Care Home: Knights Grove Nursing Home

What the care home does well The home welcomes people who will use the service and their families or representatives, to visit the home and look at the facilities of the home. The manager seeks information from external healthcare professionals as part of the assessment where necessary, to ensure that the home is able to meet assessed needs. People moving into the home are assured that the home that they are entering will meet their needs. For example, staff are trained and show perception and professionalism in the way they deliver care, which enables people who live at the home to feel safe and enjoy a varied and companionable way of life. Staff treat people who live at the home with respect; they share their companionship and give support sensitively. Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that individuals need. Health care was promoted through the use of tools that assist with monitoring the nutritional needs of individuals when that was necessary. The home has also developed good working relationships with healthcare specialists. Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home who were able to express themselves, were positive about the food that the home provided and were pleased with the activities in which they could participate and the condition of the accommodation that they occupied. People at the home, relatives and staff had confidence in the effectiveness of the home`s manager. Systems and procedures in the home worked well including, dealing with complaints, and quality monitoring. What has improved since the last inspection? Following concerns of the way doors can be opened which affected the safety of people who use the service the home has taken action to make this safer. There were no other issues raised from the last visit. What the care home could do better: The people who use the service would benefit from staff receiving training in dementia and communication. CARE HOMES FOR OLDER PEOPLE Knights Grove Nursing Home Thomas Road North Baddesley Nr Southampton Hampshire SO52 9EW Lead Inspector Val Sevier Key Unannounced Inspection 09:30 26th February 2008 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 Knights Grove Nursing Home DS0000067659.V356541.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. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knights Grove Nursing Home Address Thomas Road North Baddesley Nr Southampton Hampshire SO52 9EW 02380 741921 02380 741342 cowellk@bupa.com 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) BUPA Care Services Limited Kimberley Ann Cowell Care Home 56 Category(ies) of Dementia (56), Dementia - over 65 years of age registration, with number (56) of places Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2006 Brief Description of the Service: Knights Grove is a large newly built care home with nursing, which intends to provide a service to older people with dementia and nursing care needs. The home has three floors each with accommodation for service users in single rooms with an en-suite bathroom. Small lounges with kitchenette facilities are available on the first and second floors and a large lounge and separate dinning room are located on the ground floor. The home has a garden and patio area accessible from the lounge and this is currently being planted to improve the appearance and screening from other buildings in the area. The home is located within a new estate development and construction with local shops and transport links nearby. Current placement fees range from £430 to £600 for residential and £750 to £850 for nursing care. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included: the Annual Quality Assurance Assessment (AQAA) completed by the home, and an unannounced visit to the home, which was carried out on the 27th February 2008, during which the inspector was able to have discussions with staff and have interaction with the residents at the home. During the visit the inspector looked around the inside and outside of the home, which included a sample of bedrooms and bathrooms. Staff and care records were sampled and in addition to speaking with staff and residents, their day-to-day interaction was observed. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. What the service does well: The home welcomes people who will use the service and their families or representatives, to visit the home and look at the facilities of the home. The manager seeks information from external healthcare professionals as part of the assessment where necessary, to ensure that the home is able to meet assessed needs. People moving into the home are assured that the home that they are entering will meet their needs. For example, staff are trained and show perception and professionalism in the way they deliver care, which enables people who live at the home to feel safe and enjoy a varied and companionable way of life. Staff treat people who live at the home with respect; they share their companionship and give support sensitively. Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that individuals need. Health care was promoted through the use of tools that assist with monitoring the nutritional needs of individuals when that was necessary. The home has also developed good working relationships with healthcare specialists. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 6 Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home who were able to express themselves, were positive about the food that the home provided and were pleased with the activities in which they could participate and the condition of the accommodation that they occupied. People at the home, relatives and staff had confidence in the effectiveness of the home’s manager. Systems and procedures in the home worked well including, dealing with complaints, and quality monitoring. What has improved since the last inspection? 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. Knights Grove Nursing Home DS0000067659.V356541.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 Knights Grove Nursing Home DS0000067659.V356541.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): 1&3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering using the service are given appropriate information about the service to enable them to make an informed choice. People that use the service can feel assured that their needs will be assessed and that the home has an understanding of their needs using the assessment process. EVIDENCE: Generally the information provided indicates to prospective users of the service that they respect people as individuals. The statement of purpose and service users guide is combined in one informative folder. Statements from the folder which address this visit included: “We use our health and care knowledge, specialist skills and values to deliver an individual service to our customers. We are respectful of the individuality, Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 9 privacy and dignity of each person. Enabling our residents to be as well, as independent and as happy as they can be”. We received the AQAA for the home, which stated that: “All new service users are only admitted following a thorough individual assessment of needs and expectations. New service users are offered a trial period for anything from lunch, a day or any other period of time deemed appropriate. We promote independence, individuality, privacy and dignity”. This was supported by evidence in the records at the home and with talking with relatives of individuals who had moved to the home in the last year. The assessment includes the following areas: communication including language; lifestyle and social interaction; personal hygiene and dressing; safe environment; eating and drinking and swallowing; working and leisure; sleeping; mental state and cognition and aids to ability. It was seen that the assessment also prompts the staff to look at risk assessments and tools for ongoing assessment to meet the needs when the person has moved into the home. There was evidence that relatives have been involved and relevant other professionals for example health care and community psychiatric services, in making the assessment and ensuring that Knightsgrove can meet the individual needs. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 10 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records and systems within the home that ensure that the personal and healthcare needs of people who use the service are met safely and effectively. Staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. EVIDENCE: The manager stated in the AQAA returned to us that: “Residents are encouraged to participate as far as possible in meeting their health and personal needs. Individual capacity is assessed at each activity to facilitate maximum independence”. We sampled five care plans of people who use the service that had moved to the home since the last visit in 2006. The care plans sampled were being used in conjunction with medication records and other health-monitoring tools that are used as part of the care planning for individuals. The care plans that have been developed for the residents were seen to be a working tool, with records Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 11 of daily life and regular evaluations by the key worker. It was seen that the records had a list of names and signatures of staff who write in the plans which helps to identify staff and the support they have given. The documents seen and the plans were based on the assessments the home carried out in order to identify what help individuals needed. Assessments included a range of potential risks to residents e.g. pressure sores; falls; moving and handling and malnutrition. Where a pressure sore assessment indicated that an individual was at risk it was noted that the corresponding plan of care for the person concerned referred to the use a pressure relieving aid. We were able to see that pressure area breakdown had been present when an individual moved to the home and there were no incidents of areas having developed by people who had been at the home for some time. It was also noted that the care and treatment in support of pressure areas that had broken down had been successful. Where there are concerns about the weight of an individual the home completes a 14-day food diary and nutritional assessment. For one individual there were two days missing and action for staff was to weigh the individual weekly for four weeks and then monthly, there was no evidence that this had been done. There was evidence that the 14-day diary had been kept for others whose plans we saw. The majority of people who live at the home have dementia and often have difficulty in communication. Not all of the care plans seen had a plan of care to inform staff on how they could communicate with the individual. One person says ‘yes’ only, we asked how the staff knew what the individual wanted or if they were in pain for example. The care staff spoken with knew the individual and were able to tell us however this wasn’t recoded anywhere for others who may not know the individual, to see. The plans examined set out clearly the actions and support staff needed to take and what specialist equipment was needed to provide the support and assistance each person required. For example where support with movement was identified instructions on numbers of staff needed, equipment and communication was seen. The home has introduced a new care plan system which has several new tools for assessment and monitoring of individual needs for example: Dewing tool for wandering, which also prompts staff to complete risk assessments associated with the behaviour. This was not completed on all the care plans seen. It was seen in the care plans that physical health needs are also addressed with recent residents having moved to the home with information from health and other specialists; this information has been incorporated into the care plan at this home. It was also seen that residents have access to opticians and Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 12 dentists as needed. Notes regarding physical health indicated that other professionals had been involved as necessary for example regular visits from the community psychiatric nurses to assist the home in caring for the needs of those individuals with dementia. Records indicated that care plans were reviewed regularly and as needs changed and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Care plans are agreed with the person using the service where possible and their relative or representative. The home had written policies and procedures concerned with the management and administration of medication. Medication was kept in locked and secured medicine trolleys, cupboards and where required in a medical refrigerator. Controlled drugs were stored securely and appropriately. The home dispenses all medication from blister packs and the only staff in the home that dispensed and were responsible for the management and administration of medication on a day-to-day basis were trained staff. It was seen that monthly medication audits are carried out to ensure that staff are following the homes policy and that medication administration is carried out safely. Staff were observed speaking and assisting the residents with dignity and respect. It had been seen on care plans that the preferred choice of name had been recorded and staff were heard to speak to residents by the name they wished. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 13 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, & 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. EVIDENCE: The home has three lounge areas one on each floor where staff support individuals for activities and for meals. On the five care plans it was seen that there is the provision of tools for life mapping and recording the individual’s preferences, ritual and routines; these were not all completed on the care plans we saw. For one individual who wanders the Dewing tool had been used, part of that assessment related to the activities the individual likes to do – walking. There were three risk assessments for each activity for example walking to the pub. One individual spoken with was receiving care in bed, they were able to see out of the window however due to the positioning could only see roofs and trees. The individual said that the staff were lovely and that the food was good although they did not have much interest in it. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 14 The home offers an activities programme which includes games, crafts, music, walks to the local shops and rips to the local pub. The AQAA from the hoem stated that: “All residents’ capacity for social activity are assessed using the Jackie Poole Activity Assessment Tool. Individual preferences, interests and pastimes are documented and used by care staff to stimulate friendships, clubs and action. There are a range of structured and spontaneous, group and individual activities planned for the month in advance. Relative, friend and volunteer involvement. We provide a homely environment in which to live with flexible routines designed to meet resident’s preferences and capacities”. We spent some time on the top floor of the home before lunch and observed staff spending time with individuals and other staff enabling individuals to play bingo. Staff support enabled individuals to find their own numbers and a smile was seen when they were able to recognise numbers. The home operates an open visiting policy and maintains family ties; the home enables regular visits and has regular coffee mornings. All residents are encouraged to exercise control over their lives and it is their choice to participate in social activities if they wish. Visitors spoken with said that staff try to help the residents to maintain their rights and for them to be able to make informed choices around daily living. All residents spoken with who were able to pass comment were complimentary about the food provided. The meals seen looked nice and were presented in a way that looked appealing. The menus and records of food provided indicated that the food was nutritious and there was a wide range of meals provided with a selection of choices every day. In addition special diets and individual preferences and needs were catered for e.g. soft and pureed meals and diabetics. Residents could choose where to eat and some preferred to eat in their rooms. Food preferences, dislikes, food related allergies and nutritional and dietary requirements were recorded in residents care plans and the information was also readily available to catering staff. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 15 We spent a period of time on the middle floor observing lunch. It was seen that pureed food was presented with each item pureed separately on the plate. Staff were seen to support individuals with eating and this was done at the individual’s pace with the staff member asking if they were ready for the next spoonful, and apologising if they were going too fast. There was evident rapport between the staff and individuals. Another member of staff in the room moved around as she observed people needing support and it was felt that this was done respecting the individual’s dignity. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 16 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 &18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected through the open complaints process and the staff’s knowledge and understanding of safeguarding and protection issues. EVIDENCE: The home’s complaints procedure was seen to be available in the information given to people who use the service. There have been no complaints received by the commission. The home has received one complaint, which was seen to have been actioned. The manager advised that the home promotes an open door approach to relatives and people who use the service, to help resolve complaints and issues effectively. The home uses Hampshire’s safeguarding adult policy and staff were seen to have training in adult protection as part of their induction as well as yearly updates. There have been two safeguarding investigation carried out by social services since the last visit to the home, one is still ongoing with social services visiting the home monthly. It was seen that action that had been recommended by the meetings had been carried out by the home for example the fire alarm system and door openings have been altered. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 17 The AQAA for the home stated that: “We operate an open door policy and feedback from all service users is encouraged. Complaints are dealt with constructively and in accordance to our complaints policy and procedure that is clearly displayed for all service users to see. We have a “suggestions and complaints” box situated in the front reception and any entries are logged and acted upon with feedback given to the originator. We have internal and external audits. A complaints log and all complaints are reviewed and followed up. All our staff are trained in ‘Elder abuse awareness’”. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 18 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 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a pleasant and homely environment to live in which also has had adaptations to meet individual needs. EVIDENCE: We looked around some of the home and was able to see communal areas such as the dining room, lounge, bedrooms and bathrooms. The garden is accessible with wheelchairs. All of the bedrooms seen were brightly decorated and had evidence of individual personalities with posters and the service users photographs on the walls, and other personal effects. People who live at the home are encouraged to furnish the room with personal belongings such as furniture and pictures, to make it feel like home. Consideration is given to the support of needs with the use of equipment. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 19 Specialist beds are available at the home for those that are assessed as needing them. There is also specialist seating, a lift and adapted bathing facilities. It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working), alcohol gel sanitizers and paper towels. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. The home manages all the laundry with dedicated staff. There was no malodour in the home and it was seen to be clean and tidy. Comments from residents about the condition of the premises included: • “They are particular about keeping it clean, the windows ands so on, I think they also look after the building”. • “It is kept spotless and I like looking out of the window. The trees and plants change colours and I can see the birds”. This supported the AQAA, which said: “Our Home offers a welcoming, comfortable and friendly environment. Our home is well situated in the centre of a supportive community within easy walking distance of shops, hairdressers, churches, community centres, schools and library. Our interior decoration makes use of colour and specialist signage to assist our residents with orientation and recognition. Our service users are provided with room keys unless risk assessment indicates otherwise. They are all able to lock their room doors from within. We encourage service users to furnish their rooms with their own furniture and possessions”. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 20 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 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the services have their needs met by staff who are trained, supportive and sufficient in numbers. People who use the services are protected by the recruitment procedure. EVIDENCE: The staffing structure provides a broad spread of experience and professionalism: manager, nurses, support workers, kitchen staff, laundry and housekeeping. Other health care professionals support the team from outside the home as needed. Staff spoken with on the day of inspection indicated that they were aware of the needs of the residents who live at the home; they also seemed enthusiastic about working at the home. There was evidence that staff have received training in all mandatory areas such as food hygiene, first aid and manual handling, health and safety, vulnerable adults, infection control, continence management, challenging behaviour and dementia. Staff receive at last three days training a year and are enabled to access courses either at the home or externally. We visited the home in September 2007, to carry out a Short Observation using a specific tool (SOFI), which enables us to observe staff and resident’s interaction, the feedback from that visit included the recommendation that all staff should Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 21 have training in dementia and communication. It was seen on this visit that only five staff have received training since that date in September with a total of 27 staff out of 62 having now had training in dementia. New staff undertake an induction period when mandatory training is undertaken. This is followed by the induction pack, which is supervised by the individual staff members mentor. The time taken to complete this induction pack, which is based on ‘Skills for Life’, depends on the individual member of staff but is usually twelve weeks. Modules covered are: values, understanding the organisation and the role of the worker, health and safety for example fire and incidents, communication for example call bells and methods of communication, abuse and neglect and developing as a worker. After each model there is an exam, which is marked by an outside agency. Staff are expected to pass the exams as part of the evidence of their knowledge and understanding of their role. Records were examined of six staff that had been employed to work in the home since the last fieldwork visit to the home. Records indicated that statutorily required pre-employment checks, intended to ensure that people unsuitable to work with vulnerable adults were not employed, had been completed before the individuals concerned actually started working in the home. The manager explained that after interviewing, references are sent for and the CRB check is requested, a member of staff commences employment after the references are received and under supervision whilst waiting for the CRB check to be completed. The POVA First is included on this check and is returned before employment commences. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 22 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, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well run home; with systems and procedures in place which monitor and maintain the quality of the service provided and promotes the safety and welfare of everyone living and working in the home. EVIDENCE: The AQAA for the home stated that: “The Registered manager has achieved the NVQ 4 Registered Managers award. The registered manager has monthly meetings with line manager/ regional manager. The Home benefits from support in the form of audits, training and development proposals and quality initiatives from within the organisation from specialist Quality and Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 23 Development, Human Resource and Training departments. The Home benefits from a robust set of Policies and Procedures that are regularly updated by our specialist Health and Safety department”. We saw that there is a clear Management structure with Policy & procedures reviewed annually. There were a range of written policies and procedures available for staff to refer to as guidance and to inform their practice. These included the following: • Admission, discharge and transfer of residents • Human Rights • Confidentiality and access to personal records • Abuse of the person • Drug administration • Self administration of medication • Infection control • Complaints procedure • Whistle-blowing • Sexuality • Health and safety at work The people who use the service and their relatives or representatives and the staff, are able to discus all aspects of the running of the home generally or on a personal level. This opportunity is offered in resident, relative and staff meetings, and in questionnaires, which are sent out annually. The results of which have been included in an action plan, which includes: Reduce agency usage Improve staff skills Ensure that staff have achieved personal best in training Relative involvement to include families on an individual basis as attendance group meetings is poor Write to relatives to ask how they feel they could be involved Ask how to improve the quality of their visits Improve response to complaints and queries; implement compliments and minor grumbles log Resident’s monies & valuables can be locked in lockable drawers in the resident’s room or in a bank account. Records are kept of everything kept in the bank. It was noted that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. There were contracts in place for the disposal of clinical and household waste. Records were kept of accidents. Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 24 There was a fire risk assessment for the premises; tests of equipment and regular risk assessments of the premises and working practices were undertaken regularly. Knights Grove Nursing Home DS0000067659.V356541.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 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 3 15 4 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 3 X 3 X 3 X X 3 Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 26 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 Standard OP30 Regulation 18(c) (1) Requirement Staff must be trained in dementia and communication so that they can meet the individual needs if people who use the service. Timescale for action 21/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Knights Grove Nursing Home DS0000067659.V356541.R01.S.doc Version 5.2 Page 28 - 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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