Care Home: Knowles House

What the care home does well One of the residents moved to Knowles House after the care home where she had been living closed. She said, "This is the best home I have ever had". Staff were described as "very nice" and "good" and a resident said that she called the manager "my lovely pet". A relative said that it was the "greatest, cleanest and friendliest home". Carers said that they enjoyed working in the home and staff that had experience of working in other care homes said, "there are none like this one". Carers said that they liked coming to work in the home and that Knowles House was like their own home. They were appreciative of the support received from their line managers and were positive in their comments about the manager and how the home was run. The expert by experience spoke with residents and commented that they were fairly satisfied with the home. One resident said, "I have been here for 10 years. I never had any complaints. The food is very good". What has improved since the last inspection? The standards achieved during the previous inspection were good and only 3 requirements were identified. The home has now met these requirements. There are systems in place so that care plans are reviewed at least monthly. This ensures that changes in the needs of the residents are quickly identified and addressed. Part of protecting members of staff when they are working in the home is providing insurance cover in the event of an accident occurring. Having the certificate on display reassures people that insurance cover is in place. Protecting residents depends on members of staff being aware of their responsibility to report poor practice or incidents of abuse and members of staff on duty were able to describe the circumstances under which they would be expected to use the home`s whistle blowing procedure. CARE HOMES FOR OLDER PEOPLE Knowles House 51 Longstone Avenue Harlesden London NW10 3UN Lead Inspector Julie Schofield Key Unannounced Inspection 09:00 21st January 2008 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 Knowles House DS0000033481.V354774.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. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knowles House Address 51 Longstone Avenue Harlesden London NW10 3UN 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) 020 8961 9563 020 8963 1946 petrina.connell@brent.gov.uk London Borough of Brent Mrs Petrina I Connell Care Home 39 Category(ies) of Dementia (39) registration, with number of places Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2007 Brief Description of the Service: Knowles House is owned by Brent local authority and is registered to provide accommodation and personal care for up to 39 older people most of who are experiencing dementia. The home also offers 4 respite care places, 5 step down places and two places for emergency care. The home is divided into three floors, but only two floors are currently occupied. All bedrooms are single occupancy, equipped with furniture, washbasins and there are adequate bathing (both baths and showers) and toilet facilities. The home is located in a residential area of Northwest London close to local shopping, transportation, health, social care and leisure services and facilities in Harlesden and Willesden. The home has a large front car park, a paved garden and seating area and also a garden area to the rear of the premises. There is a balcony on the first floor, plus several communal lounges, library and relaxation room where private meetings can be held. There is also a day centre attached to the home (but which is self contained with its own entrance) that is used by non-residents. A comprehensive information pack is provided as part of the preadmission procedure and this includes a large print statement of purpose, a service users’ guide and an introduction to Knowles House. The fee for the service ranges from £446 to £596 per week. This information was given in January 2008. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection consisted of 2 visits to the home. The first visit was made on the 21st January and started at 9.00 am and finished at 1.40pm. During this visit an expert by experience accompanied me. The second visit took place on the 22nd January and started at 9.50 am and finished at 3.55pm. During the visits discussions with the manager, the administrator and members of staff took place. Time was spent talking with residents and relatives and sitting in on the activities taking place in the home. The preparation and serving of the mid day meal was observed. Records were examined and the care of a number of residents was case tracked. A tour of the premises took place. On the 8th February a visit was made to the local authority office where staffing records were kept. I would like to thank everyone for their assistance and for their comments made during the inspection. What the service does well: One of the residents moved to Knowles House after the care home where she had been living closed. She said, “This is the best home I have ever had”. Staff were described as “very nice” and “good” and a resident said that she called the manager “my lovely pet”. A relative said that it was the “greatest, cleanest and friendliest home”. Carers said that they enjoyed working in the home and staff that had experience of working in other care homes said, “there are none like this one”. Carers said that they liked coming to work in the home and that Knowles House was like their own home. They were appreciative of the support received from their line managers and were positive in their comments about the manager and how the home was run. The expert by experience spoke with residents and commented that they were fairly satisfied with the home. One resident said, “I have been here for 10 years. I never had any complaints. The food is very good”. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: For a system of administering medication to residents to be thorough and to demonstrate that carers are careful in what they do, accurate recording is needed. There were two instances where there was either a gap in the recording or the record was inaccurate. Records of training are kept but records were incomplete as attendance certificates were sometimes missing from staff files. Training in safe working practice topics needs to be updated on a regular basis so that recommended frequencies are followed. This would ensure that ways of working in the home are based on current good practice and guidance, benefiting both residents and members of staff. Please contact the provider for advice of actions taken in response to this Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 7 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. Knowles House DS0000033481.V354774.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 Knowles House DS0000033481.V354774.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Obtaining information about the resident, prior to admission, ensures that their needs are identified and that the home is able to determine whether they can provide a service that will meet the needs of the prospective resident. EVIDENCE: Files of 2 residents recently admitted to the home were examined. When residents are admitted on an emergency basis or to a “step down” bed the manager is not able to carry out their own assessment prior to the admission of the resident. However each of the 2 files, one belonging to a resident that had been admitted on an emergency basis and 1 for a resident that had been Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 10 admitted for respite care, contained information from the local authority. The documents on the files included a social worker’s report, a discharge summary from the hospital, information from the PCT, medical information, an assessment carried out by the local authority and the FACS score. A completed care plan had been developed by the home for one of the residents whilst a care plan was being developed for the other client. The expert by experience looked at the information pack developed for prospective residents and commented that “it was a very good document with detailed information about the facility”. The home does not provide an intermediate care service. Knowles House DS0000033481.V354774.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): 7,8,9,10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Assessing the needs of a resident and identifying these in a care plan enables the resident to receive a service tailored to meet their needs. The health and well being of residents is promoted through regular health care checks and appointments. Residents are supported in taking their medication, as prescribed by their GP, in order to maintain their general health. However, gaps in the recording of the administration of medication fail to assure residents of a system that demonstrates a careful approach. Discreet and caring support is given to residents by staff so that the privacy and dignity of the resident is respected. EVIDENCE: Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 12 The case files of 3 residents were case tracked. Each included a completed care plan. The manager said that since the last key inspection care plans were being developed for residents admitted for respite care. Care plans identified dietary preferences, included a manual handling risk assessment, a pressure sore risk assessment, a continence assessment, oral hygiene needs, communication needs and an assessment of the awareness and sociability of the resident. There was evidence that care plans were reviewed by the home on a regular basis and that relatives were invited to attend, to support the resident. Care plans are evaluated on a monthly basis. Monthly evaluations identify issues, the action to be taken and the residents and/or the relatives’ views. A carer confirmed that members of staff were able to read the care plans and to refer to them if needed. The statement of purpose contains useful information about care plans, their content and how they are reviewed. There was evidence that the local authority had carried out a review of the placement. A number of GP’s visit the home as residents keep the GP that they have been registered with before admission to the home, provided that they remain in the catchment area. There was evidence on residents’ case files that they had regular access to chiropody, dental and optical services. An appointment had been made for a hearing test for one of the residents. Residents are supported when attending out patient appointments at the hospital, if necessary. Residents had access to the flu vaccination in the autumn. A regular dance and exercise class is held in the home to help residents maintain their level of mobility. Risk assessments are carried out to identify residents where pressure care may be necessary and equipment can be provided in the home to make residents more comfortable and to reduce the risk. The nutritional needs of a resident are reviewed as part of the preadmission assessment process and a record is kept of the weight of the resident so that concerns abut weight losses or gains can be referred to the GP. A resident that is diabetic said that she helped to manage this in the home by medication and a suitable diet. She also attends the hospital as an outpatient. A relative said that the resident they were visiting had put on weight after coming in the home and was pleased with this. The storage of medication was safe and secure and the record book included policies and procedures. At the moment none of the residents self medicate. The blister packs were examined and one tablet had been left in the packs from the night before although the records had been signed that it had been given. This was brought to the attention of the manager who said that she would investigate what had happened. Records were up to date although the administration had not been recorded for one resident on the morning of the second visit. The District Nurse calls to assist diabetic residents requiring insulin injections. Members of staff responsible for administering medication confirmed that they had received training. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 13 All residents have their own single rooms and this provides privacy when assistance is given with personal care, when they entertain visitors and when a medical examination is required. I noticed that if assistance with personal care is offered in communal areas it was done discreetly and with tact. Relatives commented on how clean and tidy and how smartly turned out residents were and this encouraged residents self esteem. A resident was admitted to the home on an emergency basis the night of the first visit and by the next morning the resident (who was in a state of self neglect) had been helped to bathe, shave and to trim their hair. The outreach worker visiting the resident complimented the manager on the assistance given by all the staff team and said that the resident was appreciative of the help. Knowles House DS0000033481.V354774.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, 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comprehensive programme of activities provides residents with opportunities for stimulation and enjoyment. Welcoming visitors to the home encourages residents to benefit from good relationships with their friends and relatives. Residents enjoyed the atmosphere in Knowles House, which gave them opportunities to exercise choice in their daily lives. Residents’ nutritional needs are met through the provision of a diet that is wholesome and varied and which meets their religious and cultural needs. EVIDENCE: There is a library in the home and a resident said that they used this. It was well stocked and the room contained a table with several chairs. During the second visit to the home a neighbour from Longstone Ave called to the home and donated books to the library. Activities were taking place during both of Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 15 the visits. Information about activities was posted on the notice board next to the dining room. On Mondays a reminiscence session takes place and we both saw that the residents were actively taking part and enjoyed the singing. This was due to the enthusiasm and encouragement from the counsellor leading the session. On Tuesday an exercise class was taking place. The volunteer leading the session was encouraging residents to move or to dance to music and again residents taking part were smiling and enjoying themselves. A relative said that there was a lively atmosphere in the home and that the activities provided gave residents mental stimulation. One resident said to the expert by experience that the only time they had gone on an outing was to see the lights. It is recommended that a review of the activities programme takes place. Residents and relatives said that when relatives visited the home the members of staff on duty made them welcome. One resident said that when their relatives are visiting the staff come to offer tea and biscuits. Visits can take place in the resident’s room or in the quiet room or lounge. Knowles House is a dementia care unit and residents are dependent. However, they are encouraged to make choices e.g. what to eat, what to wear and whether to take part in activities and these choices are respected. The statement of purpose contains useful advice regarding advocacy services and good practice in assisting residents with financial matters. During the first visit the serving of the mid day meal was seen. It consisted of a choice of either pasta with a sauce or fish pie. Potatoes, rice and vegetables were added. Alternative meals are listed on a board in the dining room and one resident had chosen a corned beef salad. Alternative meals can also cater for an African-Caribbean, Asian, vegetarian or Kosher diet. Residents were asked at the table what they would like because the manager said that if a choice was made too far in advance the resident forgot what they had ordered and when this was provided would want something different. Residents said that the meals were very good and a relative said that they were really impressed with the quality of food. Meal times were unhurried and assistance with feeding is given, if required. Mealtimes are flexible and breakfast is served between 8am and 10.30am. Two residents prefer to have their midday and evening meals later and they were sitting in the dining room in the afternoon after having lunch at 2pm. Knowles House DS0000033481.V354774.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, 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A complaints procedure was in place to protect the interests of the residents. Protection of vulnerable adults training for staff and familiarity with the home’s procedure and the interagency guidelines contribute towards the safety of residents. EVIDENCE: The manager said that no complaints have been recorded since the last key inspection. The complaints procedure is included in the statement of purpose and is referred to in the service users’ guide. The procedure informs the complainant of their right to complain to the local authority and to contact the CSCI. The address of the Harrow office and telephone number is included in the procedure. The procedure includes timescales for the acknowledgement of a complaint and for notifying the complainant of the outcome of the investigation. Complainants are reassured that in order to promote a culture of continuous improvement a “no blame” policy is in place to prevent complainants feeling uncomfortable or under pressure. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 17 The manager said that no allegations or incidents of abuse have been recorded since the last key inspection. Staff have attended protection of vulnerable adults training and a new member of staff said that she had attended a session that had recently been organised by the local authority. When speaking with 2 members of staff they were able to explain the whistle blowing procedure and understood the circumstances under which it might be used. The manager said that the home does not practice restraint and she was very clear about trying to understand the cause of anxiety so that a caring service could be provided to support a resident. The policies and procedures manual includes guidance in respect of gifts and gratuities and not being involved in the making of a resident’s will or being a beneficiary. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 18 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, 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is decorated and maintained to a good standard and which provides them with comfort and ease. A choice of communal areas gives residents the opportunity to socialise or sit quietly according to their wishes. Residents live in a home where high standards of cleanliness provide residents with hygienic surroundings. EVIDENCE: A tour of the building took place. The home is kept in a good state of repair and the décor and furnishings provide a homely atmosphere for residents. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 19 There are a number of communal areas in Knowles House and they are arranged so that residents have a choice of environments. Some residents like to watch the television. Some residents prefer to listen to music. Some residents like to sit quietly or talk to their friends. Residents’ rooms varied in size but all were well-furnished and decorated and contained family photographs and ornaments to personalise them. There is a lockable storage facility in each room. The building was warm and levels of lighting sufficient. Residents with dementia care would benefit with more helpful signage in the building and this was discussed with the manager. During the tour of the building all areas seen were clean and tidy and the home was free from offensive odours. A relative said that they visited many residential care homes as part of their work and they praised the standard of cleanliness and odour control in Knowles House. Other relatives also agreed that the high standards were consistent. A resident said that the home was always kept clean. A number of staff are about to start a 12-week infection control training course. The expert by experience commented on the cleanliness of the home and that “bathrooms were particularly neat and clean with showers suited to the requirements of users with various disabilities”. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 20 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, 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing levels were sufficient to meet the needs of residents. The home continues to support staff undertaking NVQ training, as residents benefit from staff that have developed their understanding and awareness of the needs of the residents. Recruitment procedures are thorough and this promotes the safety and welfare of residents. Residents benefit from staff trained according to current best practice and guidance and incomplete training records fail to assure residents that members of staff have attended refresher training. EVIDENCE: A discussion took place about staffing levels in the home. During the morning and early afternoon there are 6 carers on duty and in the late afternoon and early evening there are 5 carers on duty. The manager’s hours are supernumerary. At night there is a senior carer and 2 carers on duty. The senior carer who was in the home during the first visit said that although the number of calls for assistance varied from night to night staffing levels were sufficient to enable regular checks to be made on all residents, unless they had Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 21 asked to be excluded from this. If a resident is a light sleeper they may not wish to have the door opened in case this wakes them up and then they have difficulty going back to sleep. The topic of NVQ training was discussed with both the manager and with members of staff. The manager confirmed that over 50 of the carers working in the home have successfully completed their NVQ level 2 training. A new member of staff confirmed that she had started her NVQ level 2 training and that her assessor was visiting her later in the week. A senior carer confirmed that she was nearing completion of her level 3 training. Three personnel files were selected to view and this was done at another building where they were kept. The recruitment and selection procedure was summarised and the content of the files demonstrated that it had been followed. The procedure provided a system where checks and references were undertaken. Each file viewed contained an application form, statement of terms and conditions, evidence of an enhanced CRB disclosure being obtained, 2 satisfactory references and proof of identity (passport details). Where necessary, the right to work and to reside in the UK had been established. Induction training is given to new members of staff and the Sector Skills Council’s “Common Induction Standards are used. All carers working in the home have received dementia care training and the administrative officer, who also has substantial contact with the residents, has also attended. She said that this helped her in her contact with residents and it helped her to understand and to appreciate the service provided in the home. Carers were able to list all the training courses they had attended. However the training records were incomplete. Staff personnel files lacked copies of attendance certificates for some recently completed training. This was partly due to certificates being sent to personal addresses rather than to Knowles House, partly due to certificates not being sent out promptly following training sessions and partly due to certificates in Knowles House not being filed on the staff files. Without an up to date training profile for individual members of staff it is difficult to ensure that staff receive refresher training at the recommended intervals. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 22 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, 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. By continuing her personal development, through further training, the manager ensures the efficient and effective running of the home. Quality assurance systems in place enable the future development of the service to reflect the views and needs of the residents (or persons acting on their behalf). Support is given to residents who need assistance in managing their finances so that residents’ financial interests are protected. Training for staff in safe working practice topics promotes the health and safety of residents, staff and visitors to the home and refresher training would keep this knowledge current. The testing/servicing of equipment in the home demonstrates that it continues to be safe to use. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 23 EVIDENCE: The registered manager has managed the home for 13 years. She qualified as an RGN. She has successfully completed the DMS and CSS and is currently undertaking the RMA. Staff said that the manager was approachable and is willing to listen to and discuss new ideas. The expert by experience commented that the manager “radiated commitment and resolve to do a good job”. The manager gave examples of the quality assurance systems used to monitor the quality of the service provided. A monthly audit of the home as a whole is carried and monthly audits of all the individual bedrooms also are done. An annual satisfaction questionnaire is sent to relatives and approximately half of these are completed and returned to the home. The idea for a quiet room in the home originated from one of these questionnaires. During the inspection I saw that residents came to the office on an informal basis to speak to the manager or to other members of staff on duty. The home has achieved IIP and ISO 9001 status. The administrative officer for the home is responsible for the day-to-day support to 21 residents with their personal allowances. She was able to show me records of the money held by the home, on behalf of the individual residents and the records of when money is either given to the resident or spent on their behalf. Checks are in place when money is given and receipts are kept when money is spent. Money kept centrally on behalf of residents is kept in individual accounts. Certificates for the servicing of systems and equipment in use in the home were shown. There were valid certificates for the Landlord’s Gas Safety Record, the electrical installation, the testing of the portable electrical appliances, the fire extinguishers, the fire precautionary systems and for the lift. Records were available for the weekly testing of the fire alarm system and for regular fire drills. Staff confirmed that they receive working practice topics i.e. fire safety, first aid, food hygiene, manual handling and fire safety although a member of staff said that they had not undertaken manual handling training recently. The manager said that there is a qualified first aider on duty on each shift. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 24 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13.2 Requirement Timescale for action 01/03/08 2 OP30 18.1 3 OP38 18.1 The registered person must ensure that the administration of medication to residents is accurately recorded so that residents are supported by a system, which is safe and thorough. The registered person must 01/04/08 ensure that residents benefit from a service based on current best practice and guidance so training records must be complete to demonstrate that refresher training is undertaken at the recommended intervals. The registered person must 01/04/08 ensure that ways of working promote the safety and welfare of the members of staff, residents and visitors to the home by regular training updates for safe working practice topics for all staff. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 26 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 2 Refer to Standard OP12 OP19 Good Practice Recommendations That the activities programme is reviewed and amended to include opportunities both inside and outside the home. That helpful signage is displayed in the home so that residents with dementia may feel more comfortable with their surroundings. Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Knowles House DS0000033481.V354774.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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