six were returned and all commented positively on the home. During the inspection a range of records were examined and time was spent with service users and staff. What the service does well: What has improved since the last inspection? The statement of purpose has been amended. Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 6 There is now a staff training plan and some good training has been carried out. Staff have now received one to one supervision. Social activities have been introduced and residents now have things to do. The manager has plans to further improve this. The recording and management of medication is better. Staff have received training in medication. There is now a quality assurance system to assess areas requiring improvement. Resident’s views are sought as part of this. The manager carries out audits of all systems in the home. This has resulted in safer more effective procedures and has improved care for residents. The manager is now running the home well and has more support from the owners. All of the requirements made at the last inspection have been met. 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. Thomas Knight Care Home DS0000060989.V302936.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.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. Prospective service users had the information they need to make an informed choice about where to live. All residents have their needs assessed before moving into the home. Intermediate care is not provided at Thomas Knight. EVIDENCE: The home’s statement of purpose has just been reviewed and is now available in the home. This tells residents what to expect from the service and what is provided for the cost. Three resident’s care plans were examined. They all contained adequate preadmission information. The information included the different ethnic and cultural needs of one resident. Of the residents spoken to one was able to recall the manager visiting him before admission. Thomas Knight Care Home DS0000060989.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. Residents’ needs are set out in a plan of care. 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. These included one resident with diverse cultural and religious needs and one new resident. The care plans reflected the differing needs of the residents. All aspects of care were identified. Care plans were clear and easy to read. All assessments and plans had been reviewed monthly. The staff nurse in charge was able to discuss the care of the residents in detail. These accounts corresponded with what was written. Residents or their representatives had signed care plans. Resident’s health needs were clearly recorded in care plans. This included visits from health professionals. All residents spoken to, or who responded to the questionnaires, said they were well looked after. Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 10 All medication administration records were examined. Medication management was satisfactory. The manager now audits all medication practices. Resident’s spoken to confirm that they were treated well in the home and they felt that staff treated them respectfully. On a resident questionnaire one resident said staff were “very nice and lovely to talk to”. Privacy is assisted through the use of single bedroom accommodation. Thomas Knight Care Home DS0000060989.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. Resident’s lifestyles do meet their social needs. Resident’s are helped to maintain community links and to exercise choice and control. Food provision was adequate. EVIDENCE: An activities co-ordinator has recently been appointed. During the last inspection the residents were complaining of being bored. At this inspection they were happy that they had things to do. The manager reported that he has plans to further improve the amount of activities taking place. Families and friends do visit residents in the home. One relative spoken to was happy with the care provided. She confirmed that she was able to come and go freely in the home. Staff appeared to have a good relationship with relatives and families and greeted visitors in a friendly manner. Residents have recently been consulted about the running of the home. The proprietor sent out a survey asking questions about the premises and the food. A good response was received. The initial findings are that 80 of residents Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 12 were very happy with the home in these areas. The manager has also had resident meetings. Meetings with the kitchen staff have been held to discuss menus and food quality. A relative was invited to attend these as well as a staff member from each floor in the home. This is good practice. The food quality has improved though the manager feels that there is room for further improvement. The amount of food budgeted for each resident is £1.90 per day. This is below average and should be reviewed. For this reason alone this standard has not been met. The Cook and Kitchen Assistant have received Intermediate Food Hygiene training. Thomas Knight Care Home DS0000060989.V302936.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. Residents are confident that their complaints will be listened to. Residents are protected from abuse. EVIDENCE: There have been two complaints and two incidents requiring use of the vulnerable adults procedures. Two residents spoken to said they would complain if they needed to and they all thought that their complaint would be taken seriously. Residents know whom to complaint to. Two complaints were recorded since the last inspection. One was about accident recording procedures and was a misunderstanding that was quickly cleared up. The other was about the attitude of a staff member who was disciplined and has since left. Adult Protection procedures are available in the home. All staff have now received training in adult protection. Two incidents took place that resulted in the adult protection team being involved. This led to concerns being raised about the home in general and the suspension of contracts. This inspection was suspended whilst this took place. The manager acted in a cooperative and open manner throughout the investigations. Good strategies were put in place to improve the care within the home. The protection issues were raised because staff did not follow moving and handling procedures. Staff have been retrained in this. The manager is now monitoring staff to ensure that they comply with procedures. All residents were reviewed by external health and Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 14 social care professionals who were satisfied that they were safely cared for in the home. Reviews and monitoring are ongoing. Thomas Knight Care Home DS0000060989.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The quality in this outcome area is adequate. This judgement has been made using evidence gathered both during and before the visit to the service. The premises were safe but could be better maintained to improve the environment for residents. The home was clean. 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. During the initial visit to the home some areas were noted to be untidy. The bathrooms were becoming scuffed and the paintwork, which was never gloss painted, was stained. The inspector suggested that putting a staff member in charge of house keeping would help to co-ordinate the cleaning team. This was done and a good improvement was seen at the second visit. Care staff carry out maintenance for small issues, such as changing light bulbs. The manager reported that this is because the home has to “borrow” the handyman from a neighbouring home, owned by the same proprietor. This is Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 16 not satisfactory and could be dangerous. The home is big enough to need it’s own handyman. 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. There were no offensive odours in the building. The laundry, though busy, was well organised and clean. Thomas Knight Care Home DS0000060989.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. Resident’s needs are met by the numbers of staff. Residents are protected by 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: 11 residents. One RGN at all times. Two carers through the day and one at night. Middle Floor: Four residents. Two care staff throughout the day. One carer at night. Second Floor: 15 residents One RMN/RGN at all times. Three carers throughout the day. Two carers at night. Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 18 34.8 of care staff have been trained in NVQ2 or above. The standard to reach is 50 . This should be reached at the next inspection as all staff are currently on an NVQ training course. Three staff recruitment files were examined and 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. The manager has produced a good competency assessment for trained staff to work through before they are left in charge. This is also going to be used for senior care staff in charge on the first floor. This is good practice. Staff training has included some vocational subjects such as diabetes, equality and diversity and stress management. The inspector recommended that more staff are trained in the management of challenging behaviour. Thomas Knight Care Home DS0000060989.V302936.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36 and 38 The quality in this outcome area is good. This judgement has been made using evidence gathered both during and before the visit to the service. There is a registered manager in the home who has been assessed as “fit” to run the home. The home is run in the best interests of residents. Resident’s financial interests are safeguarded. Staff are appropriately supervised. The health and safety of residents and staff is protected. EVIDENCE: The manager has been at the home for a number of months. He has just been registered with CSCI. The manager has had a challenging time managing the home since his appointment and has proved that he is capable of doing so. Good improvements have been seen in this home since his appointment. There was evidence to suggest that the home is run in the best interests of residents as they are now formally consulted about the running of the home. Thomas Knight Care Home DS0000060989.V302936.R01.S.doc Version 5.2 Page 20 A quality assurance system has been started. Resident’s and staff questionnaires have been issued. So far the results look good and are an indication of how far the home has improved. Finance records for all residents were examined. Monies are held individually and receipts kept for amounts spent. Four amounts were checked and found to be correct. The manager has started to formally supervise staff. Staff spoken to said that they used their supervision time to put forward ideas and raise things they were not happy about. The manager reported that this is working well. 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. Thomas Knight Care Home DS0000060989.V302936.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Thomas Knight Care Home DS0000060989.V302936.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. Standard OP15 OP19 Regulation 12(1)(a) 16(2)(i) 23(2)(b) Requirement Review the amount of food budget for each resident. Provide designated maintenance to the home. Redecorate and improve the appearance of bathrooms. Timescale for action 01/12/06 01/12/06 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 OP28 Good Practice Recommendations 50 of the home’s staff should be qualified to NVQ level 2. Train staff in the management of challenging behaviour. 2. OP30 Thomas Knight Care Home DS0000060989.V302936.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: 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 Thomas Knight Care Home DS0000060989.V302936.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. 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. 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