Care Home: Knowle House Nursing Home

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What the care home does well The acting manager has managed the home well in the absence of a registered manager. Mr Sivasubramanian has provided daily support in the home to ensure the efficient running of the service. Staff spoken with said they work very well together and understand people`s needs; they said they feel well supported by the acting manager.There is a programme of training including specialist training in dementia care. The management team encourage and support staff in their personal development. There is a strong commitment to involving relatives in the running of the home and the majority of people living at Knowle House benefit from having relatives involved in their care. A meeting is held every three months for residents and families. Meetings are held on Saturdays so that it is easier for relatives who may be working to attend. These meetings are well attended and people contribute useful ideas. Relatives have requested that staff photos should be displayed so that they know who is on duty and that raised flowerbeds should be provided for people in wheelchairs. Both ideas are due to be followed up. The visitors spoken with said they are made to feel part of their relatives` lives when they visit. There is a lively programme of activities that are organised by a dedicated member of staff. People are encouraged to take part in activities that they enjoy including making up flowerpots for the garden and baking cookies. Most people where in the lounge and were enjoying a fun activity before they had their lunch. The home is well decorated and furnished. The gardens are well cared for and people said they enjoy using them in good weather. The home sent thirty satisfaction surveys to residents and relatives and seventeen were returned. The comments that people made included: " The nursing staff are excellent", "The home is comfortable and warm", "The staff are cheerful", "The care and attention of the staff, always helpful and keep you informed" and "I feel that my mother is in good care and well looked after". The people spoken with during the visit were happy with the care they receive and two visitors said they are always made welcome in the home and offered a drink as soon as they arrive. What has improved since the last inspection? The requirement made at the last inspection has been addressed and no newly recruited staff begin work until the necessary checks are carried out. Good relationships have been established with relatives, staff, care managers, GPs and the management team of the home through meetings and good communication. A new call bell system has been installed. New furniture has been purchased for areas of the home. Some of the information documents have been reviewed to make them easier for people to understand and to include more information. The policies and procedure manual has been updated. What the care home could do better: The newly appointed manager should make an application for registration with the Commission as soon as possible after she begins her new post in September. There should be a system for monitoring the nutritional intake for people where a possible risk to their health has been identified. CARE HOMES FOR OLDER PEOPLE Knowle House Nursing Home Lingfield Road East Grinstead West Sussex RH19 2EJ Lead Inspector Annette Campbell-Currie Key Unannounced Inspection 3rd July 2008 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knowle House Nursing Home Address Lingfield Road East Grinstead West Sussex RH19 2EJ 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) 01342 317740 01342 317743 Yourcare Ltd Post vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 35. Date of last inspection 17th July 2007 Brief Description of the Service: Knowle House is registered to provide personal care and nursing for 35 people in the category of older persons (OP). Knowle House is a large detached three-storey house situated on a residential road near the town centre of East Grinstead. Accommodation is provided in 19 single bedrooms, 12 of which offer en-suite facilities. There are 8 shared bedrooms; 2 of which offer en-suite facilities. A passenger lift provides access to most of the bedrooms. There is a lounge and conservatory, which is also used as a dining room, situated on the ground floor. There is a small lounge on the second floor. Yourcare Ltd owns Knowle House and Dr Sivasubramanian is the responsible individual for the company. There is currently no registered manager and Mr Sivasubramanian oversees the day-to-day running of the home. Fee levels for the home are from: £450 - £650 per week. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is Two Star. This means that the people who use this service experience good quality outcomes. Annette Campbell-Currie carried out the site visit over five and three quarter hours. The deputy manager has been acting manager since April and she assisted with the inspection. All the information that we (the Commission) needed was available. There were twenty-five people staying permanently in the home and three people receiving respite care at the time. The acting manager had completed an annual quality assurance assessment form (AQAA) before the inspection and this provided a great deal of useful information that was used in the planning of the site visit. During the visit four people living in the home were spoken with, two visiting relatives and five members of staff including the acting manager. The gardens, communal areas and some bedrooms were seen. The following documents were read: the case records of four people living in the home, the recruitment records of four staff, training records, quality assurance documents, key policies, the complaints records and other relevant documents. The lunchtime medication round was also observed. Surveys had been sent out to people living in the home, staff and healthcare professionals to find out what people think about the home. One person living in the home and one member of staff returned surveys; the people who replied were positive about the service. The home carried out their own survey in April and some of the comments people made have been included in the report. The outcome for people living in the home has been assessed in relation to twenty-two of the thirty-eight National Minimum Standards for the care of older people, including those considered to be key standards to ensure the welfare of people living in the home. The requirement made at the last inspection regarding the need for checks to be carried out on staff before they begin work has been addressed. What the service does well: The acting manager has managed the home well in the absence of a registered manager. Mr Sivasubramanian has provided daily support in the home to ensure the efficient running of the service. Staff spoken with said they work very well together and understand people’s needs; they said they feel well supported by the acting manager. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 6 There is a programme of training including specialist training in dementia care. The management team encourage and support staff in their personal development. There is a strong commitment to involving relatives in the running of the home and the majority of people living at Knowle House benefit from having relatives involved in their care. A meeting is held every three months for residents and families. Meetings are held on Saturdays so that it is easier for relatives who may be working to attend. These meetings are well attended and people contribute useful ideas. Relatives have requested that staff photos should be displayed so that they know who is on duty and that raised flowerbeds should be provided for people in wheelchairs. Both ideas are due to be followed up. The visitors spoken with said they are made to feel part of their relatives’ lives when they visit. There is a lively programme of activities that are organised by a dedicated member of staff. People are encouraged to take part in activities that they enjoy including making up flowerpots for the garden and baking cookies. Most people where in the lounge and were enjoying a fun activity before they had their lunch. The home is well decorated and furnished. The gardens are well cared for and people said they enjoy using them in good weather. The home sent thirty satisfaction surveys to residents and relatives and seventeen were returned. The comments that people made included: “ The nursing staff are excellent”, “The home is comfortable and warm”, “The staff are cheerful”, “The care and attention of the staff, always helpful and keep you informed” and “I feel that my mother is in good care and well looked after”. The people spoken with during the visit were happy with the care they receive and two visitors said they are always made welcome in the home and offered a drink as soon as they arrive. What has improved since the last inspection? The requirement made at the last inspection has been addressed and no newly recruited staff begin work until the necessary checks are carried out. Good relationships have been established with relatives, staff, care managers, GPs and the management team of the home through meetings and good communication. A new call bell system has been installed. New furniture has been purchased for areas of the home. Some of the information documents have been reviewed to make them easier for people to understand and to include more information. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 7 The policies and procedure manual has been updated. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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 Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Knowle House Nursing Home does not provide intermediate care Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs assessed to ensure that the home would be able to meet their needs. EVIDENCE: The acting manager or one of the registered nurses carries out an assessment before a decision is made about whether or not a person’s needs could be met at Knowle House. Relatives, healthcare professionals and social workers are also involved in this decision as well as the person themselves. Samples of pre-assessment forms were seen and included details of each person’s needs so that an informed decision could be made about them moving to the home. Information included emotional and physical needs, personal history, history of falls, dependency profiles and hobbies and interests. There was space on the forms for people to indicate their agreement with the assessment. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 10 The acting manager explained that a number of people are admitted to the home from hospital and although Knowle House does not provide intermediate care they do provide short term care to help people with their recovery following a hospital stay so that they are able to return to their homes if they wish to. A number of people are assessed in hospital just prior to their discharge. One person spoken with and their relative said that a short stay in the home really helped with his recovery and he had received good care and was looking forward to going home. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health, personal care and social care needs are set out in an individual plan of care. People’s health care needs are met and they are protected by the home’s policy and procedures for dealing with medicines. People feel they are treated with respect and their right to privacy is upheld. EVIDENCE: There is a process for care planning and review. There is a standard format that is used; this includes a detailed assessment of need that is completed when people arrive at the home and includes information gathered before the person moved in. Samples of care plans were read and included details gathered through the assessment process and provided guidance for staff about the way that care should be provided. Cultural and spiritual wishes were included in the care plans as well as physical and emotional needs. There was a detailed life history of the people whose care plans were read. These included names of important people in their lives so that staff would be more familiar Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 12 with relatives and family members involved in the person’s life. Residents had signed their agreement to their care plan. The care staff spoken with said that they understand the needs of people living in the home and if they are uncertain about anything the registered nurses provide guidance. Important information is also passed on at daily handover sessions. Risk assessments had been carried out in general areas of risk including nutritional screening, skin integrity and mobility. It was clear that care plans are reviewed monthly and changes of need had been noted with new guidance for staff. There was space for people to sign their agreement to changes made to their care. People’s health care needs were documented and there were records of GP visits and outpatients appointments. A local GP visits the home once a week to see people who need a consultation. The acting manager said that there is a good relationship with the local surgery. People can access the services of a dentist, optician and chiropodist. Some staff have recently attended training in supporting people with dental hygiene. Aromatherapy massage is also available at an additional cost. There is an emphasis on good wound care and wound mapping and wound photographs are taken on admission and monitored to make sure the best wound care is being provided. An early referral is made to the tissue viability nurse. Samples of records of wound care were seen and showed that through good wound management improvements had been made. Nutritional assessments were seen on the care plans and people are weighed monthly so that any weight gain or loss can be monitored and action taken if necessary. Fluid charts were seen and guidance about people’s nutritional needs was noted. The acting manager was advised to ensure that there is a system in place for monitoring nutritional intake where a risk has been identified; she agreed to do this. There are policies and procedures in place regarding medication in the home. No one in the home at the moment administers their own medication. Only qualified nursing staff administer medicines. The administration of the lunchtime medication was observed; medicines were appropriately stored and recording was in order. Care staff are given advice and guidance about the way to provide personal care as part of their induction. The staff spoken with were clear about their responsibilities and during the day people were being treated with sensitivity and respect. 94 of people who returned surveys circulated by the home said that they receive good nursing care and that they have sufficient privacy. A new call bell system has been installed so that people are better protected. Call bells were being answered with little delay although some people commented Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 13 in the home’s survey that they sometimes have to wait for the call bell to be answered. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People find the lifestyle experience in the home matches their expectations. People are supported to maintain contact with relatives and friends. People are supported to make some choices in their daily lives. People are provided with a balanced and nutritious diet. EVIDENCE: A lively programme of activities is provided. There is a newly appointed activities coordinator who was a member of the care team and knows most of the people in the home well. People’s hobbies and interests were noted in their care plans and the coordinator spends one-to-one time with people as well as organising small and large group activities. The previous day people had planted seeds. Recently a group of people had planted flowers in pots for the garden and cookies were made and eaten for tea. There was a lively activity taking place before lunch and most people in the room were enjoying this; those who weren’t able to take part were happy to watch and to be involved. Birthdays are celebrated in the home and relatives are encouraged to visit and take part. During the day people were being supported to make use of the Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 15 garden for exercise and pleasure. Small groups of people with their relatives had visited the local school fete and people are supported to attend coffee mornings and other activities that take place in the local church. There were photographs of activities displayed and the coordinator said that she gives copies to relatives with the agreement of residents. Activities are planned and carried out so that people are involved in choosing the things they enjoy doing and can really be involved. The home supports people to maintain contact with relatives and friends. Efforts have been made to actively involve relatives in the daily care and running of the home so that they are very much a part of their relative’s life. Meetings are held every three months on a Saturday and there is a very good attendance. Minutes are kept and ideas followed up; there is a social element to the day and the management team always attend. Mr Sivasubramanian said this provides an open opportunity for people to feel part of what is happening in the home. Visitors are welcomed in the home although they are discouraged from visiting at meal times. The relatives spoken with said that they are always made to feel welcome and offered a cup of tea when they arrive. People have some choice in their daily lives regarding when they get up and go to bed. Short-term care is provided and people are supported to gain their independence following a stay in hospital or personal difficulty so that they can make a safe an informed decision about returning home if they wish to. People are provided with a balanced diet and nutritional assessments are carried out to make sure people are getting the nutrition that they need. The chef was on leave during the visit and two other kitchen staff prepared the meal. There was a choice of meal. 88 of people who returned surveys circulated by the home said that they are satisfied with the meals provided by the home. Special diets are catered for and some people were provided with soft food. Some people were sitting at the tables in the dining room and other people had meals on trays in the lounge. Two people were provided with meals in their rooms. Possible ways to make meal times more relaxed and social occasions were discussed with the manager. Those being assisted with eating should be supported in a way that ensures their food is appetising and that they know what they are eating. Some staff were assisting people to eat with sensitivity and careful attention. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their complaints will be listened to and taken seriously. Policies are in place to help protect people from abuse. EVIDENCE: There is a complaints policy and procedure for investigating complaints. 88 of people who returned surveys sent out by the home said they are informed of their right to make a complaint if they are not satisfied with the service. People also felt that those complaints would be listened to and acted upon. Eleven complaints have been received by the home in the past twelve months. The records of the complaints made were seen and showed that they had been appropriately investigated and resolved. The Commission has not received any complaints about the home. The home has a copy of the West Sussex multi disciplinary policy and procedure for safeguarding vulnerable people. The staff have all attended training on adult abuse and there is a strong commitment from the staff spoken with to make sure that people in the home are protected. Staff have regular opportunities to update their understanding through training sessions using training DVDs. The acting manager and staff spoken with were clear about their responsibility to protect people and report any concerns to the Social and Caring Services. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe and well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: The home is well maintained and provides a comfortable place for people to live. The home was clean and hygienic with no unpleasant odours. There is a member of staff who works full time to provide maintenance for the building. There is an improvement plan that includes providing a separate office space for staff that does not encroach on the communal dining room area, a wheelchair storage shelter and a larger conservatory. Mr Sivasubramanian said that the improvements are dependent on finances so there are no clear timescales. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 18 There are safety measures in the home to ensure that people are kept safe. The acting manager said in the AQAA that a new call bell system has been installed and the laundry equipment has been replaced with more modern, efficient and energy saving machines. All equipment is serviced as required and risk assessments of the building are carried out. The communal areas are bright and well used and people are happy with their bedrooms. There are dedicated staff for cleaning, laundry and kitchen duties so that other staff can concentrate on providing care. There are sluicing facilities and staff have attended sessions on infection control to make sure they know how to prevent cross infection. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of people living in the home are being met by the numbers and skill mix of staff on duty. The home’s recruitment policy protects people living in the home. Staff are trained and competent to do their jobs. EVIDENCE: At the time of the visit the acting manager was on duty and Mr Sivasubramanian spent the day in the home. There was a full time administrator; four care staff, a registered nurse, the activities coordinator, a cleaner and two kitchen staff. In the afternoons there were three carers and a registered nurse on duty and at night two care staff and a registered nurse. Most people were in the lounge and were being well cared for; two people were being nursed in bed. There were sufficient staff to meet the needs of people in the home. Staff were providing care in an unhurried way and call bells were being answered in a reasonable time. Care staff are encouraged and supported to register for a National Vocational Qualification (NVQ) award. The acting manager confirmed in the AQAA that nine of the sixteen permanent care staff have achieved NVQ level two or above. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 20 The recruitment records of four members of staff were seen including two who have been appointed recently. Application forms had been completed and some applicants had included a curriculum vitea (CV). The administrator was advised to make sure that a full employment history is requested on the application form so that any gaps in employment can be explored as part of the short listing and interview process. The records seen showed that all the required checks had been carried out before new members of staff began work. POVAfirst checks are obtained before a full enhanced Criminal Records Bureau check is received. The management team were clear about the need for supervision of new staff before the full check is received. The records seen showed that two references had been obtained and the Home Office had been contacted regarding one person’s immigration status. There is an induction and training programme. Staff said that they have the knowledge and skills that they need to do the work. There were certificates of attendance at training sessions on staff files. There was no system for recording when staff have attended training so that the manager can be sure that people attend updated training as it falls due. The administrator said that she would devise a system to record all staff attendance at training sessions. Every day there is a session in the early afternoon for staff to read and discuss a policy; the acting manager started this process to make sure all staff understand the policies and procedures of the home. Every Thursday afternoon a group of staff meet to watch a training DVD and discuss their learning with a senior member of staff. Nursing staff have the opportunity to develop their nursing skills. The acting manager has recently attended training on pressure area care, catheter care, colostomy care, working with people who have a visual or hearing impairment and guidance on completing continuing care paperwork. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is well run by managers who have the knowledge and experience to do so. The views of people living in the home are sought. People’s finances are being protected. The health, safety and welfare of people living in the home and staff working there is being promoted and protected. EVIDENCE: The acting manager has been in post since April and will return to her duties as deputy manager when the newly appointed manager begins work in September. Mr Sivasubramanian was advised to make sure the new manager applies to the Commission for registration as soon as possible after her appointment begins to make sure the home is complying with the legislation. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 22 The acting manager has made sure the home is running efficiently and the staff team work well together. There is a quality assurance process in place to make sure a good standard of care is maintained. The acting manager carries out a monthly audit of case files and other records in the home. Surveys are circulated to relatives and residents once a year. The feedback is collated and published in an easy to read format so that people know their views are taken into account in the planning of the service. Three monthly meetings with residents and relatives are well attended and people have contributed ideas that are followed up, for example photographs of staff are displayed so that people know who is on duty and raised flower beds are to be built in the garden so that people in wheelchairs can reach them easily. Mr Sivasubramanian is in the home every day to oversee the running of the home and to make sure that the acting manager is well supported. Some people have support with small amounts of money and there are systems and checks in place to make sure their monies are kept safe. The administrator said that either relatives or solicitors support people in managing their finances. There are systems in place to protect the health, safety and welfare of people living in the home and staff. The AQAA states that all the equipment is checked and serviced as required. All staff receive training on health and safety matters so that they know how to keep people safe. Records are kept of incidents and accidents and these are checked and monitored. Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 4 X 3 X X 3 Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Knowle House Nursing Home DS0000031332.V365417.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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