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Care Home: Knotty Ash Residential Home

  • 69 East Prescot Road Liverpool Merseyside L14 1PN
  • Tel: 01512541099
  • Fax:

  • Latitude: 53.416000366211
    Longitude: -2.904000043869
  • Manager: Mr Andrew Feeney
  • UK
  • Total Capacity: 33
  • Type: Care home only
  • Provider: Knotty Ash Home Ltd
  • Ownership: Private
  • Care Home ID: 9300
Residents Needs:
Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 12th October 2009. CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Knotty Ash Residential Home.

What the care home does well Knotty Ash Residential HomeDS0000025353.V377458.R01.S.docVersion 5.2People who live in the home said they thoroughly enjoyed being there and felt comfortable, valued and at ease. They said they get a good standard of personal care and are able to access entertainment, general conversation, do their own thing if they choose whilst always being well looked after. The atmosphere in the home was one of calm and comfort and staff were seen to enjoy excellent interactions with all the residents. The manager was able to demonstrate how he and his staff provided needs led care for the people living in the home and care plans showed that each person was treated as an individual with their own preferences, choices and capabilities. Discussions and observations of staff demonstrated how they work together as a team and staff revealed they feel supported and valued by their manager who they said they admire and respect. Comments from people living in the home were most positive and included: This home is like one big happy family. We can do what we want to do, just look at us now being together and having a laugh. The staff are very good to us. The manager and staff are very good and they make sure we are well cared for. The food is good; I can go out to the shops or the pub or enjoy other activities in the home, its nice here. Most of the staff have been here for ever and we get to know them and they look after us well. Staff are kind and caring and make us feel safe. We all get on well together and are safe and secure. I can join in activities if I wish and I can sit in my room and read or watch television if I want. Staff always check to see I am alright and we enjoy a little chat. What has improved since the last inspection? Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 The manager and staff have made great progress in improving the quality of the service and the service has developed well since the last inspection. The policies and procedures in the home have been monitored and reviewed and where necessary amended and updated. Care plans have been drastically changed and now have all the necessary information to ensure that needs, preferences and capacity are recorded and a plan of care and support recorded as how staff can meet all assessed need. Care plan reviews now take place to address any changing needs. Risk assessments take place as an ongoing process in the home to include how to manage changing needs and all environmental factors. The medication management has been reviewed and recording systems now are clear. Risk assessments for people who managed their own medications are detailed to tell staff as to how the risk will be reduced. Staff training has been updated and staff spoken with said they had been provided with interesting training to enable them to carry out safe supportive care. Recruitment and selection procedures have been amended and staff are thoroughly vetted prior to them being offered employment. People living in the home said that the fabrics, furnishings and decoration had improved and they were more than happy with the comfort and good atmosphere which prevails. Comments from staff, people living in the home and their families and friends were very positive about the good quality of care and support provided and comments included. We love it here, its one big happy family. The manager and staff are kind and really do care about the people living here. They respect it as their home. The staff are good and they always ask us if we are alright and if we need to discuss anything when we visit. They give us all the necessary information to ensure that we know about the daily care and general wellbeing of our friend. The home is great, we love it, we can do what we want, when we want and know we will always be supported.Knotty Ash Residential HomeDS0000025353.V377458.R01.S.docVersion 5.2Page 8 What the care home could do better: The manager and staff have worked hard to make many improvements since the last inspection visit and this was fully evidenced by the many changes made to policies, procedures and documents viewed. However the manager accepted that there was one shortfall remaining in respect of the recording of formal staff supervision and fully detailing staff training and development needs. He provided information during the inspection to show that procedures were in place for informal staff supervision although he said that formal supervision policies were being developed for one to one supervision and training assessments and he was in the process of implementing them into his working practices to ensure that staff are provided with formalised and structured supervision and support. It is essential that staff supervision sessions are arranged at regular intervals, held at a prearranged time and place and are recorded to ensure clarity of all discussions held. This will enable staff to discuss any issues relating to their personal and professional roles and their future training needs. Key inspection report CARE HOMES FOR OLDER PEOPLE Knotty Ash Residential Home 69 East Prescot Road Liverpool Merseyside L14 1PN Lead Inspector Lynn Paterson Key Unannounced Inspection 12th October 2009 09:00 DS0000025353.V377458.R01.S.do c Version 5.2 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. Knotty Ash Residential Home DS0000025353.V377458.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 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knotty Ash Residential Home Address 69 East Prescot Road Liverpool Merseyside L14 1PN 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) 0151 254 1099 knottyashhome@hotmail.co.uk Knotty Ash Home Ltd Mr Andrew Feeney Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people 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 The maximum number of people who can be accommodated is: 33 Date of last inspection 2nd September 2008 Brief Description of the Service: Knotty Ash is a residential care home providing personal care and accommodation for 30 people with an age related condition. The home is purpose built with 26 bedrooms on the ground floor and 3 bedrooms on the top floor. There are handrails and a lift to assist people in accessing all areas of the home. A dining room, a separate smoking room and two lounges provide a variety of different areas for people living in the home to use. All bedrooms have ensuite facilities. Knotty Ash is located in a residential area, within walking distance of the Old Swan shopping area of Liverpool. The home is on a one way street and located near Alder Hey Hospital it can only be accessed in one direction due to the oneway dual carriage way. There is parking at the front of the building and a signpost at the entrance helps visitors easily identify the home. There are gardens surrounding the building and a large park is located at the adjacent to the home. The fees for Knotty Ash are at Local Authority rates although private residents can be accommodated. The current rate of fees range from £330.50 to £445 and this depends on the individual’s needs and the services that they require. Knotty Ash Residential Home DS0000025353.V377458.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 star. This means the people who use this service experience good quality outcomes. The inspection of Knotty Ash Care Home was carried out by one inspector over a one day period on 12th October 2009. The visit to the premises was one part of the inspection. Other information received was also looked at. Before the visit the agency manager was asked to complete an annual quality assurance document (AQAA) to provide up to date information about the services provided. Questionnaires were provided for people who use the service, relatives and staff to find out their views. Other information that had been provided since the last inspection was reviewed. During the visit various records, policies and care files were looked at and a partial tour of the premises undertaken. A number of people who live at the home were spoken with as well as six staff members and they all gave their views about the service. The manager was able to give clear information about the services undertaken by the home and detailed changes to policies and procedures that had recently been implemented. All information gained from discussions, surveys and document reading were used as a basis for the process of this report. All of the key standards were covered in this site visit; the findings and evidence are detailed in the report. The manager was most helpful during the inspection and feedback was shared throughout the day. The arrangements for equality and diversity were discussed during the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs, promote independence and support to make informed decisions in line with individual choices What the service does well: Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 6 People who live in the home said they thoroughly enjoyed being there and felt comfortable, valued and at ease. They said they get a good standard of personal care and are able to access entertainment, general conversation, do their own thing if they choose whilst always being well looked after. The atmosphere in the home was one of calm and comfort and staff were seen to enjoy excellent interactions with all the residents. The manager was able to demonstrate how he and his staff provided needs led care for the people living in the home and care plans showed that each person was treated as an individual with their own preferences, choices and capabilities. Discussions and observations of staff demonstrated how they work together as a team and staff revealed they feel supported and valued by their manager who they said they admire and respect. Comments from people living in the home were most positive and included: This home is like one big happy family. We can do what we want to do, just look at us now being together and having a laugh. The staff are very good to us. The manager and staff are very good and they make sure we are well cared for. The food is good; I can go out to the shops or the pub or enjoy other activities in the home, its nice here. Most of the staff have been here for ever and we get to know them and they look after us well. Staff are kind and caring and make us feel safe. We all get on well together and are safe and secure. I can join in activities if I wish and I can sit in my room and read or watch television if I want. Staff always check to see I am alright and we enjoy a little chat. What has improved since the last inspection? Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 7 The manager and staff have made great progress in improving the quality of the service and the service has developed well since the last inspection. The policies and procedures in the home have been monitored and reviewed and where necessary amended and updated. Care plans have been drastically changed and now have all the necessary information to ensure that needs, preferences and capacity are recorded and a plan of care and support recorded as how staff can meet all assessed need. Care plan reviews now take place to address any changing needs. Risk assessments take place as an ongoing process in the home to include how to manage changing needs and all environmental factors. The medication management has been reviewed and recording systems now are clear. Risk assessments for people who managed their own medications are detailed to tell staff as to how the risk will be reduced. Staff training has been updated and staff spoken with said they had been provided with interesting training to enable them to carry out safe supportive care. Recruitment and selection procedures have been amended and staff are thoroughly vetted prior to them being offered employment. People living in the home said that the fabrics, furnishings and decoration had improved and they were more than happy with the comfort and good atmosphere which prevails. Comments from staff, people living in the home and their families and friends were very positive about the good quality of care and support provided and comments included. We love it here, its one big happy family. The manager and staff are kind and really do care about the people living here. They respect it as their home. The staff are good and they always ask us if we are alright and if we need to discuss anything when we visit. They give us all the necessary information to ensure that we know about the daily care and general wellbeing of our friend. The home is great, we love it, we can do what we want, when we want and know we will always be supported. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 8 What they could do better: 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. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 9 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 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 10 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): 1.3. 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. Assessments are detailed to make sure that the individuals wishing to move in the home have all their needs recognised EVIDENCE: People living in the home said they had been provided with information about the home, staffing and services provided so that they knew what to expect when they came to live there. They said that information about the home was also displayed near the entrance and people could read about the home and see the inspection reports if the wished. Discussion with the manager identified that he had reviewed that pre admission assessment documentation together with the care planning process Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 11 and as a consequence had updated all paperwork to ensure that he could address personalisation issues. Four care files were looked at in detail and they evidenced that the manager had discussed all aspects of peoples care, choices and capabilities at the initial assessment and had continued with the assessment after the person’s admission to the home. All assessments detailed how the person who wished to be accommodated at the home was involved in the assessment process and how s/he was involved in every decision from the outset. It detailed how the persons independence would be maintained, gave full details of life history, likes, dislikes, and who s/he wished to keep contact with in the community. People living in the home said they were verbally told all about the home as well as being given written details before they made their minds up if they wanted to live there. They said that they were asked about themselves and their wishes for the future and felt very much a part of the process. They said they were given full information and treated with respect and were able to make informed choices about their future. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 12 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): 7.8.9.10. 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. The consistency of practice regarding the planning and delivery of care and medications means that all individuals can be sure that their health and personal care needs will be met EVIDENCE: Care plans viewed showed that all health and social care needs were recorded on file and they were monitored and reviewed on a monthly basis, more often if required, to ensure all changing needs were addressed. The manager advised that he had recently carried out some research in respect of care planning documentation and process and as a consequence had re written all care plans using a new format. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 13 He said that people living in the home and their relatives or representatives are now involved in the care planning process and sign each document to show their agreement that the plan is suitable for their needs. Care files looked at show that healthcare professionals are contacted when needed and their visits and care directions are recorded on file. A community matron is allocated to the home. The community matron works with the local health service and gives the staff support and advice regarding any nursing care. The manager said that the community matron is a great asset to the home and regular meetings are held with external health and social care staff in which they share need to know information and good practices to make sure the health and wellbeing of the people who live in the home is maintained. Daily records detailed health and social care of each person and any external interventions. Four care plans for individuals were looked at; all four had been regularly reviewed or updated. Information in all the care plans was detailed, with changes in condition or personal circumstances included. People living in the home said they knew what was in their own care plans and said staff always carried out the care and support in the way it was detailed on file. Staff said that they had been give training in care planning and said they shared need to know information throughout the day and always exchanged information at handover. The manager advised that medications reviews take place on a monthly basis as part of the care plan review process. He said that the home has ensure that sufficient amounts of medication are received for each person in the home and that medicines are checked in and recorded by 2 senior care staff. Staff said that the medication polices have been reviewed and updated and staff have received training in all aspects of medication management. Staff said the manager has insured that all instruction for medication is clear to include the medications that are prescribed on a when required basis. Staff said that the manager carries out weekly and monthly audit checks in respect of medication and full risk assessments are undertaken for people who wish to self medicate. . The manager said the home had addressed the concerns expressed at the previous inspection and as a consequence had totally reviewed and amended the medications systems used to ensure the safe effective management of medication. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 14 Observations of interactions between staff and people living in the home indicated mutual respect and good rapport. Discussions with people living in the home confirmed the observations and comments included. Staff treat us all so well, they make us feel special. I do not know what I would do without them, they are all so kind. We have a laugh and a joke and all get on well, they certainly know how to look after us. Staff said they had been trained in care practices, understood diversity and liked to treat everyone as they would like to be treated themselves. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 15 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): 12.13.14.15. 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. All the people living in the home receive a lifestyle experience that meets their choices and personal preferences. EVIDENCE: Care files hold details of individual’s life history, likes, dislikes capacity, hobbies and interest and staff try to work around these details in respect of activities. Care staff undertake the responsibility to arrange activities as part of their normal duties and they say they do their best to ensure that an activity is in place every day. A number of the people living in the home are able to organise their own activities, such as going out with friends, going shopping or visiting the pub and they said that staff assist them to go out into the community to enjoy Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 16 themselves. Recent events arranged at the home include bingo, a visiting entertainer and a party night. People living in the home said they were given choices as to what they wanted to do during the day and evening and all people spoken with said they enjoyed their daily life whatever they choose to do. Some people said they joined in activities others said they preferred to read books, watch television, have general chats or receive visitors. All said they were happy and contented and felt at home and at ease with their accommodation. People living in the home said that a variety of food was available to choose from the said that food was generally to everyone’s taste and if not them options were always available. All the individuals living in the home spoken said that they enjoyed the food. The manager said that staff have listened to the people living in the home and included some of their wishes in arranging the menus. A menu-board was available in the dining room that listed what meals were available each day. Menus were available in the kitchen, which were set for a two weekly cycle. Staff ask each person during the day what meal they would like from those choices. Staff said they had endeavoured to try different meal choices according to the wishes of the current residents and utilise flexible meal times to suit individuals. People who live in the home said that breakfast is anytime from 8am to about 11am. Lunch is between 12.30pm and 1.00pm and the evening meal around about 4.30pm. They said that if necessary theses times can be changed, however everybody spoken with said they were happy with the mealtimes and the flexibly afforded. Super is provided between 8pm and 10pm with the provision of toast, tea cakes, biscuits and drinks. One resident advised that if s/he is hungry during the night the staff will make some food on request, which it was said is always tasty. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 17 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): 16.18. 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. Individuals and their families feel safe and listened too and staff are trained and knowledgeable in safeguarding vulnerable people. EVIDENCE: Examination of complaint records indicated that no concern had been investigated since the last inspection. Previous investigation records were available, for review and detailed that any issues had been dealt with as per the homes complaints policy. Staff files looked at had the correct checks in place to confirm their suitability to work in the home. Records available in the commission showed that no referrals have been received regarding protection of vulnerable adult’s .However discussion with staff and staff training files evidenced that training in protecting adults from potential abuse had taken place. All staff members spoken with were clear as to how allegations of this nature are dealt with and demonstrated in discussion that they fully understood the process. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 18 Twelve people living in the home were spoken with about their understanding of the homes complaints process. All knew about the process and felt able to raise their concerns and were happy to tell staff if their was something they did not like .Returned surveys and general discussion indicated that all people living in the home were sure that any concerns they had would be addressed. Feedback from the families and representatives of people living in the home revealed that they were confident that any concerns would be quickly dealt with. Comments included: Staff are kind and considerate and listen to what is being said. I am sure that they would deal with matters quickly. We know that staff are only too pleased to have constructive comments made about the service. They ask us all the time if anything can be improved upon and give us questionnaires to ask our opinions. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 19 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): 19.23.24.26. 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. The home is clean and well maintained and decorated in a domestic style that is warm and welcoming. EVIDENCE: The premises presents as being most homely with spacious communal areas including two lounges a smoking room and a dining room. This offers a variety of communal space from which to choose. People spoken with said they were very happy with the fabrics, furnishings and accommodation which they said was always clean and tidy. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 20 People said their bedroom accommodation was good and they were able to personalise their own rooms with small furnishings, pictures and ornaments. Every bedroom has a brass plaque outside that has the individuals name on. A number of people living in the home invited me into their bedrooms for a chat and a look around. All viewed had personal items in place and were well presented. , Comments from people included I like my bedroom, it is a place I can come to, to read and be at peace. My bedroom is like my own tenancy. I have my furniture, my television and radio, my photographs and my privacy. I sit here in the afternoons and watch the world go by. All areas of the home were clean and well maintained. Individuals spoken with said, “It’s very clean and tidy”, “it’s a lovely home, it’s always clean and tidy”. All areas that needed redecorating have been completed and the home utilise a continuous refurbishment plan to ensure the home retains its good standards. There is a maintenance person in place who is the fire marshal and checks lighting, alarms etc. and staff said they let the maintenance person know about anything that’s needs doing and he quickly deals with it. The manager advised that he had attended NHS briefing meetings in respect of managing any epidemics to include swine flu and all infection control policies and procedures had been reviewed and amended where necessary. . Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 21 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): 27.28.29.30. 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. Staff are fully checked before they commence employment at the home and receive mandatory training to ensure they provide safe care for the people living in the home. EVIDENCE: Staffing records viewed identified that the manager has updated all the recruitment and selection procedures at the home and all staff now have a Criminal Records Bureaux (CRB) check and 2 written references on file. The manager advised that he has reviewed all the staff files and they now have the appropriate documentation in place to meet the required standards. Records available in the home show that the manger now completes a monthly check on staff files as part of the homes quality assurance process and Protection of Vulnerable Adults know as POVA first checks are automatically undertaken. Staff records show that staff have ongoing training and documentation seen indicated that the home manager works with Liverpool Training and development team when formulating the annual staff training plan. Specialised Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 22 training is also provided and includes the mental capacity act, nutritional care of older people and dementia care. Staff spoken with said they had received induction training and were provided with lots of ongoing training to ensure they could meet the needs of the people living in the home. However staff training records were inconsistently stored and the staff training file was not fully organised. The staff training plan was in place and detailed what planned training was in place. However it did not fully evidence when training updates were due. Staff said they had received some training in the past 12 months and said that they had been given a training programme which detailed updates for training in adult protection moving and handling and fire safety within the last 12 months. The manager agreed that the training records, whilst in place were not easily accessible and advised that he was in the process of devising a system in which all staff training records were held together in one file with a matrix of training updates to ensure that all staff receive training that is timely and appropriate to their role. The staffing rota identified that there was adequate staff and skill mix to meet the needs of the current residents of the home. People spoken with were most positive about the staff and comments included. The staff here are very nice, nothing is too much for them. I like living here the staff are always busy but they make sure they have time for us. The staff work very hard but we know we can rely on them to assist us. They are always pleasant, kind and caring, no matter how busy they are. They are like a breath of fresh air they are wonderful. Staff spoken with presented a being professional and caring and appeared very motivated to provide quality care for the people living in the home. Discussion with staff identified that they had clear understanding of residential care and the individual needs of the people living in the home. They said they were generally busy but because they worked well together as a team they were able to provide sufficient care and support at all times. Staff said that the staff team had got to know each other because of the low staff turnover and they felt at ease with each other and this assisted them to maintain a good atmosphere within the home. Staff said they respected the manager and deputy who they said led by example and encouraged them to develop their skills. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 23 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 24 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): 31.33.35.36.38. 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. There has been great progress in increasing the overall quality of the service. Action improvement plans have been put in place to help the manager to improve the quality of the service. EVIDENCE: Discussions with people living in the home and staff revealed that the manager is well thought of both by people living in the home and the staff. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 25 Comments about his popularity have been written throughout this report and general opinions are that he is an excellent manager who works hard to improve services by listening to staff and people who live in the home. The manager is assisted by a deputy manager to give the manager extra support and staff said this works well. Staff comments included Excellent management team, Very supportive line management, We all feel well supported and know exactly what our roles are. The policies and procedures in the home have all been reviewed and updated where necessary and now provide staff with all the guidance and instruction they need. People living in the home said they were involved in everything to do with the daily living activities to include food choice, entertainment and decoration. They said this involvement was by way of meetings with the manager and staff, completing questionnaires and general discussion. People said they were able to record their needs, wishes and preferences when they entered the home and this information is continually reviewed on a monthly basis. The manager implemented an action plan after the last inspection and has worked on this plan to ensure that audits are carried out to ensure that staff are providing a quality needs led service. The manager and staff now consult with the people who live in the home and check the quality of the service, in order to recognise the areas that are in need of development. Staff files looked at and discussions with staff showed that none received regular formal supervision. However staff said that they were provided with informal supervision whenever they wanted and found this most useful. Staff spoken with said that staff meetings now took place which gave them the opportunity to raise any issues and gain need to information. Staff said they felt valued, supported and motivated by the management team and revealed that because of this they were proud that the home had developed services so well. The arrangements for managing individual funds has been reviewed and the manager said that most people living in the home either manage their own money or have family to deal with tier finances. However any money which is managed by the home is clearly recorded, double checked and audited with records being accessible on request. Staff records show that health and safety training takes place and other documentation viewed identify that environmental risk assessments, essential Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 26 service checks and maintenance management are all ongoing processes in the home. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 27 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 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 2 X 3 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 28 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 OP36 Regulation 15 Requirement The registered person should ensure that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice to assist staff in their personal and professional development. Timescale for action 12/12/09 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 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 29 Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 30 Care Quality Commission North West Region 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). 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. Knotty Ash Residential Home DS0000025353.V377458.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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