Care Home: Knighton Manor

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What the care home does well Staff recruitment and training is carried out well, with consistent staff supporting service users. Service users can participate in community life and a range of leisure activities.The home is kept clean and comfortable.Service users are treated with respect, and their opinions matter. What has improved since the last inspection? Service user’s plans are kept under review. Service users lead their lives as they choose with minimum risks. Complaints procedures have been updated. Staff recruitment checks are in order and people`s finances are safeguard. The home provides a quality assurance programe to ensure the best service delivery for service users. What the care home could do better: The complaints procedure needs further review and updating. This will ensure service users have current information if they wish to raise a concern or complaint. Ongoing adult protection training should be provided. This will ensure staff know and understand how to protect service users from harm and abuse. Key inspection report Care homes for adults (18-65 years) Name: Address: Knighton Manor 31 Knighton Drive Stoneygate Leicester LE2 3HD The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Helen Abel Date: 1 7 1 2 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 30 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Knighton Manor 31 Knighton Drive Stoneygate Leicester LE2 3HD 01162448455 01162872676 rsmithfieldhouse@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Knighton Manor Limited care home 13 Number of places (if applicable): Under 65 Over 65 13 13 0 0 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 13. The registered persons may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: Learning disability - Code LD Physical disability - Code PD. Date of last inspection 2 5 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Knighton Manor is a home for younger adults with learning disabilities, some of whom also have physical disabilities. It opened in 2005 and is situated in a quiet residential area of Stoneygate, Leicester. The property is large and detached with accommodation on two floors. There are thirteen bedrooms, all with ensuite facilities, and a lounge on both the ground and first floors. The ground floor and gardens are wheelchair accessible. Current fees range from £352 per week plus additional for individual support, total to £550 per week. The current inspection report is held in the office area at the home. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This inspection was a Key Inspection that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for younger adults. The Inspector spent time planning the areas to focus on based upon information gained from reviewing the homes service history, the last inspection report, the Annual Quality Assurance Assessment (AQAA), and surveys. Care Homes for Adults (18-65 years) Page 7 of 30 The people living at Knighton Manor prefer to be called service users. The primary method of inspection used was case tracking that involved selecting three service users and reviewing the care that they received through inspection of the written information available on their care, such as the care and support plans. Discussions took place with service users and staff. The registered manager and one of the registered providers were present on the day of our visit and assisted the Inspector. The visit was unannounced and started at 9.20 am on a Thursday morning and took place over a period of Care Homes for Adults (18-65 years) Page 8 of 30 approximately five hours. In addition policies and procedures and records in relation to service users, staff recruitment, medication, meals and upkeep of the home were viewed. The quality rating for this service is 2 Star. This means the service users who use this service experience Good quality outcomes. Care Homes for Adults (18-65 years) Page 9 of 30 What the care home does well Staff recruitment and training is carried out well, with consistent staff supporting service users. Service users can participate in community life and a range of leisure activities. The home is kept clean and comfortable. Service users are treated with respect, and their opinions matter. Care Homes for Adults (18-65 years) Page 10 of 30 What has got better from the last inspection Service user’s plans are kept under review. Service users lead their lives as they choose with minimum risks. Complaints procedures have been updated. Staff recruitment checks are in order and peoples finances are safeguard. The home provides a quality assurance programe to ensure the best service delivery for service users. Care Homes for Adults (18-65 years) Page 11 of 30 What the care home could do better The complaints procedure needs further review and updating. This will ensure service users have current information if they wish to raise a concern or complaint. Ongoing adult protection training should be provided. This will ensure staff know and understand how to protect service users from harm and abuse. Care Homes for Adults (18-65 years) Page 12 of 30 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Helen Abel CQC East Midlands, Citygate Gallowgate Newcastle Upon Tyne NE1 4PA If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 13 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive detailed information; and a reliable assessment that ensures their needs and aspirations can be met. Evidence: Written information is available and is called Statement of Purpose and & Service Users Guide. This includes a clear range of information for people who use the service. The information is dated and reviewed and clearly confirms the contact details of the registered manager and the registered providers to contact at any time. The assessment process in not confirmed in the written information but there is a clear and explicit referral and assessment process. Care planing and assessment start before the actual service is provided. This will ensure service users are appropriately and individually assessed before they are admitted to Knighton Manor. Care Homes for Adults (18-65 years) Page 15 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are involved in day to day decisions, are well supported to take reasonable risks and good support plans reflect their needs. Evidence: Services user care plans were sampled and found to be detailed covering all aspects of support in relation to their all round needs. Comprehensive risk assessments form part of each plan and address risk to the service user as well as those around them. Any restrictions on service user’s behaviour are clearly documented with reasons given for restrictions. Person centred plans were completed by the key worker together with the service user. They were individual to the service user and included photographs and celebrated service users achievements. Service users told us: I cant go out alone, only with staff. When I go out I tell the staff where I am going and when I will be back. Care Homes for Adults (18-65 years) Page 16 of 30 Care Homes for Adults (18-65 years) Page 17 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have opportunities to engage in vocational, leisure and community activities and are given support in maintaining links with family and friends and enjoy nutritious food. Evidence: There are opportunities for service users to pursue appropriate vocational and educational activities such as college courses, gardening, and working at a luncheon club. Some service users go to day centres and their work and achievements were illustrated in their person centred plans. The home provides regular cooking activities and art activities. One service user spoke of joining a choir and was heard singing in her room Christmas carols to music. A service user told us they attended regularly a local gay club and had met new friends. Some service user are preparing for independent living and staff are supporting individuals with programmes with teaching them to cook and look after themselves. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Service users surveys told us, “They give us presents for Christmas and birthdays. They look after us and do activities with us as well. “Would like to go swimming again and do more fun stuff like arts and crafts. They do cooking and cleaning and support me, and make sure I am safe and sound. The registered manager and care staff confirmed arrangements are made to ensure family and friends keep in touch with the service user. This was confirmed from reading daily records and service user’s person centred plans. Service user family and friends are welcomed and involved in the service user life, with their agreement. Service users told us about the meals at Knighton Manor: The meals are alright. We have fish and chips on Friday. I like chicken pie and a pudding. I can go into the kitchen whenever I want and make a hot drink. “You can have what you want. I have had lemon curd on toast and yogurt for breakfast. I am cooking curry tonight with the staff. I am waiting for my chicken to defrost. The meals are planned over four weeks and offer choice, variety, and are nutritionally balanced. Attention is given to ensuring people likes and dislikes are always taken into account. Lists are displayed in the kitchen to reflect this. Service users are offered healthy varied meals. Care Homes for Adults (18-65 years) Page 19 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service user receive appropriate personal support and their health and medication needs are well met. Evidence: Service users personal support plans are clearly documented. Service user have the support of their key worker and staff are aware of service users health needs. Some service users are monitored by community psychiatrists and medication and general reviews are held and follow the Care Programme approach. Good arrangements are in place to for accessing additional support from physiotherapists and other professionals to meet the additional physical health needs that some service user have. All service users have access to primary care services such as GP, dentists and opticians. This will ensure service users health needs are well met. Service users medication and the records were viewed and found to be in order. Staff have received medication training and knew about service users medicines and the side effects of medication Care Homes for Adults (18-65 years) Page 20 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service user concerns are listened to and acted upon. Evidence: Two service users told us, I have my own money, my brother brings my money in. I sign for it when I want it. I feel a bit safe. I can talk to staff. I like it here the staff are alright they are a laugh. Two staff I didnt feel comfortable with. I told the manager they are gone now and I am glad. A service user told us they would like a separate service user telephone they could use for privacy. They told us there are regular service user meetings and they discussed plans for Christmas at the last meeting. Service users can also raise concerns at these meetings and anytime with their key workers. A complaints procedure is held in the Statement of Purpose & Service User Guide. The section for complaints needs updating with the current Care Quality Commissions (CQC) contact details. The complaints procedure displayed around the home with pictures, needs updating in the same way. A service user pointed to the picture complaints procedure when explaining how they would raise a complaint. Service users felt their complaints and concerns would be acted on. Polices are in place with regards to physical or verbal aggression displayed by service Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: users and how this should be dealt with. Staff confirmed no recent adult protection training. It would be benefit service users if staff were trained and aware of local area protocols with regards to adult protection. There are good recruitment practices including obtaining staff checks before staff begin work. This contributes to good outcomes for service users in terms of protection. Care Homes for Adults (18-65 years) Page 22 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in clean, comfortable and homely environment which meets their needs well. Evidence: The home is in keeping with the style of property in the local community and has a parking to the rear and accessible grounds. There is adequate entry to the front door. Both communal and personal rooms are spacious, light, well decorated, furnished and maintained. All areas appeared clean and some staff members have undertaken training in infection control. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are effectively supported by well trained staff through sound recruitment practices. Evidence: Staff told the Inspector about the range of training they had received, equality and diversity, infection control, palliative care, mental health, healthy eating, deprivation of liberties and others. Staff, managers and the registered providers have the opportunity to work towards National Vocational Qualifications (NVQ) in Care at level 2 and above. There was limited evidence of training for staff around learning disabilities and specific conditions of service users. The registered provider should consider providing this learning for staff. Three staff recruitment records were sampled. They all contained an application form, which included a full employment history, two written references, evidence that staff checks were being made. This will ensure staff are safe to work with service users. Two staff told us they enjoyed working at the home, and felt it was nice and friendly and people were happy there. The managers tell us they work to keep good staff, and service users benefit from consistent staff that understand and support them well. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: There are monthly service users, seniors meetings and management meetings. Both the registered providers are closely involved in the day to day running of the home. Service users are supported by an effective staff team. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good systems are in place to ensure service users views are listened to and inform the way the service is delivered. Evidence: The registered manager is experienced in Learning Disability. Both service users and staff spoke positively about her. The two registered providers are also regularly involved in the home. Service users spoke with appeared to be satisfied with their key workers and confirmed they knew who they were, and would approach them first if they needed anything. They told us they are consulted on how the home is run at service users monthly meetings. Other issues such as menus and social events are discussed. Staff meetings are held and staffs views are opinions are regularly sought. The registered providers and registered manager meet regularly to discuss the operation of the home and plan for the future. Good systems are in place to ensure safe working practices and protect service users. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Risk assessments relating to safe working practise are in place. Staff have received training in first aid, food hygiene, fire safety, moving and handling and other health and safety learning. Service users health and safety is protected and promoted. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 22 Review and update all complaints procedures. This will ensure service users have access to current complaints procedures and they remain accessible to service users. To ensure service users are protected from abuse ensure staff receive ongoing and appropriate training with regards to adult protection. 2 23 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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