Care Home: Knowle Manor

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What the care home does well Care is provided in a clean, tidy, well-maintained home. The manager and staff have established good relationships with the residents in the home and their relatives. There are systems in place to make sure that a consistently high standard of care is given. This includes care plans that give a clear picture of the person and how to meet their needs, communication systems, regular training for staff, formal staff supervision, monthly resident’s consultation meetings and regular surveys of people’s views. There is a programme of planned activities and ample provision of books, DVDs, board games. The home has access to a mini bus and there are regular trips out. The 24 hour café and the daily breakfast bar give residents choice and independence. Residents said that they were happy living in the home, they were more than satisfied with the care given to them and that the food was very good. They said that staff were polite and respected their privacy. The home has a warm, friendly and welcoming atmosphere. Visitors said that they were welcomed at any time and they were able to help themselves with refreshments. They also said that they were kept up to date and informed about any changes in their relatives care needs. It was clear that that there are good relationships between the staff team, residents and visitors to the home. Yearly quality assurance surveys are carried out which involve residents in the running of the home. Staff told us in the surveys what the home does well: • Good care and support for residents and staff, the home is well maintained and good team work. • Good choice of meals, cleanliness, all round good care and team work. One staff said “I think staff could give a bit more time to residents that cannot speak for themselves; by chatting to them just a little time puts a big smile on their faces.” Overall staff are well supported by the management team. The manager manages the home well. What has improved since the last inspection? Soap dispensers and hands drying facilities have been fitted in people’s bedrooms. This means that the risk of cross infection is reduced. The home have started work on care plans information; using the current life style plan format; by having more details which give staff clear information on Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 resident’s care and support needs and the action that must be taken to meet resident’s needs. This would prevent needs being overlooked, and residents receiving their care how they wish. Residents who have moving and handling plans have details to show the assistance and support staff should give. This means that people are handled safely. All staff files include a recent photograph of the person and copies of two written references. All staff have had updates of mandatory training such as moving and handling and food hygiene as required. Where money is handled over on behalf of a person living at the home a signature is obtained from the person handing over the money and the person receiving the money. This means that the risk of errors, misunderstandings and financial abuse is reduced. What the care home could do better: The numbers of staff on duty during the night should be reviewed taking into account the dependency levels of the people living at the home and the layout of the home. This is to make sure that the safety and well being of residents and staff are not compromised. Key inspection report CARE HOMES FOR OLDER PEOPLE Knowle Manor Tennyson Terrace Morley Leeds LS27 8QP Lead Inspector Valerie Francis Key Unannounced Inspection 24th June 2009 10:00 DS0000033246.V376320.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. Knowle Manor DS0000033246.V376320.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 Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knowle Manor Address Tennyson Terrace Morley Leeds LS27 8QP 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) 0113 2534740 0113 2538728 Leeds City Council Department of Social Services David Richard Monaghan Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. 3. Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is 29. One specific service user in the category of DE, named on the variation dated 21 September 2006, may reside at the home. 4th June 2007 Date of last inspection Brief Description of the Service: Knowle Manor is a local authority home providing personal care without nursing for older people. There are 26 places for permanent occupancy and 3 places for respite occupancy. Accommodation is provided in single rooms, the majority of which have ensuite facilities. The home is on two floors with a passenger lift proving access to the second floor. The communal areas are on the ground floor where there is a large dining room and a choice of lounges, one of which is a designated smoking area. The home is situated close to Morley town centre where there are a wide range of amenities including shops, library, doctors and dentists. The home is well served by public transport with bus services running to and from Leeds and other local areas. There is a car park at the front of the home. Copies of previous inspection reports are available in the home. Knowle Manor DS0000033246.V376320.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 *** star. This means the people who use this service experience excellent quality outcomes. One inspector made a visit on the 24th June 2009 at 10:0am until 5:45pm. The home did not know that this inspection was going to take place. Feedback was given to the manager and care officer on duty. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the people who live there. We were told that people in the home had a ballot about what they would like to be referred to and they all said they wish to be referred to as residents. Therefore we have referred to them in this report as residents. Before the visit we asked for information from the manager, by sending them a self assessment form, an (AQAA) Annual Quality Assurance Assessment, which gives the home the opportunity to say what they have done since the last key inspection what they are doing to do in the next twelve months and what they could do better. The information includes what policies and procedure they have and when they were last reviewed; when maintenance and safety checks were carried out and by whom. We sent surveys to the home to give to people and staff to find out what their views of the home were. Five residents and seven staff returned surveys. During the visit we spoke to residents, staff and visiting relatives; their comments are included in the body of this report. The current scales of charges at the home range from £102.90 to £519.30 per week. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. 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 services 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. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 6 What the service does well: Care is provided in a clean, tidy, well-maintained home. The manager and staff have established good relationships with the residents in the home and their relatives. There are systems in place to make sure that a consistently high standard of care is given. This includes care plans that give a clear picture of the person and how to meet their needs, communication systems, regular training for staff, formal staff supervision, monthly resident’s consultation meetings and regular surveys of people’s views. There is a programme of planned activities and ample provision of books, DVDs, board games. The home has access to a mini bus and there are regular trips out. The 24 hour café and the daily breakfast bar give residents choice and independence. Residents said that they were happy living in the home, they were more than satisfied with the care given to them and that the food was very good. They said that staff were polite and respected their privacy. The home has a warm, friendly and welcoming atmosphere. Visitors said that they were welcomed at any time and they were able to help themselves with refreshments. They also said that they were kept up to date and informed about any changes in their relatives care needs. It was clear that that there are good relationships between the staff team, residents and visitors to the home. Yearly quality assurance surveys are carried out which involve residents in the running of the home. Staff told us in the surveys what the home does well: • Good care and support for residents and staff, the home is well maintained and good team work. • Good choice of meals, cleanliness, all round good care and team work. One staff said “I think staff could give a bit more time to residents that cannot speak for themselves; by chatting to them just a little time puts a big smile on their faces.” Overall staff are well supported by the management team. The manager manages the home well. What has improved since the last inspection? Soap dispensers and hands drying facilities have been fitted in people’s bedrooms. This means that the risk of cross infection is reduced. The home have started work on care plans information; using the current life style plan format; by having more details which give staff clear information on Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 7 resident’s care and support needs and the action that must be taken to meet resident’s needs. This would prevent needs being overlooked, and residents receiving their care how they wish. Residents who have moving and handling plans have details to show the assistance and support staff should give. This means that people are handled safely. All staff files include a recent photograph of the person and copies of two written references. All staff have had updates of mandatory training such as moving and handling and food hygiene as required. Where money is handled over on behalf of a person living at the home a signature is obtained from the person handing over the money and the person receiving the money. This means that the risk of errors, misunderstandings and financial abuse is reduced. 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. Knowle Manor DS0000033246.V376320.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 Manor DS0000033246.V376320.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&4 People using the service experience Excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s needs are properly assessed before they move into the home, so everyone can be sure that the person is moving into the right home and their needs can be met. EVIDENCE: Prospective residents wanting to move in the home are given a copy of the home’s information. The Statement of Purpose and Service User Guide is available in the home. A copy of the last key inspection report was displayed in the magazine rack with other information relating to the care services. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 10 The statement of purpose had recently been reviewed and updated. We found the information gave people information, which clearly described the care provided in the home. We were told that all new people moving into the home receive a welcome pack which includes the Service User Guide. During our discussion with residents and their relatives they said that they had been given enough information about the home to enable them to make the decision on whether or not it would meet the needs of their relative; they and residents living at the home said that they had been invited to visit the home, to look round and meet other people already living there. People are invited to spend time at the home. During this time an assessment is made of the person’s needs and how they get on with the residents who live there. Assessments are carried out by the manager and care officer with input from care staff who observed the person during their time in the home. Although we were told by the home that residents and their familes are involved in the assessment process, to make sure that the home get as much information as possible. The assessments forms seen had not been signed by people or their representative, to indicate that they had been involved in the process. Residents spoken to during the visit and in surveys said that they had been given enough information to help them decide if the home could meet their needs and that they were happy with the admission process when they moved in. During discussion with the manager and care officer they were very clear about making sure resident’s needs could be met by the numbers and skills of staff in the home. If resident’s needs changed they would be reassessed and appropriate action taken; such as arranging any specialist support needed for the individual. Knowle Manor DS0000033246.V376320.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. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive a care service that meets their needs. Care is delivered in a manner that respects people’s wishes. EVIDENCE: The home has a strong ethos for involving people in all aspects of their lives, and staff work in a manner that takes account of all people’s needs and support and delivers people’s care in a dignified and respectful way. We looked at three residents’ care file; one person was on respite care at the home. We saw that each person had a care plan (Life style plan), some contained more information than others. However, from discussions with staff it was clear that they had good knowledge about people’s care and support needs. They told us they get as much information about people before they come to live in the home. The manager told us that they were changing the way care plans are written and we were shown plans that they were working Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 12 on. We felt that the information was clear about people’s care and support needs with the action staff must take to deliver the care in the way people wanted; thus providing them with person centred care. We were told that one of the care officers carries out a monthly check of resident’s care files to make sure that nothing gets missed and residents get the care they need. Appropriate health assessments are carried out. These include moving and handling, nutrition and risk of developing pressure sores. If a risk is identified, a care plan is put in place with the action staff must take to manage and minimise the risk. We were told and we saw that the home work closely with health care professionals, with staff requesting their input for appropriate specialist advice, from such as the district nurses. We spoke to a visiting nurse, who commented on the high standard of care residents receive at Knowle Manor. They told us that staff always act on any advice they give them and ask for help when needed. They added” staff are very committed to provide residents with a high standard of care” Residents indicated in their surveys, they receive the medical care and support they needed, staff listened to and acted on what they said. Relatives said their relatives living in the home received the care and support as they expected and agreed, and they had seen their relatives care plans. During our visit residents told us “This is a nice place, staff always makes sure we are consulted and have our say in what is going on in the home.” “The staff are wonderful.” Everyone is kind.” Resident’s relatives told us “staff are very good, nothing is too hard for them to do, they go that extra mile.” One relative told us that their mother has a key worker who treats her like a “queen” and her mother always look “well turned out.” They also said “Staff were very good at keeping them informed of any changes in their relative’s condition, such as illnesses or accidents if they happened. Relatives and residents told us that the manager and staff are very good and the manager is approachable, and can discuss any issues they may have. It was clear that there are good relationships between staff and residents. Staff were seen to be polite and respectful when talking to people and knocking on bedroom doors before entering. Policies and procedures around dealing with medication were in place. They had a copy of the Royal Pharmaceutical Guidelines for residential homes. One of the care officers was the designated person responsible for the ordering of Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 13 medication. All staff who administers medications have received training on the safe handling of medication. Knowle Manor DS0000033246.V376320.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. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to participate in social and leisure activities, to maintain links with their friends and family and to exercise choice and control over their lives. EVIDENCE: As part of the admission assessment the home make sure that they get as much detail and information as possible about the person’s social, cultural and religious needs. This is to make sure that any special needs identified can be catered for. Resident’s social and recreational interests and preferences are recorded in their (Life style plan) care plan. These provide good detailed information about their life history and what they had enjoyed doing. When people move into the home they are given a copy of the home’s information pack that contains information about the local churches and other places of interest. There are regular planned activities in the home, which include quizzes, bingo and video/DVD sessions. Information about planned events in the home was Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 15 displayed on the residents’ notice board. There are several sitting areas: two sitting areas are mainly used one is a designated resident’s smoking room and the other lounge has a wide screen TV and DVD player. We were told that the main lounge with the wide screen TV is used for “Super Sundays” which is a film night where residents sit and watch a movie of their choice and are served popcorn and ice cream giving them the cinema style atmosphere. These rooms have a loop system for residents with hearing aids. During the visit we saw residents playing a game of dominoes in one of the lounges and in the afternoon we saw that some residents were taking part in art and craft work with a member of staff in the dining room. During the visit some residents were taken out in the mini bus for a fish and chips lunch at a local restaurant and two resident’s relatives came and took them out for the day. During the tour of the building we saw people sitting in their rooms watching TV or reading. The home has purchased a Wii game which residents told us is very much used and that they have set up a Wii team, who play residents in other care homes; residents go to other homes to play and they come back to Knowle Manor for a rematch. Recently there was a tournament and Knowle Manor residents won the league cup, which they said they were proud of. The nominated captain spoke highly of the fun they have with the game. We observed that residents were friendly and supportive towards each other. Residents and the manager told us about resident’s consultation meetings which are held monthly, we were told that they had agreed with the manager, to send relatives copies of the minutes of the meetings. Residents told us that having these meeting mean that they have a say in the running of the home, and they vote to make sure it is the general consensus of the group. For example, residents had voted for the twenty four hour café where people can independently help themselves to drinks and snacks; staff help residents who need assistant to use this facility. This area provides residents with seats where they can enjoy their drinks. Relatives told us that it was a good idea and they are able to help themselves to drinks without bothering staff. We observed that residents took themselves to their rooms or different parts of the building including the enclosed garden, residents appeared to be relaxed in their surroundings. Menus are varied and nutritionally balanced. There is a choice of food at each mealtime and special diets are catered for. Residents enjoy home baked cakes and pies. Residents mostly eat in the dining room. However, those who prefer to eat in their rooms are given a tray. The food was served from hot trolleys. We took the opportunity to have lunch, residents said the food was very good and there is always more if you want it. The menu seen offers people a choice of food, if a resident did not like what was on offer then they could have an alternative. We noted that people were given help discreetly. We found Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 16 mealtime relaxed and unhurried allowing people as much time as they needed to complete their food. From discussion with the chef it was clear that he knew residents like and dislikes and any special meal they needed. Knowle Manor DS0000033246.V376320.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. Residents feel safe and are confident that their concerns will be listened to and dealt with. Robust procedures and staff training protect people from abuse. EVIDENCE: The local authority leaflets for complement and complaints is available in the leaflet rack in the hall way. The procedure is included in the information given to residents and in the home’s written information. A record of all complaints is kept. There has been no complaint since the last key inspection. Residents indicated in surveys that there was someone they could speak to formally if they were not happy and they knew how to make a formal complaint. On the day of the visit during our conversation with residents and their visitors, we were told by a resident “I would speak to my key worker or I would speak to the manager,” this was echoed through the discussions with residents. Relatives said “if I have any concern I can speak to the manager who I know will take it serious and deal with it. Staff told us,” the manager is approachable and we can talk to him and any of the officer team.” Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 18 We were told that the Local Authority is revising their complaint procedure to make sure all the details are up to date, and when this is completed the home would be issued with copies. All staff have had adult protection and seven staff have had updated training on safeguarding adult with a plan in place for all other staff to have the updated training. The home had a copy of the local authority multi-agency procedure for adult protection. We were told that staff having NVQ (National Vocational Qualification) training learned how to deal with abuse as part of the course. The manager has recently attended the Mental Capacity Act Deprivation of Liberty training with a view to cascade it down to the staff via team meetings and staff supervision. Staff said that they would not hesitate to report any actual or suspected abuse. Knowle Manor DS0000033246.V376320.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 & 26 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live a clean, tidy, safe and well maintained home which is suitable for their needs. EVIDENCE: The home is decorated and furnished to a very high standard. It was clean, tidy and well maintained. Since the last key inspection many areas in the home have been refurbished, some bedrooms, ground floor corridor have been redecorated. Bathrooms have been re-tiled and assisted baths and shower fitted, giving people a choice of bathing facilities. We looked around the building and overall we found it to be clean and maintained to a good standard. Residents have taken the opportunity to Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 20 personalise their room with personal affects such as pieces of furniture they had before they moved into the home and photographs. There are two lounges, a large dining area, conservatory and the Café, these seating areas give residents a choice of places to sit. Since the last key inspection the home has had a conservatory built providing residents with an additional sitting room. We saw that the home has carried out risk assessment for any potential identified risk with action on how to minimise the risk. For example the café has a hot water boiler and a risk assessment has been put in place. The manager showed us that he had researched all the equipment, to make sure they are safe as possible. For example they made sure that the hot water boiler was cool touch. Residents are able to sit out in the garden in the centre of the home; this area is also used for barbeques. One resident who like gardening had planted tomatoes and sweet peas. All staff have had infection control training and all bedrooms have been fitted with a soap dispenser for hand washing and hand drying facilities, for the prevention of cross infection. Residents’ clothes looked well laundered and neatly pressed. Through out our tour of the premises the home was found to be very clean and smelled fresh. Knowle Manor DS0000033246.V376320.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. Residents are protected by safe recruitment procedures. Their needs are met by trained and competent staff on duty. EVIDENCE: Staff rotas seen showed that there were to be enough staff on the rota to meet the current care needs of the number of residents. However, there were some staff vacancies at the time: care officer and kitchen domestic. We were told that these hours were covered by overtime. Residents spoken to and in surveys told us that they get the help they need and staff are very helpful, and they get the care and support they need. In previous reports we have made recommendation that the night staffing levels are reviewed. This is because of the layout, number of residents and their dependency. Currently there are two staff on nights available to residents, who may require two staff to meet their needs. We still recommend this is reviewed. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 22 Staff have had on going up date training such as infection control, moving and handling; fifteen care staff have got NVQ (National Vocational Qualification) at level 2 or above and this training is ongoing. The manager said that all new staff receives induction training that is equivalent to the Skills for Care common induction standards. Recruitment records for three staff were looked at. These showed that all appropriate pre employment checks had been carried out before employment was offered. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 23 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 & 38. People using the 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 well managed and run in the best interests of people living there. EVIDENCE: The manager is qualified and experience in managing the home for residents. He keeps himself updated on current best practice through training opportunities. Residents said that they receive a good standard of care from staff who are courteous and respectful. They also said that the management team is approachable and easy to talk to. The manager ensures that the ethos of enabling residents to ensure that they have control of their lives is adhered to. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 24 There are regular meeting with residents and staff and one to one supervision to promote an open and transparent management style that focuses on the needs of the people living in the home. There is a quality assurance scheme in place in the home where audits are carried out. Resident’s care files are monitored, surveys are sent to people and others who are involved in the home, to get their view about the service given at the home. The manager told us that they had been surveyed by dignity in care and the annual audit is carried out by from someone other than staff from the home, so that people have the opportunity to be open about their views of the home and staff. The finding of the audit is published on the notice board. Some resident’s finances are looked after by the (DPW) Department pension and work. But people are encouraged to look after their finances. There are some residents who look after their personal allowance. From discussion with the manager and care officer it was evident that they work with other agencies to ensure continued improvement of the service provided at the home. The home works to a clear health and safety policy and regular safety checks are carried out. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? 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. 1 Refer to Standard OP27 Good Practice Recommendations The number of staff on duty at night should be reviewed taking account the dependency levels of the people living at the home and the lay out of the home. This is to make sure that the wellbeing and safety of residents and staff is not compromised. Knowle Manor DS0000033246.V376320.R01.S.doc Version 5.2 Page 27 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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. 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