Care Home: Knowle Court

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What the care home does well People live in a very comfortable home where they are enabled and supported to live as independently as possible. People who live at the home and, where appropriate, their relatives are fully involved in a care planning process which concentrates on supporting people`s strengths and weaknesses to promote their dignity and self worth. People get involved in a range of stimulating social and leisure activities including more unusual ideas such as hatching chickens, adopt a donkey scheme and breath of fresh air scheme. People`s rights are acknowledged and following mental capacity act assessments, where needed, independent representatives will be appointed to act in peoples best interests. The home is very much family run and management are fully involved in the day to day care of the people living at the home. People said the food was very good. People who responded in surveys were very complimentary of the service. These are some of the things they said: "Moving my mother to Knowl Court has been a very good thing - we know she is well looked after and she fells safe and happy" "Makes me feel at home and as though it is my home" " I am a local person, it is nice to feel that I am back home" What has improved since the last inspection? The service has continued to build on the high standards of care and services provided to the people who live there. Mental capacity act assessments have been introduced to make sure that people`s rights are protected. What the care home could do better: The manager needs to make sure that staffing numbers are kept under review to make sure that there are always enough staff available to meet the needs of the people who live there. Key inspection report Care homes for older people Name: Address: Knowle Court 38 Knowl Road Golcar Huddersfield West Yorkshire HD7 4AN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Gillian Walsh     Date: 0 8 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Knowle Court 38 Knowl Road Golcar Huddersfield West Yorkshire HD7 4AN 01484658357 01484658357 admin@knowlcourt.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Knowle Court Limited care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is : 22 The registered person may provide the following category of service only: Care home only, Code PC, to service users of the following gender: either, whose primary care needs on admission to the care home are within the following category : Old age, not falling within any other category: Code OP, maximum number of places : 22 Date of last inspection Brief description of the care home Knowle Court is a care home providing personal care and accommodation for up to 22 older people with care needs. The home is owned by Knowle Court Limited, and the manager is a company director. The accommodation is a converted and adapted former Victorian Sunday School situated in the village of Golcar, a former weaving community, on the outskirts of Huddersfield. The accommodation is built over two floors that are joined by a staircase containing stair lifts. The majority of bedrooms are for single occupancy with a few shared rooms for those who prefer. There are two lounges and a designated dining room. The home is a short distance from local Care Homes for Older People Page 4 of 26 Over 65 22 0 Brief description of the care home amenities. The front of the building has a small car park and garden. The provider informed the Care Quality Commission in December 2009 that fees are £418 per week. Additional charges include hairdressing, private chiropody, newspapers and toiletries. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out to assess the quality of care provided to people living in the home. The inspection process included looking at the information we have received about the home since our last key inspection as well as a visit to the home. One inspector carried out the visit over one day and it lasted for approximately 6 hours. During the visit we spoke to people living in the home, some visiting relatives, some members of staff, the homes owner, registered manager and wider management team. We observed care staff delivering care, looked at various records and looked around the home. Before the visit we sent surveys to 10 people living in the home and their relatives, 5 staff and 5 health care professionals involved in the care of the people at the home. Care Homes for Older People Page 6 of 26 This gives people the opportunity to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. We received completed surveys from 4 people living at the home and their relatives, and 2 members of staff. Their comments have been used in this report. We asked the manager to complete an Annual Quality Assurance (AQAA) document so that she could tell us how she thought the home was doing, any improvements they have made or have planned and any problems they may be facing. The document also provides us with some numerical information about the home to assist us in our inspection process. The AQAA was completed and returned to the Commission within timescales. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 26 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home are sure that their health and personal care needs will be met there. Evidence: The homes owner said that the registered manager and himself always go to meet people who are enquiring about moving into the home. This is so that they can assess the persons health and care needs to make sure that they can be properly met by the staff at the home. The person is then invited to the home to have a look around and meet the people already living at the home. The initial assessment of the persons needs is included in the care file as a basis for the care plan and to aid the re-assessment and evaluation process. Care Homes for Older People Page 11 of 26 Evidence: The home does not provide intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good care planning and review processes mean that people recieve excellent standards of care and support. Evidence: During the visit to the home we looked at three peoples care files in detail. We saw that each care file included a personal profile and a life history. These help care staff to have a good understanding of the person, how they have lived their lives, their family history and what their interests are. The care plans covered each area of daily living such as personal hygiene, mobility, elimination, eating and drinking and social and recreational needs. The plan gave clear details about the support staff should give the person to meet their needs in the way they prefer. Alongside the care plan was an information sheet about the individuals strengths and needs. This is to make sure that staff know how to support people to maintain their independence and therefore their dignity and self worth. Care Homes for Older People Page 13 of 26 Evidence: One of the people who lives at the home said that they liked the fact that they are encouraged to do whatever they can for themselves.They said that staff make sure that their privacy and dignity is protected. One person said Its a hundred percent the care here Care files included a range of assessments such as moving and handling, nutrition and the waterlow assessment which determines how prone a person may be to developing pressure sores. These assessments are used in the development of care plans. Also included in the files was a page of contact details for all of the health care professionals, such as the GP, district nurse and optician involved in the care of the individual. Records were made of any interventions from a health care professional. The registered manager and the homes owner said that wherever possible, people go to the doctors surgery, opticians, dentist etc rather than the health care professional visiting the home. Again this encourages and supports people to retain their individuality and independence. All of the files contained a copy of a mental capacity assessment which had been completed to determine whether or not the person had the ability to make informed decisions about their lives and care. The homes owner said that they would appoint an independent person to represent anybody who was assessed as not being able to make decisions for themselves. This means that the home are making sure that peoples rights are protected. We saw that people are involved in their own care plans and either they or where appropriate, their next of kin, sign to say that they agree with the planned care. The homes owner said that they review the care plans on a regular basis with the person concerned or their relatives. Where relatives are unable to visit, the home contacts them to discuss the review. We saw that review notes were thorough and that any changes were recorded. We saw that everybody looked smart, clean and dressed in well cared for clothing. Ladies had their hair set and gents appeared clean shaven. We observed the lunchtime medication round which was done by two senior members of staff. The registered manager said that all medication rounds are done by two people. We checked to see if systems for ordering and storage of medication were safe and found that they were. Care Homes for Older People Page 14 of 26 Evidence: Care Homes for Older People Page 15 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with choices which enable them to follow individual, enjoyable lifestyles Evidence: We saw during the visit that people are able to follow their preferred routines in how they spend their days. People who chose to had stayed in bed until late morning whilst others were in the lounge or spending the morning in their own rooms. Staff were engaging some people in a game of throwing bean bags on to a large target on the floor. People appeared to be enjoying this very much and were engaging with each other and the staff. Some people were spending time with their visitors, one of whom said to the inspector youll only find good things here. We saw a large photograph and notice board in the entrance which showed some of the activities people had recently enjoyed. This included visits from donkeys from the Adopt a donkey charity which the home contributes to. The photographs showed the donkeys in the lounge of the home and the peoples faces showed how much they Care Homes for Older People Page 16 of 26 Evidence: were enjoying this unusual activity. There were also photographs of when the people at the home had taken part in the living eggs scheme where they incubated twelve eggs and then returned the chickens to the scheme to live free range. The homes owner said that they planned to participate in his scheme again at Easter. As well as these activities, the home also participates in the national Breath of Fresh Air competition for care services. As part of this they developed a vegetable patch and grew their own produce. In their second year of entering the home was placed in the top twenty five services nationally. People living at the home engage in the local area particularly a local working museum where people who are able take part in activities. for those not able to go to the museum arrangements were made for the museum staff to come to the home along with children from the local playgroup who dressed in period clothing. People spoken with said that they very much enjoyed their lives at the home with one person saying how well they were supported to live as independently as possible. Observations from the day, information within care files and what people told us confirms that people have choice and autonomy within their lives. The home does not employ catering staff as all meals are prepared by a member of the management team. The home achieved five stars in the Kirklees healthy eating choice award this year. We saw that the main meal of the day was served at lunchtime in the homes very pleasant dining room. People who needed additional support from care staff had their meals first with staff sitting at the table with them to assist as required. Everybodys meals were delivered to the table in tureens so that people could either serve themselves or staff could assist if needed. The meal time was very relaxed with lots of interaction between staff and the people who live at the home. People were asked how they were enjoying the meal, if they wanted more and offered choices throughout. Care Homes for Older People Page 17 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live safely in a home where they know how to raise any issue of concern. Evidence: People spoken with said that they would speak to any of the staff if they had a concern or a complaint although one person said that there was never anything to complain about. The home has a complaints procedure which is made available to everybody in the information about the home pack which is in every bedroom. There is also a book in which staff record any compliments, concerns or complaints. No complaints had been received by the home since the last key inspection and none have been made about the home to the Commission. Staff training records showed that staff have undertaken training to help them in making sure that people in the home are safeguarded from any form of abuse. Staff spoken with knew what to do if they had any suspicion of people living at the home being subject to abuse. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and very pleasant home. Evidence: Since the last key inspection the home has had a small extension completed which has slightly increased the occupancy but has improved the communal space especially in the dining room. New bathing facilities including hydrotherapy baths with special hair washing facilities have been fitted and are enjoyed by the people living at the home. The home throughout was very nicely presented; clean, tidy, homely and comfortable throughout. Peoples bedrooms had been very nicely personalised and it was evident that staff take care to look after peoples possessions. The homes owner explained that people can choose the decoration for their own room and an example of this was seen. The homes owner does a number of weekly safety checks to make sure that the environment is safe. The safety standards within the home were confirmed in the AQAA sent to the Commission prior to the inspection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a safely recruited and appropriately trained staff team who treat people with respect and kindness. Evidence: During the visit we saw that there were plenty of staff available to people to make sure that their needs were met. We saw that the staff rota showed that on some evenings, there are only two staff available in the home. As there are now a couple of people in the home who need more than one member of staff to support them with their needs, this means that whilst one of these people was being attended to, there would not be anybody available to all of the other people who live at the home. The homes owner said that although the rota didnt reflect it, he would often be in the home during the evening. He also said that he would make immediate changes to the rota to make sure that the situation didnt arise again. The homes owner said that ninety percent of the care staff within the home hold the NVQ (National Vocational Qualification) level two award in care. This far exceeds the minimum standard of fifty percent and means that staff are qualified to look after people properly. Care Homes for Older People Page 20 of 26 Evidence: The homes owner said that all newly appointed staff undertake the Skills for Care Council induction along with the the homes own induction procedure. This makes sure that people have a good understanding of the job before they start to work supporting people. We saw that staff training in areas such as moving and handling, fire, health and safety and safeguarding is up to date and more training has been planned for the new year. We looked at recruitment files for four staff. The files contained documentation to show that all proper checks and clearences are obtained before a person is offerred employment Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed to assure the safety, comfort and quality of life of the people who live there. Evidence: The homes owners are husband and wife, both of whom work in the home alongside the registered manager. Mr Lunn, one of the owners and the registered manager both hold the registered managers award. The deputy manager is also to start studying for the award. All of the management team, as well as managing the home on a day to day basis, have a hands on approach to care and also do the catering and safety and maintenance checks. We saw the results of the most recent quality monitoring survey, where people living at the home, their relatives and other people associated with the home had completed questionnaires. The results of this is put into a graph and a report and made available Care Homes for Older People Page 22 of 26 Evidence: to everybody. One person had said in a survey You provide a wonderful service and have made my mother a very happy lady The home had also completed and returned Annual Quality Assurance Assessment (AQAA) as requested by the Care Quality Commission. in this the homes management told us about how they think they are performing and also of any ideas or plans they have to continue to improve their service. We also saw the minutes from the most recent residents meeting. We saw that people actively make suggestions and give feedback in these meetings which are arranged on a monthly basis. Some of the people who live at the home have small sums of money kept for them in the safe. We saw that good accounting procedures were in place for this money and that all the balances were correct. The home had confirmed in their AQAA that all safety and maintenance checks were in place and some of the records in relation to this were seen. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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