Inspection on 20/04/06 for Hovenden House Nursing Home

This inspection was carried out on 20th April 2006.

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 15/08/07

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 Mr Toby Payne Key Unannounced Inspection 20th April 2006 08:10 Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 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.V289994.R01.S.doc Version 5.1 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.V289994.R01.S.doc Version 5.1 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) Vacant 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.V289994.R01.S.doc Version 5.1 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 19th October 2005 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. Fees at the home on the 20/4/2006 range from £997 to £1,020 per week depending on their carer needs. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and started at 8.10 am. It was undertaken using a review of all the information available to the inspector regarding our service history about Hovenden House. It took place over six and a half hours. The inspector spoke to 10 residents, 5 members of staff and the acting manager. The main method was called “case tracking”. This involved selecting two residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of how staff responded to their needs and that of the other residents. What the service does well: What has improved since the last inspection? A Care Supervisor has been appointed to support the staff and residents. The home has continued to provide care practice training (NVQ) for staff. Two bedrooms have been redecorated after consultation with the residents. A new boating lake in the grounds of the home has been provided to enable a resident to enjoy using a model boat. A new generator has been purchased to maintain power in case of power failure. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 6 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. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 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.V289994.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 All residents are assessed before entering the home and written confirmation is sent to them that the home is able to meet their needs. Residents living in the home have information to help them make an informed decision about whether they wish to live in this home. EVIDENCE: There is a detailed statement of purpose and service user’s guide outlining the services the home provides. There is a detailed admission procedure, which identifies the needs of residents coming into the home. No new person has been admitted to the home since the last inspection but records showed that each person receives a service user’s guide and a costed terms and conditions/contract. Individual records are kept for each resident. All residents are assessed by the acting manager and care supervisor before admission. Information is obtained wherever possible from the resident, relative/advocate and other relevant people. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Information in the care plans is now much more clearer and consistent to provide staff with information to meet the resident’s needs. EVIDENCE: Care plans have improved since the last inspection. They are now more relevant to the assessed needs of the people living in the home. The information is simpler and easier to follow. All residents care details have been transferred across to a new very detailed person focussed care system. Care records included a personal profile some of which had been written by the resident, detailed assessment, nutrition assessment and daily record. The new system will allow additional information to be included where required. There were risk assessments and where possible residents had been involved in identifying their needs. Residents are involved where possible in aspects of life in the home. There is a resident’s council made up of residents. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Residents are encouraged and supported in a variety of social activities. Activities suit the residents and have been expanded. There is a dedicated transport service provided to enable residents to be independent and participate in the community. Visitors are welcome to visit at any time. EVIDENCE: The home employs one full time and one part time activities organizer. Since the last inspection, a survey has been carried out to learn from each person about the range of activities they wished to see. The activities person has sat down with each person and asked their views. Activities are therefore being reviewed and more outside trips are to be arranged as a result of this. Activities are wide ranging and include craft, art and computer. There are also darts, table tennis and snooker available. There are links with local clubs and residents are also able to access further education classes. The home also employs a physiotherapist. Residents visit local shops, pubs, cinemas and leisure centres. The home provides 2 minibuses accessible for wheel chair users. A new internet accessible large screen computer has been provided. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 11 Holidays can also be arranged. Residents commented, “activities have improved” and “there is certainly more to do”. The statement of purpose and service user’s guide refer to visitors being welcome at any time. This was also confirmed with residents and a visitor. There are also regular functions including BBQs and musical entertainment. On admission to the home details of service user’s dietary needs and likes and dislikes are obtained. Breakfast is served between 07.00 and 11.00. Lunch is served between 12.30 and 13. 30 hours and there is a choice with an alternative if required. An evening meal is provided between 16.30 and 17.30 hours and includes a hot choice. The menu is displayed in the dining room and meals can be taken in the dining room, the resident’s bedroom and the resident’s kitchen where visitors can have shared meals with the resident. All these facilities are on the ground floor. A survey is taking place to learn how the residents feel about the food and catering service in the home. Separate staff are provided for catering and all have food hygiene certificates. The home was awarded following an Environmental Health officer’s inspection on the 16/3/2006 “2 Tulips = good” in recognition of its catering service by South Holland District Council. The home has a hot drinks machine in the dining room to further provide choice and enhance independence Residents commented, “I like the food”, “it served well with plenty of choice” and “the dining room is to be redecorated in the future and we have been involved in choosing the decoration”. Staff were also seen to sit and assist residents who could not feed themselves in a calm manner. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 An educated team of staff delivers care. Staff have received training on disability awareness and residents are respected more. Medication is safely administered. EVIDENCE: Since the last inspection 60 staff have received training concerning disability awareness and this has improved their approach to the residents. Resident’s care is provided by a trained care team, which includes registered nurses. The home has detailed policies concerning privacy and dignity and rights. This is also in the service user’s guide and statement of purpose. This is also covered during induction for all new staff. Residents said that the staff respected this important aspect of their life. Staff knew the needs of the residents and were observed attending to residents in a calm and respectful manner. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 13 The home has a detailed medication policy, which includes self-medication. Registered Nurses administer medication when in the home. However, when people are out of the home, care staff administer medication. All staff responsible for this have received training on this subject. The home receives regular visits by Boots who supply medication. Staff have also received training on the needs of people who require Percutaneous Endoscopic Gastrostomy (PEG) feeding. The inspector examined a sample of medication records and found them to be well maintained and up to date. Residents commented, “things have improved” and “I find the staff very kind and helpful”. Staff commented, “I now have more confidence and understanding about the needs of the residents”. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Any complaints received are taken seriously and there is a comprehensive complaints procedure. Staff are recruited and checked to ensure that they are safe to deliver care to people living in the home. EVIDENCE: Each resident receives a copy of the complaints procedure. The CSCI has received no complaints since the last inspection. Since the last inspection a complaint was received by Lincolnshire County Council’s Social Services Department in December 2005 and investigated with the full co-operation of the home. The complaint concerned the practice and approach by a number of staff. The home has addressed this issue by ensuring all staff have received disability awareness training. All Staff receive training concerning the prevention of abuse during their detailed induction programme. A member of staff confirmed this and knew what abuse was and what she should do if abuse was suspected. Staff are correctly recruited. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, and 30 Residents live in comfortable accommodation, which is designed for their individual needs. This enables them to access all services and the extensive grounds of the home. There is also a large range of equipment available which staff have been trained to use to enable the residents to be cared for in a safe and dignified manner. The building is also well maintained and any repairs are attended to swiftly. EVIDENCE: All residents spoke of how they liked their bedrooms. Comments were “I like my room” and “I like it here”. There were a variety of wheelchairs to suit the individual needs of the residents. Residents were observed to access bedrooms and the wide corridors with ease. Residents also commented on the cleanliness of the home. Separate housekeeping staff were observed cleaning and vacuuming the home. They spoke of the pride they took in their work. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 There is a well trained and competent staff team. The numbers of staff provided are sufficient for the numbers and dependency of residents. Staff are also correctly recruited and there is a well established team. Staff now receive formal supervision. EVIDENCE: Residents felt there were sufficient staff to meet their needs. Staff were observed to respond promptly to resident’s needs. Staff also felt they had sufficient time to care and support the residents. They also spoke of the support they received from nurses and the acting manager. There is a training department with its own training co-ordinator who has been in post since November 2005. There is an extensive training programme available, which includes induction, National Vocational Qualifications, internal lectures and training from outside providers. This has enabled 82 of care staff to obtain a care qualification (NVQ) and the rest of the care staff have started courses to achieve this training qualification. Once this has been achieved all staff will have a nursing or care qualification. Staff commented, “I received a very well supported and comprehensive induction when I came here and “We receive a lot of training”. Hovenden House received an Investors in People award in March 2004 in recognition of the training and support provided. Since the last inspection staff have now started to receive formal supervision. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The staff are lead by a competent management team even though there is no registered manager. However a suitable person has been appointed and has been interviewed by CSCI. This person has addressed a number of practices, which were having a detrimental affect on a number of residents. There is a confident and supported staff team. There are established external audit systems but internal audits need to be provided to ensure that practice is consistent. EVIDENCE: There is no registered manager. However the acting manager has been interviewed by CSCI. Residents commented, “we have a very nice manager” and “the staff’s approach is different and they are kinder and more understanding”. Staff commented, “the manager is very approachable” and “I feel very supported and feel I can discuss any concerns”. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 18 There is a resident’s committee, which enables residents to voice any concerns they have about the home. Minutes of meetings were displayed on notice boards. There are also regular staff meetings. An annual quality assurance internal audit is carried out by the home and a survey was carried out in January 2006 to learn of the resident’s views about the home. Twenty eight surveys were sent out and 21 returned. Comments were mainly positive. The management makes monthly unannounced monitoring visits and a detailed report is produced and a copy sent to the CSCI. There was a detailed health and safety policy, which included risk assessments, and staff felt safe working in the home. A member of staff commented, “I am not allowed to use equipment unless I have received training and feel safe and competent to use it”. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 19 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 3 2 3 3 x 4 x 5 3 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 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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.V289994.R01.S.doc Version 5.1 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations It is again strongly recommended that the manager conducts a regular internal audit to monitor care records, medication and care practice. Hovenden House Nursing Home DS0000002538.V289994.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 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.V289994.R01.S.doc Version 5.1 Page 22 - 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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