Inspection on 02/10/07 for Howard Court Care Home Ltd

This is the latest available inspection report for this service, carried out on 2nd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Howard Court Care Home Ltd 03/02/06

Howard Court Care Home Ltd 30/08/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Howard Court Care Home Ltd Howard Arms Lane Brampton Cumbria CA8 1NH Lead Inspector Mrs Margaret Drury Unannounced Inspection 2nd October 2007 11:00 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 Howard Court Care Home Ltd DS0000062516.V346182.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. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howard Court Care Home Ltd Address Howard Arms Lane Brampton Cumbria CA8 1NH 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) 016977 2870 Howard Court Care Home Ltd Ms Jean Beattie Care Home 28 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (12), Physical disability (1) Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 28 service users to include: - Up to 14 service users in the category of DE(E) (Dementia over 65 years of age) - Up to 12 service users in the category of OP (Older People - not falling within any other category) - 1 service user in the category of MD (Mental Disorder under 65 years of age) - 1 named service user in the category of PD (Physical Disabilities) may be accommodated within the overall number of registered places. 31st July 2006 Date of last inspection Brief Description of the Service: Howard Court is registered to provide accommodation, social and personal care for up to 28 older people, 14 of whom may have varying forms of dementia. The home is owned by Howard Court Care Home Ltd and managed on a dayto-day basis by Mrs Jean Beattie. It is situated in the centre of Brampton, a market town approximately eight miles from Carlisle, and close to all amenities and public transport. Resident accommodation is on two floors, the upper being served by a passenger lift and a stair lift. On the ground floor there are bedrooms, a large lounge/diner, a quiet lounge, toilets and a bathroom. On the first floor there are two small lounge/diners, bedrooms bathrooms and toilets. There is also a ground floor conservatory providing further communal space for the residents. There is a small courtyard to the front of the building and limited parking space. The fees in this home are £373.00 to £434.00 per week as at the date of the visit. There are extra charges for newspapers/magazines, personal toiletries and hairdressing. This home does not provide intermediate care. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit to Howard Court that forms part of the key inspection took place over two days in October. We were in the home for a total of seven hours. Information about this service was gathered in a number of ways prior to this visit: • Annual Quality Assurance Assessment completed by the registered manager. • Survey questionnaires returned by the residents and healthcare professionals. • The service history. • Interviews with residents, visitors and staff on the days of the visit. What the service does well: What has improved since the last inspection? Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 6 Redecoration of some bedrooms and ground floor has been completed. New dining tables and chairs have been purchased. The tiling of the toilets has now been completed. 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. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 7 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 Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 8 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, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home are fully assessed prior to moving in. This helps to ensure their needs can be identified and met. EVIDENCE: Admissions are not made to this service until a full assessment of needs is completed. This assessment is conducted sensitively by the registered manager and includes family members if this is considered appropriate. If the Local Authority has undertaken an assessment, the home always asks for a copy of the documentation. A further assessment by the manager is also completed in cases such as this to ensure that the home is suitable and able to meet the identified needs. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 9 Prospective residents and/or their families are invited and encouraged to visit the home to view any vacant rooms and to meet with the staff and other people living in the home. This also gives opportunity to discuss with the manager the assessed needs and to ensure the home can provide the level of care and support to meet those needs. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their identified needs. Privacy and dignity are respected at all times. EVIDENCE: Each resident has a plan of care that is drawn up from the initial assessment of needs and capabilities. During the visit we looked at a sample of four and found them to be basic, in that the information documented was limited. There was evidence in the care plans and daily notes of health care treatment and intervention and, generally, an outline of the care required to meet the residents’ needs. We found some gaps in the information recorded but during discussions with the staff on duty it was evident that they were able to identify the needs of the residents and meet them in a personal and caring manner. The monthly reviews were not up to date and the manager agreed to ensure Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 11 this would be rectified as soon as possible. We did make a requirement regarding this. Healthcare needs are met by the local doctor’s surgery and the manager told us that the home receives excellent support from the doctors and the district nurses attached to the practice. Comments recorded on the returned survey forms included,” this home provides a homely atmosphere” and “ the home has a professional approach”. We looked at the medication procedures and found that the residents are protected by safe systems for handling medication and record keeping was completed in an appropriate manner. The pharmacist has provided training for the staff in safe handling of medicines and the manager conducts regular audits of the procedures and records. We observed, during the visit, the interaction between the staff and those living in the home. This was very positive and it was evident that the staff knew the residents very well indeed. One gentleman told us that he was delighted because” sooty (his dog) was able to live with him and the staff look after him as well as me”. The dog was popular with the others living in the home as many of them had pets of their own before they moved in. The staff were very polite when speaking to the residents and ensured all personal care was given in he privacy of their bedroom. This was also noted on one of the survey forms returned by one of the visiting doctors. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to make choices about their lifestyle and are supported to maintain their independence. EVIDENCE: The routines in this home are flexible to meet the needs of those living there. There are no set times for residents getting up or going to bed and the manager did advise that one resident never gets up before 3 o’clock in the afternoon. She did discuss this with his family when he moved into the home and was advised that this was his regular routine when he lived at home. We were able to speak with some residents who chose to sit in their rooms apart from mealtimes when they met with other residents for their meal. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 13 The home has an activities organiser who provides some activities on most afternoons. Although these are the normal bingo, dominoes and quizzes the residents told us they enjoyed taking part when they felt able. Some residents were able to go to the near-by shops accompanied by the organiser and they had all enjoyed the recent party organised by the manager to celebrate the home’s 20th birthday. Visitors are welcome at Howard Court at anytime. If the visit coincides with a mealtime they are invited to enjoy a meal with their relative. We were able to speak with relatives during the visit and were told that they were always made very welcome. One lady visited her mother most days and could not speak too highly of the care and support her mother, who has lived in the home for almost 20 years, received. We observed lunch being served and obviously enjoyed by the residents. The menus are varied and nutritious and the cook, who has only recently taken over as fulltime cook, told us that she speaks with the residents regularly to ensure the meals prepared for them are enjoyable. There is a choice at all meals and vegetarian and diabetic diets are catered for. When we asked the residents if they enjoyed their meals they all said they did and that there was “always plenty to eat Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are able to express their concerns knowing they will be listened to and acted upon. EVIDENCE: There are suitable procedures in place for dealing with complaints. The complaints policy and procedure is part of the guide for the people using this service and there was also a copy on display. The manager said that there had been no complaints for some considerable time and The Commission for Social Care inspection (CSCI) have not received any. We did discuss what should be recorded as “ a complaint” and the manager agreed that, in future, all concerns raised by residents and visitors would be recorded, showing what action was taken and the outcome. The residents and family members we spoke with during the visit were all aware of the procedure to follow should they need to use it. The service has internal policies and procedures for the Protection of Vulnerable Adults (POVA) and a copy of the Local Authority’s procedure was also seen to be available .All staff have enhanced Criminal Records Bureau (CRB) checks before they start work There have been no allegations of abuse. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 15 Some staff training in this subject has been completed and the manager is hoping to access further training. We discussed adult protection with the staff during the visit and all showed a good understanding of the procedure to follow and the signs to look for. This subject is covered in National Vocational Qualification (NVQ) training and one member of staff had made this topic a speciality whilst completing her level 3. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 16 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, 20, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a comfortable and homely living environment. The premises are reasonably well maintained and kept to a good standard of cleanliness. EVIDENCE: Some internal decoration has been completed since the last inspection but there are still some areas, including the first floor corridors that are in need of attention. Discussions with one of the owners confirmed that arrangements are in hand for this work to be started in the next 3 months. New dining furniture has recently been purchased and new carpet fitted in the ground floor lounge. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 17 There is a large lounge with dining area on the ground floor and 2 smaller lounge/diners on the first floor. There is also a sitting area/hall on the ground floor that is occasionally used by the residents. The home does, therefore, provide a physical environment that is, on the whole, appropriate to meet the specific needs of the people who live there. There is also a conservatory adjoining the courtyard entrance that is used during the warm weather. Some of the bedrooms are rather small but those in the later extension are much larger and some have en-suite toilet facilities. There is one room that is shared but this is only with the agreement of the people using this service. Screens are provided for privacy and dignity when delivering personal care. Residents are encouraged to personalise their rooms and have done so with pictures, ornaments and photographs. The bathrooms and communal toilets are fitted with appropriate aids and adaptations to ensure the safety of those using these facilities. The home employs domestic staff to ensure the home stays fresh and clean and it was very clean and odour free on the day of the visit. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are protected by appropriate recruiting procedures. Trained and experienced staff ensure all residents are supported and cared for. EVIDENCE: This home has a very stable staff team with a very low staff turnover. We interviewed several members of staff who all agreed it was a lovely place to work and that Jean, the manager, was “lovely and very supportive”. Many of the staff have worked at the home for many years and “could not imagine working anywhere else”. During this visit we looked at samples of staff recruitment and training records and found them to be in order although the staff files could be a little tidier. All prospective staff are requested to complete an application form, supply referees and attend for interview. Special checks such as Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) first are undertaken prior new staff to starting work. This helps to ensure the safety and protection of those living in the home. New staff shadow existing staff until the manager feels they are confident enough to work alone or as part of the team. Staff rotas were checked and found to be appropriate to the number of people living Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 19 in Howard Court. We saw that the staff interacted well with the residents and although there was plenty of light-hearted conversation this was carried out in a polite and friendly manner. Records show that staff are provided with, and participate in training courses suitable for the work they are doing. These include, first aid, continence, moving and handling, food hygiene, safer food - better business and dementia care. This was a 2-day course at the local day centre with a 3rd day to be held within the next few weeks. Two members of staff have completed a course covering the Mental Capacity Act and arrangements are in had for other staff to undertake this training. Residents commented on the staff and said, “they are lovely girls” and “we would all be lost without them” Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a home that is safe, well managed and run in their best interests. EVIDENCE: The manager has the qualifications and competence to run the home. She has a great deal of experience, having worked at the home for a number of years, first as a carer and then through promotion to her current position as registered manager. She has completed her NVQ and registered manager’s award. We spoke to residents during the visit and they all assured us that Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 21 “Jean, (the manager) is lovely and so helpful”. She is very enthusiastic about her job and keeps the best interests of the residents very much to the fore. The home takes care of a small amount of money on behalf of some residents. This is used to pay for hairdressing newspapers and toiletries. Individual records are kept with two members of staff recording and checking each transaction. This helps to ensure that residents’ finances are protected and managed safely. All risk assessments are completed and updated by the manager, who also walks around the building each week to identify any work that may need to be done and also to identify any potential hazards. Discussions with the owner of the home confirmed that all equipment is maintained and serviced through annual service level agreements and documentation supported this. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 22 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 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 3 3 3 X 3 X X 3 Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP7 Regulation 15 Requirement All care plans should be more person-centred and include more in depth information regarding health, social and personal needs. They should also be more outcome focussed. Timescale for action 31/12/07 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 OP7 Good Practice Recommendations It is recommended that the review of the care plan is signed and dated even when there is no change to the level of care required. Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Howard Court Care Home Ltd DS0000062516.V346182.R01.S.doc Version 5.2 Page 25 - 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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