Care Home: Knoll House

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What the care home does well Residents expressed a great deal of satisfaction regarding the quality of service they receive at Knoll House, a view reflected in surveys and as echoed by all staff spoken to. Their views including those of staff have been reflected throughout the report. Residents admitted to the home now have a comprehensive needs assessment undertaken at the initial stage of the care to be delivered. The resident is consulted about the intended care to be implemented The care plan is of a good standard and reflects how identified needs are being addressed. The implementation of health and personal care needs are being monitored internally through a monthly review system, which involves the resident and their representative. The staff members on duty were positive about different aspects of their work and they are well supported. All staff members receive training including mandatory training. NVQ training for staff is being given a high profile. Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 The registered manager is skilful, knowledgeable and experienced to manage this service. She is appropriately supported by a very able deputy manager. Care and staff management systems within the home are well organised and effective. The atmosphere throughout the home was calm. What has improved since the last inspection? The standard of the care plans has improved and the care staff have greater knowledge of how to assist the individual resident. Furthermore, they are more confident in delivering person centered care. The recording of accurate care needs are carried out by the senior care staff on a regular basis, and also the junior carers are being encouraged to contribute to this. The home has introduced a system for auditing medication; this helps to ensure the ordering, storage, administration and disposal of medication is safe and satisfactory. Complaints relating to the home are clearly documented. This includes maintaining records of any investigatory actions, and letters of correspondence relating to the complaint. There is an established system in operation to ensure that staff receive formal one to one supervision sessions from the manager. The manager’s supervisory needs are also being well met. The manager has undertaken an audit of all training completed by staff and any further training necessary for their future development. She showed us a training matrix she has in place. The recruitment process has improved, which means that residents and staff are protected. What the care home could do better: There are 3 requirements and 2 recommendations arising from this report, which need addressing. Requirements: Staff personnel files must contain a photograph of the staff member. This is to ensure the safety of residents. Fire drills are undertaken weekly, which may inconvenience residents; this must be carried out at suitable intervals and a comprehensive record maintained. This is to ensure the safety and protection of residents and staff. Infection Control must be completed by the 2 staff that have not received this mandatory training. This would ensure the safety of residents and staff.Knoll HouseDS0000072747.V378801.R01.S.doc Version 5.2 Recommendations: The existing placement contracts/terms and conditions are from the previous owner. This should be amended and a new contract issued to each resident by the current owner. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occurring over a month period. Key inspection report CARE HOMES FOR OLDER PEOPLE Knoll House Studham Lane Studham Nr Dunstable Bedfordshire LU6 2QJ Lead Inspector Neil Fernando Key Unannounced Inspection 23rd December 2009 11:25 DS0000072747.V378801.R01.S.do c Version 5.3 Page 1 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. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people 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. Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 Page 2 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 Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knoll House Address Studham Lane Studham Nr Dunstable Bedfordshire LU6 2QJ 01582 873607 01582 873607 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) www.silvertreecare.co.uk Silver Tree Care Ltd Jane Munford Care Home 22 Category(ies) of Dementia (22), Mental disorder, excluding registration, with number learning disability or dementia (22), Old age, of places not falling within any other category (22), Physical disability (22) Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical Disability - Code PD Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is 22 16th February 2009 2. Date of last inspection Brief Description of the Service: Knoll House is situated in a rural location in a village just outside of Dunstable. The proprietor is Silver Tree Care Ltd. Accommodation includes single occupancy bedrooms, two lounges, a communal dining room, bathrooms and toilets throughout the home. There is a large wellmaintained garden and patio area alongside spaces for car parking within the grounds of the home. A copy of the service user’s guide and an information pack is available for prospective residents and visitors to read. The fees for this service vary between £550 and £580, per resident per week, depending on the funding source and assessed needs of the person. The exact fees are reflected in individual service contracts for the residents. Knoll House DS0000072747.V378801.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 is 2 stars. This means the people who use this service experience good quality outcomes. We, the Care Quality Commission, undertook this unannounced key inspection of this home on 23 December 2009, the last having occurred on 16 February 2009. Silver Tree Care Limited is the registered provider since September 2008. We spoke with 6 residents, the manager and one of the owners, and 4 staff members including the cook. We spent some time observing residents and staff care practices so we could assess how staff interacted with and assisted with the care and support of residents. We undertook a brief tour of the home and viewed some of the records the home must keep. At the time of the visit, there were 17 people in residence, with 5 vacancies. We have received the AQAA (Annual Quality Assurance Assessment - a document, which gives the manager the opportunity to tell us how well outcomes are being met for people living in the home); it provides good details about the service. We have also received surveys from 7 residents and 8 staff. The manager and one of the owners were available throughout the inspection. What the service does well: Residents expressed a great deal of satisfaction regarding the quality of service they receive at Knoll House, a view reflected in surveys and as echoed by all staff spoken to. Their views including those of staff have been reflected throughout the report. Residents admitted to the home now have a comprehensive needs assessment undertaken at the initial stage of the care to be delivered. The resident is consulted about the intended care to be implemented The care plan is of a good standard and reflects how identified needs are being addressed. The implementation of health and personal care needs are being monitored internally through a monthly review system, which involves the resident and their representative. The staff members on duty were positive about different aspects of their work and they are well supported. All staff members receive training including mandatory training. NVQ training for staff is being given a high profile. Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 Page 6 The registered manager is skilful, knowledgeable and experienced to manage this service. She is appropriately supported by a very able deputy manager. Care and staff management systems within the home are well organised and effective. The atmosphere throughout the home was calm. What has improved since the last inspection? What they could do better: There are 3 requirements and 2 recommendations arising from this report, which need addressing. Requirements: Staff personnel files must contain a photograph of the staff member. This is to ensure the safety of residents. Fire drills are undertaken weekly, which may inconvenience residents; this must be carried out at suitable intervals and a comprehensive record maintained. This is to ensure the safety and protection of residents and staff. Infection Control must be completed by the 2 staff that have not received this mandatory training. This would ensure the safety of residents and staff. Knoll House DS0000072747.V378801.R01.S.doc Version 5.2 Page 7 Recommendations: The existing placement contracts/terms and conditions are from the previous owner. This should be amended and a new contract issued to each resident by the current owner. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occurring over a month period. 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 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. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 8 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 Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2, 3, 4 and 5. Standard 6 is not applicable. People using the service experience good quality outcomes in this area. The new resident has their needs fully assessed and they are able to visit the home, prior to admittance. In this way, both the resident and staff can be sure that the home can meet their identified needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA tells us ‘A Full assessment is carried out by the Manager (or Deputy Manager) using a professionally prepared pre-admission assessment before offering a place in the home. We will only offer such a place if the assessment indicates that the home can meet the identified needs of the applicant’. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 10 A copy of the written contract of occupancy/terms and conditions is available in each of the three case files viewed. These are from the previous owner to the residents. A new contract should be issued by the current owner to each of the residents. The manager said that this is being updated and will be replaced as soon as possible. The care records for three residents were assessed and evidence indicates that the manager or the deputy manager undertakes a pre-admission assessment of needs before any new person can be admitted to the home. Assessments also include information from placing authorities and health care providers where people are admitted from hospital. Each assessment is dated and signed by the manager or deputy manager. Information from residents, the manager and staff members, and records provide evidence that the arrangements to enable residents and their representatives the opportunity to visit and make an informed decision about the facilities offered at Knoll House is satisfactory. Some residents spoken with recalled having visited the home with their family, prior to moving in. ‘I visited with my son and daughter in law’, said a resident. The resident is admitted on a trial basis to enable them decide if they want to stay at the home. A review meeting is held at the end of the trial period involving the resident, their representative and the placing authority; only then the placement is made permanent. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. People using the service experience good quality outcomes in this area. The residents observed during the course of the visit appeared to be well cared for and they were being treated with dignity and respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The care plan is developed with contribution from the resident, their representative and home staff. Information from care plans, residents and staff members indicates that the needs of residents are being identified and addressed satisfactorily. The care plan indicates how the identified needs are to be met. The care given, progress made and interactions with other residents are consistently recorded on each shift. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 12 Case records viewed for 3 residents evidence that their health care requirements are being appropriately addressed. The resident and their representative, where appropriate, have also signed the care plan, thus demonstrating their participation in the care planning process. Some of the residents spoken with identified their key worker by name and they provided good examples of how their key worker assists them as a routine. Each resident has an annual review completed by a social worker from the placing authority. The key worker has delegated responsibility to undertake a monthly review for each resident. Evidence indicates that these reviews are being completed regularly. However, review minutes should be in greater details, in order to reasonably reflect relevant issues occurring over a month period. Risk assessments are completed for each resident and these are reviewed as and when required. All senior staff including the manager are authorised to administer medicines to the residents. They have all received training on this subject. Records, storage, administration, and disposal of medicines are in good order. All residents are registered with a GP from a local group practice. District nurses currently visit twice weekly. All residents spoken with expressed a good deal of satisfaction in the manner their health care needs are being addressed. ‘I have a district nurse visiting me presently’, reflected a resident. Other professionals, residents have access to include dentist, optician, podiatrist, and dietician. Residents also very much appreciate the weekly visits from a hair dresser. Staff members on duty were seen to deliver care and attend to residents’ needs in an extremely sensitive manner that very much respects their privacy, dignity, choice and wishes, whilst actively promoting their independence. ‘Staff are polite, helpful and very good’ said a resident. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People using the service experience good quality outcomes in this area. Varied activities are available for those that wish to participate, which often include friends and families, and food offered is of good quality with choice and variety available. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The AQAA tells us ‘Each Service Users life style is matched to their own personal needs and requirements in this area of their life. They are actively encouraged to make choices when and wherever possible. The care plan format enables staff to record and access the resident’s life history, interests, social contacts; daily social activities are recorded within the care plan, and the data included in review’. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 14 Staff members facilitate a good level of activities for residents. Staff also ensure that residents are able to undertake activities they like and choose. The home has an activities programme in place and again choice is offered. On the day of the inspection residents were seen to participate in activities being facilitated. Residents said that there are always some activities taking place. Examples of comments from residents include ‘I like reading and watch television’, ‘I had my birthday celebrated the other day and my family attended’, ‘The church representative visits monthly and most of us attend the service’, ‘I do various thing to fill the day, board games and Christmas decoration is going up and I love it’. There is evidence that diversity is maintained through religious and cultural means. Amidst the above positive comments, 2 staff and 1 resident have suggested ‘More outside activities’; this has been shared with the manager to address. Visitors are made welcome at any time, and encouraged to join with their relatives in events and outings, where appropriate. Some residents go out for the day with their relatives. Some of the events already involve the local community, for example some residents had visited the local school as part of the Christmas activities. The cook was spoken to and appeared knowledgeable about the dietary needs of the people using the service. He has undertaken all mandatory training including Basic Food Hygiene. They received fresh produce regularly and residents were observed being offered choice in their meals. As a result of regularly seeking the views of residents and their representatives, the home has made changes to the meals to suit the taste and preference of individuals. Menu is user friendly and has been redesigned in pictorial forms. The dining room was nicely set with tablecloths, cutlery and condiments. The meal on the day of inspection was nutritious, served hot and of sufficient quantity. Comments from residents about food include, ‘The food is very good although my appetite is not wonderful’, ‘very good and ‘I just had lunch and I enjoyed it’. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. People using the service experience good quality outcomes in this area. Residents can be assured that their concerns would be listened to and acted upon, and their welfare protected and promoted. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home’s policy and procedure have been reviewed and updated in November 2009. Staff members spoken with demonstrated an understanding of the procedure and echoed confidence in that complaint would be responded to swiftly and sensitively. There is information in the home to show anyone how to make a complaint. Residents spoken to in the home said they would speak to a member of staff or the manager if they were not happy with something. This is also confirmed in the surveys returned by 7 residents, for example “I would speak to staff.” One resident named the person they would speak to. Another person did not know who to speak to if they wanted to complain, but would speak to a named person if they were not happy. Most ticked the box to say they know how to complain about the service. ‘I’ll speak to the manager’ said a resident. A total of 5 complaints have been received by Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 16 the home since the last inspection on 16 February 2009; records viewed show that these have been dealt with satisfactorily. The Commission has not received any complaints regarding this service. The whistle blowing policy is available to the staff team. The home also has procedure on safeguarding vulnerable adults. All staff members have received training on safeguarding of vulnerable adults. The home’s management team has referred one incident to the local safeguarding team, since the last inspection; they however decided that it was a practice issue rather than a protection matter. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 23, 24, 25 and 26. People using the service experience good quality outcomes in this area. People using the service are cared for in an environment that is homely, comfortable and safe. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: We undertook a brief tour of the premises to include 7 bedrooms, 2 lounges, dining room, 1 bathroom, 1 shower room, 2 toilet facilities and the kitchen. The standard of decoration and furniture and fittings in the lounge/diners and bedrooms is good. Washroom facilities are numerous throughout the building, Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 18 with clear picture signage on the doors, to enable residents with cognitive impairment to identify these areas more easily. The home was kept fresh and pleasant and a good standard of cleanliness was evident. Residents spoken to said that the home was always kept clean and bedrooms are well furnished and comfortable. They also said that they were happy with their bedrooms and that they are able to bring their personal possessions and belongings. Evidence of furniture, mobiles and other personal effect brought by residents was seen in the bedrooms viewed. Since the previous inspection in February 2009 a number of bedrooms have been refurbished to include painting and decorating, and carpet replacement has been completed. New wooden flooring has been fitted to the dining room and a new medication room has been built. The home was able to create a warm and welcoming family atmosphere that was noted by all the residents spoken to on the day of the inspection. The property is surrounded by open gardens, which were covered with snow at the time of the visit. Staff reported and residents spoken with confirmed that they are accessible to residents during the warmer season. All staff bar 2 members have undertaken training in infection control. Protective clothes and gloves and hand washing facilities are provided. There were no health and safety hazards noted. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People using 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. EVIDENCE: The AQAA tells us ‘On recruiting new staff, we try and look to see if the individual seems to have a person centered approach to care, so they can look at the service user as a whole and meet all their needs. The recruitment system used is a rigorous procedure which is compliant with all legal and regulatory requirements, and best HR management practice’. An established staff team is in place to ensure the needs of people living in the home can be met. During our visit, we looked at staff rotas, and observed staff on duty in the home. There is sufficient care staff employed to meet the identified needs of the individuals living in the home, together with ancillary staff. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 20 The home has good recruitment policy and procedure in place. The recruitment records examine for 3 staff members indicate that staff are only employed after satisfactory clearances, including Criminal Records Bureau checks and at least 2 written references, are completed. Minor improvement (for example a current photo) is required in one case to reflect the documents stated in Schedule 2 and 4 of The Care Homes Regulations 2001. The home has a mixture of staff to reflect the diversity of residents accommodated. The manager explained that she recruits staff to meet the changing needs of the residents. One staff is able to speak at least 3 different languages and this would assist staff to communicate and understand better the needs of residents from different cultural and ethnic backgrounds, if any. Training profiles for three staff members were viewed and these indicate that they have good opportunities for relevant training. Specific training completed by staff members includes Dementia, Medication, Risk Assessment and Safeguarding of Vulnerable Adults. All staff are booked to attend training on The Mental Capacity Act on 8 January 2010. Of the 10 care staff, 5 hold an NVQ level 2 or 3 qualification and the remaining 5 members are currently working towards it. It is evident that training is being given a high profile and this investment in staff would ensure an improved quality of service delivery for residents. Surveys received and residents spoken with indicate that they are happy with the service offered to them at Knoll House. Comments include, ‘I like them, they are all very obliging’, ‘my key worker is very good ’and ‘very polite and helpful staff’. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36, 37 and 38. People using the service experience good quality outcomes in this area. Good systems are in place to ensure people using the service are able to benefit from the ethos, leadership and management of a service that also safeguard their interests. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 22 The AQAA states ‘The Manager is appropriately qualified and experienced. She has been a Manager at Knoll House for 3 years. She is both competent and passionate about the Service Users’ receiving the best care that can be provided. Her approach is person centered, always maintaining dignity and respect’. She holds an NVQ Level 4 in Management and Care; she said that she is due to start her training in Leadership in Management and Care in February 2010. She has completed her mandatory training. Evidence indicates that she has the knowledge, experience and skills to run a home for older people. The manager confirmed that she is appropriately supported. The management systems are transparent and residents and staff members spoken to confirmed that the manager is supportive. ‘The manager is available, supportive and operates an open door policy and this means we have her full support’, said a staff member. Residents echoed a sense of confidence in the manager – ‘The manager is visible and you can talk to her’, said one resident. Observation of care practice during the visit also demonstrates that staff and residents enjoy a very good relationship. Quality assurance systems are in place to monitor and improve the quality of service delivery. Staff confirmed that they receive supervision at least once every two months and are happy with this. One of the owners undertakes monthly visits to the home, in order to ensure that appropriate standards are being maintained. In addition, the owners visit weekly to maintain close contact with the service. Samples of visit report from September 2008 to November 2009 were viewed and are satisfactory. Records viewed are maintained in order. The procedures for dealing with residents’ finances are robust; financial records and monies examined for 2 residents were satisfactory. Health and Saftey matters are being attended to and records are maintained. However, there are 2 issues that must be addressed: 1). There are couple of staff who have not completed Infection Control training. 2). Fire drills are being carried out on a weekly basis. However, the frequency is too high and this may cause inconvenience to residents. Fire drills must be undertaken at suitable intervals and a comprehensive record maintained. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 24 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 OP29 Regulation 19 & Sch. 2 Requirement Staff personnel files must contain a photograph of the staff member. This is to ensure the safety of residents. Fire drills must be carried out at suitable intervals and a comprehensive record maintained. This is to ensure the safety and protection of residents and staff. Infection Control must be completed by the 2 staff that have not received this mandatory training. This would ensure the safety of residents and staff. Timescale for action 31/01/10 2 OP38 23 (4) 15/02/10 3. OP38 18 & 19 28/02/10 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 Good Practice Recommendations DS0000072747.V378801.R01.S.doc Version 5.3 Page 25 Knoll House 1. Standard OP2 2. OP7 The existing placement contracts/terms and conditions are from the previous owner. These should be amended and a new contract issued to each resident from the current owner. The monthly review minutes should be in greater detail, in order to reasonably reflect relevant issues occurring over a month period. Knoll House DS0000072747.V378801.R01.S.doc Version 5.3 Page 26 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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). 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