Inspection on 15/08/07 for Hovenden House Nursing Home

This inspection was carried out on 15th August 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

Hovenden House Nursing Home 20/04/06

Hovenden House Nursing Home 19/10/05

Hovenden House Nursing Home 09/05/05

Hovenden House Nursing Home 08/12/04

Hovenden House Nursing Home 07/04/04

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

CARE HOME ADULTS 18-65 Hovenden House Nursing Home Lowgate Fleet Spalding Lincs PE12 8LP Lead Inspector Julie Western Key Unannounced Inspection 15th August 2007 09:30 Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 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 Hovenden House Nursing Home DS0000002538.V341530.R02.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 Adults 18-65. 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. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hovenden House Nursing Home Address Lowgate Fleet Spalding Lincs PE12 8LP 01406 423037 01406 425243 julia.wiggins@lc-uk.org www.leonard-cheshire.org.uk Leonard Cheshire 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) Mrs Julia Elaine Wiggins Care Home 32 Category(ies) of Physical disability (28), Physical disability over registration, with number 65 years of age (4) of places Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of registration The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Physical disability (PD) 28 Physical disability over the age of 65 years of age (PD(E) 4 The category PD applies to service users who are under the age of 65 years The maximum number of service users to be accommodated is 32 2. 3. Date of last inspection 20th April 2006 Brief Description of the Service: Hovenden House is a large country house set in extensive landscaped grounds in a rural setting approximately 3 miles from the market town of Holbeach. The home is one of many run by the Leonard Cheshire Foundation. It is approached from a driveway and there are car parking spaces to the front of the home. There are 3 single storey extensions at the rear of the home where there is a garden and patio area designed for physically disabled people. The care home provides nursing and personal care and accommodation for people with a physical disability. On the day of the inspection there were 28 people living in the home. All accommodation, which is accessible by disabled people, is on the ground floor. There is also a shaft lift installed which gives access to the first floor. The Leonard Cheshire charter which is outlined in the service users guide states, we believe that each individual person, whatever his or her disability, is a uniquely valuable individual and that people with disabilities should have the personal freedom to pursue their aspirations and take their own place in the world. Transport is available to enable people living the home to access local services in the community. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, any preinspection questionnaires completed by the Manager and any residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection was unannounced, took place over three hours and consisted of tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. At the time of the inspection the home confirmed that the weekly fees ranged from £1028 - £1227, depending on the assessed needs of the resident. Additional charges are made for services such as hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the reception area or the manager’s office. What the service does well: What has improved since the last inspection? Two bedrooms have been redecorated as part of the ongoing maintenance programme; the residents were consulted about this. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 6 A health and safety link person has been appointed to undertake all risk assessments in the home. 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. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 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 have good information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: The senior in charge confirmed that the care supervisor or service manager usually visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Residents spoken with had received prior information such as the statement of purpose and service user guide before admission. A visitor said she had been given a list of issues to consider when looking around the other homes in the area, to enable her to make a decision on behalf of her relative. One resident said her relatives helped her to chose the home. One other confirmed that they had visited the home for day care before living there permanently, so knew the home well before they moved there permanently and a third had visited the home for a day and had a meal. Written admission documents were clear and gave sufficient information to residents. Contracts were comprehensive and were signed by residents or their families /advocates. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 9 A staff member described the admission process and the importance of making new residents and their families feel welcomed. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are clear on health and personal care needs, although they do not always give a picture of the social, emotional and spiritual needs of the residents. The staff group meets the needs with sensitivity and regard for residents’ privacy and dignity. EVIDENCE: The care plan for the most recent resident to be admitted was clear but not yet completed; for two other residents the care plans were unwieldy, with some duplication of information. It was unclear as to whether the residents had taken part in their care planning for these two care plans. Assessments focused on health and personal care needs and there was insufficient information about social, emotional and spiritual care, although this was much improved for the most recent residents to be admitted. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 11 Risk assessments were present for all residents, although some reviews were not up to date. The senior in charge said that all care plans were to be updated eventually but that there had been recent delays in carrying this out due to staffing shortages. Staff members were observed communicating with residents sensitively and with regard for their dignity, allowing them choices wherever possible. One resident said ‘they’re very good people here; they’ll always help you’. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a wide range of activities for residents to participate in and the catering arrangements reflect residents’ choices and preferences. EVIDENCE: The home employs one full time and one part time activities organiser. There was a monthly list of activities in the dining room and a weekly events board in the entrance area. On the day of the inspection residents were involved in a sewing circle, with a volunteer present, sailing a toy boat on the boat pond, miniature housebuilding and preparing a raffle for the forthcoming weekend’s family barbecue held in the grounds. Residents spoken with said how much they enjoyed the activities and, in particular, the volunteers who helped them; one said ‘I love it here; there’s such a lot to do’. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 13 Other activities ranged from visiting the local pub to walks around the village or to local places of interest. Two mini-buses adapted for wheelchair users were available. Indoor activities included art, darts, 10-pin bowling, bowls, table tennis and snooker. Three residents could access media such as television, radio and music and there was a large-screen computer for the use of residents. The home had a sensory room. The activities organiser said that some residents were having annual holidays; two were going to Florida, one to Norway on a cruise, two to Tenerife and five to Tenby in a specially adapted bungalow. On admission to the home details of residents’ dietary needs were obtained. The menu is displayed in the dining room and meals can be taken there, the resident’s bedroom and the residents’ kitchen, where visitors can have shared meals with the residents. All these facilities are on the ground floor. Menus showed that residents had a choice of meals from a balanced and varied diet, with a use of fresh fruit and vegetables. Residents said they enjoyed the food very much; one said ‘it’s so good I have to watch my waistline!’ Pureed meals were attractively presented and sensitively given to those who needed assistance. There is a hot drinks machine in the dining providing choice and more independence for residents. All kitchen staff have food hygiene certificates and the most recent visit from the environmental health officer resulted in the home being awarded ‘Three Tulips’ which equalled a rating of excellence, by the District Council. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health care needs of residents are met by having an educated staff team, who have received training on disability awareness as well as training on medication and health care. EVIDENCE: Care plans seen recorded visits to the local GP’s, dentists and hospital. They included weight and medication records. Medication records were comprehensive and the Boots system of medication was used; pharmacy visits were quarterly and staff members verified that any issues from these had been addressed. The senior in charge confirmed that all staff members had received medication training in the last year and medication training was also part of the induction process. Residents spoken with said they felt safe and well looked after; one said ‘I know they’ll see me alright!’ Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that comments and complaints will be listened to. Residents are kept safe from harm by clear policies and procedures or allegations concerning safeguarding adults and staff members are clear on the action to take in the event of this happening. EVIDENCE: Each resident receives a copy of the home’s complaints procedure. Two residents said they would go to one of the volunteers if they had a concern and volunteers spoken with had received POVA training. Records showed that there had been one complaint since the last inspection and this had been addressed within the given timescales. Staff members spoken with said they had received external training in safeguarding adults and records confirmed that all staff received training on adult protection issues within the homes induction modules. A member of staff confirmed this and knew what to do if abuse was suspected. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a generally comfortable and homely place for residents to live. There is a variety of equipment to aid residents with a disability. EVIDENCE: The building was in a good state of repair internally, with the exception of the carpet in parts of the corridor; this was stained in places. The kitchen and bathroom areas were clean and hygienic. The senior in charge said that the long-term plan was for the home to move to Spalding; consequently maintenance was adequate to keep the home sufficiently well decorated but there were no major improvements planned. Residents’ rooms were well personalised and there was equipment throughout to meet the needs of residents, including bed rails, hoists, specialised wheelchairs and raised signs on the walls to assist residents. Residents spoken with said that the home was clean and well looked after during the week, but there were no domestic carers and no laundry at the Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 17 weekends; this meant that by Sunday afternoon, when there were a lot of visitors around, the home often looked untidy. One staff member said ‘Mondays are a nightmare, with a lot of catching up from the weekend’. The gardens and grounds were extensive and well tended, with access by wheelchair users and places to sit out in. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents, with the exception of auxiliary staff at weekends; staff members are suitably trained, qualified and competent. EVIDENCE: The staff rotas showed that there were enough staff members to meet the needs of the residents. Although there were three domestic staff and one laundry assistant at weekends, there were none at weekends; see comments in Environment. Staff members spoken with said they usually had enough time to complete their tasks during weekdays and observations on the day showed that there were seven members of staff on duty; this was one less than usual, due to staff absences. There was also usually a breakfast assistant, who, again was not present on the day of the inspection. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 19 Two staff files were examined; they contained recruitment and induction procedures, including criminal records bureau and protection of vulnerable adults checks. Training records showed that twenty-two members of staff had achieved the NVQ, a nationally recognised qualification at level 2 with a further two working towards it. Nine staff members had achieved the NVQ at level 3. There is a training department with its own training co-ordinator. Staff members spoken with had received training in infection control, fire safety, vulnerable adults and moving and handling; records confirmed this. The home received the ‘Investors in People’ award in March 2004 in recognition of the training and support provided to staff. The home has monthly staff meetings. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of residents and their supporters are listened to. EVIDENCE: The registered manager, who was not present on the day of the inspection, is a Registered Nurse and has the Registered Manager’s Award in management, a nationally recognised qualification. She has worked at the home for many years as a nurse carer and has managed the home since September 2005. The home also has a care supervisor. Staff members said they had confidence in the manager and that she was approachable and accessible. Most of the staff had worked in the home for a long time and felt valued and supported. Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 21 The home has a set of policies and procedures consistent with those of the other Leonard Cheshire homes and these are well maintained. The home has a quality assurance system and in January of this year has had audits on Quality and Standards, Accounts, Human Resources and Health and Safety all by representatives from Headquarters. The results of the audit are then acted upon at local level. In addition the home has its own health and safety link person, who looks at all aspects of risk assessment around the building. Staff members said they received regular supervision and there were regular staff meetings. Residents said there was a residents’ committee, which enabled them to have a say in the running of the home.. Surveys were also carried out by the home to learn of residents’ views. Minutes of meetings were displayed on notice boards. Hovenden House Nursing Home DS0000002538.V341530.R02.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? none 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 YA6 Good Practice Recommendations All care plans should be updated to include assessments on the social, emotional and cultural needs of each resident. Staffing hours at weekends should be monitored to ensure that residents are not suffering as a result of the absence of cleaning or laundry staff at weekends. 2. YA30 Hovenden House Nursing Home DS0000002538.V341530.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Hovenden House Nursing Home DS0000002538.V341530.R02.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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