Inspection on 31/07/06 for Howard Court Care Home Ltd

This inspection was carried out on 31st July 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

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 31st July 2006 09:15 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.V297849.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.V297849.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 Mr Michael Dresser 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 (13) Howard Court Care Home Ltd DS0000062516.V297849.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). 1 service user in the category MD (Mental disorder under 65 years). Up to 13 service users in the category OP (Older person over 65 years of age not falling within any other category). 3rd February 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 day to 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. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit, which forms part of the key inspection, took place over one day in July. During the visit the inspector spent time talking with the registered manager, care manager, care staff and residents. Care plans and records to do with the care of residents were examined and some parts of the building were looked at. The owners of the home were present during part of the visit and were able to discuss the running of the home with the inspector. As the visit took place over the lunch period the inspector was able to observe the lunch being served and medication being given to service users. Both were completed in a relaxed manner. The fees at this home range from £317.00 to £422.00 per week as at April 2006. There are extra charges for, hairdressing, newspapers, magazines and some toiletries. This home does not provide intermediate care. What the service does well: All prospective residents have a full assessment before moving into the home to ensure all individual needs can be met. There is a care planning system in place with most of the residents involved in the process. The resident or a family member signs all care plans, which evidences their involvement. The details on the care plans ensure the carers are given all the information they need to deliver a high level of care and meet the assessed needs. All healthcare needs are met and there is an up to date record of professional healthcare visits and appointments documented in the daily record. Arrangements are made for residents to have access to chiropody, optical services and dental treatment. There is a programme of organised activities for residents to join in if they wish, and Holy Communion is offered to those who want to partake. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Howard Court Care Home Ltd DS0000062516.V297849.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.V297849.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 4 & 5 Quality in this outcome area is good. Admissions to the home only take place if the manager is confident staff have the skills, ability and qualifications to meet the assessed needs. The assessment process is good and ensures the needs of the residents can be met. Each resident is provided with a contract and terms and conditions that set out in detail the facilities the home provides. Prospective residents are given the opportunity to spend time at the home prior to admission. This judgement was made using available evidence including a visit to the service. EVIDENCE: All prospective residents are fully assessed prior to admission to ensure the home is able to meet the assessed needs. Information obtained from this assessment is then used as a basis for the plan of care. Wherever possible Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 9 family members and/or social workers are present during the assessment to ensure all concerned know that the needs of the resident can be met. All residents have a contract either with the home or the Local Authority Social Services Department. All residents are given a copy of the home’s terms and conditions of residency, which they sign to agree the details. In future a second copy will be kept on the resident’s file that is held in the home. All those wishing to move in are invited and encouraged to visit the home to meet the staff and other residents and to enjoy a meal and/or refreshments. This also gives opportunity to view the accommodation provided. Care is taken to ensure the needs of those people already living in the home are taken into account when assessing prospective residents. Howard Court Care Home Ltd DS0000062516.V297849.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is good. Residents health, personal and social cares needs are addressed in the care plans and care needs are met effectively. The home works to an efficient medication policy supported by procedures and practice guidance. Residents are treated with dignity and respect at all times. This judgement was made using available evidence including a visit to the service. EVIDENCE: Since the last inspection the care plans have been changed to the new format, which allows for more information to be provided to the care staff. All aspects of care are detailed, including, activities and hobbies, spiritual needs, healthcare needs and a medical history. The manager checks the daily report in conjunction with the care plan and notes any changes in the level of care that may be required. Currently, if there is no change this has not been noted Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 11 and the inspector recommended that the care plan review document is noted and signed even when there is no change to the care provision. All resident risk assessments are in place and up to date and healthcare visits are recorded in the daily record. The manager confirmed that the home has a very good working relationship with the local GP surgery and district nurses who come into the home on a regular basis. The medication is received in a monitored dosage system and all the care staff responsible for giving out the medication have completed training in “safe handling of medication”. Records were checked and found to be in order. There is only one resident who is responsible for her own medication and the family have requested that this continues for as long as possible. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms. Howard Court Care Home Ltd DS0000062516.V297849.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is good. The routines of the home are planned around the residents’ needs and wishes and are flexible enough to meet the changing needs of the individual. Family and friends feel welcome and know they can visit the home at anytime. Maintaining independence and enabling the residents to make their own decisions about how they wish to live is a key objective for the home. An experienced cook is responsible for providing quality, nutritional meals that meet the cultural and dietary needs of the residents. This judgement was made using available evidence including a visit to the service. EVIDENCE: Discussions with the residents evidenced that they all have control over their lives and routines are flexible to meet their needs. They can rise when they want to and retire when they wish. One resident sometimes likes to stay in bed until teatime. Some of the residents were in their rooms during the inspection visit, whilst others were enjoying conversations in the lounges. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 13 Those who spoke with the inspector said, “we can do what we like “ and “ the staff let us please ourselves”. Spiritual needs are met through visits from local ministers when Communion is given to those who request it. There is a programme of activities, based on what the residents like to do and organised by the activities co-ordinator. The programme includes quizzes, bingo, chess and draughts. Residents, staff and family members had recently enjoyed a day out at Silloth, which ended with all enjoying “ fish and chips out of the paper”. A recent questionnaire completed by the residents has resulted in a list of places they would like to visit. The manager recently organised a 4 course evening meal for residents and their families in the home. This proved a great success with some residents said it was like “going out for a meal just like when we were at home”. Contact with friends and family is encouraged and visitors are always made welcome, although no one was visiting on the day of the site visit. If visitors can only come during a mealtime they are invited to have a meal with the resident they have come to see. The inspector was in the home over the lunch period and discussions with the residents evidenced that all were happy with the choice of food. Special diets are catered for. Howard Court Care Home Ltd DS0000062516.V297849.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. The home has a complaints procedure in place that is clearly written and easy to understand. Training in the area of protection has been completed and staff are aware of the procedure to follow. This judgement was made using available evidence including a visit to the service. EVIDENCE: The home has a complaints procedure that forms part of the information pack given to all prospective residents and/or their families. There is a complaints register in place but there have been no complaints to record. There is also a copy on display in the hall by the front door. Some of the care staff have completed adult protection training and this subject is also covered in the staff induction programme and NVQ training. Arrangements have been made for the remaining staff to attend a second course by the same provider. The staff who spoke to the inspector showed a good knowledge of abuse issues and the process to follow should this ever be required. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 23, 24, 25 & 26 Quality in this outcome area is good. The home offers comfortable, homely accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. The home provides aids and equipment to meet the care needs of the residents. The residents’ rooms are suitable to meet the assessed needs. This judgement was made using available evidence including a visit to the service. EVIDENCE: The home provides warm and comfortable surroundings for the residents, with reasonably good furniture and fittings. The registered provider ensures that there is a programme of redecoration, in order that the environmental standard remains good. Four of the toilets have been tiled and plans are in hand for two bathrooms to be tiled also. The front patio of the home has been Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 16 completely re-paved with block paving and new garden furniture has been purchased for the residents to use. This has greatly improved the appearance of the front of the building. The home has twenty-two single rooms and three doubles, one of which is currently used for single occupation. Eight of the rooms have en-suite shower and/or toilet facilities. All of the rooms are suitable for their stated use although the room that is designated for respite care is a little on the small side. The rooms are nicely furnished and personal to the residents with ornaments, pictures and photographs. The home has specialist equipment for those residents requiring it. This includes, handrails on corridors, assisted bathing, raised toilet seats and hoists. All of these facilities ensure the residents live in safe, comfortable and suitable surroundings. Cleaning arrangements are in the hands of a professional cleaning company and the home was very clean on the day of the inspection. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. Staffing arrangements are good, ensuring the needs of the residents are met. Staff are well trained and provide a skilled and experienced workforce. This judgement was made using the available evidence including a visit to the service. EVIDENCE: Howard Court has an extremely low staff turnover, with the last new member of staff appointed almost two years ago. This ensures the residents are cared for by an integrated and experienced staff team that they know well. There are 5 members of staff plus the manager on duty in the morning, 4 plus the manager in the afternoon and 3 on duty in the evening until 9pm. The home has 2 waking night staff. This staff ratio ensures that the residents are provided with a level of care that meets their assessed needs. There are 6 members of staff qualified to NVQ level 2 and 3 and 5 members of staff almost completed the course. Two members of staff are enrolled with Carlisle College to start in September. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 18 The home has a full recruitment and selection process that ensures all the legal checks are completed before the applicant stars work. Staff files that were examined during the visit were found to contain all the required documentation. There is a staff training programme in place and recent training completed has included, first aid, moving and handling updates, infection control, medication and POVA. The registered manager has completed her NVQ level 4 in care and the registered manager’s award. The inspector was able to observe the staff and found their attitude to be caring, supportive and enabling. This attitude ensures that the residents can maintain as much independence for as long as possible. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is good. The registered manager has the required experience and qualifications, is competent to run the home and is highly regarded by the staff and residents. The home has comprehensive policies and procedures that are reviewed on a regular basis. Sound health and safety procedures ensure the residents’ safety. This judgement was made using the available evidence including a visit to the site. EVIDENCE: The registered manager has worked at Howard Court for many years and has worked her way up via internal promotion to her present position as the Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 20 registered manager. She is resident focused and works hard to ensure the home provides a high standard of care. During the visit she demonstrated an awareness of the residents’ needs and the importance of meeting those needs. Discussions with the residents and staff evidenced they valued her help and support. Although she is responsible for the overall management of the home she does provide a “hands on “approach when required. The home does hold some personal monies for residents and the home has put into place records to show any monies spent behalf of the residents. Two members of staff countersign any cash paid out and the remaining cash is held in the safe. All receipts are kept on file. The general risk assessments are completed by the manager and are reviewed annually and there is also a fire risk assessment in place. The gas safety check was up to date and all the equipment is serviced regularly under annual contracts. The hoists, including those over the baths are services every six months and the portable appliances are tested annually. Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 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 3 X 3 Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 22 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 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.V297849.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Howard Court Care Home Ltd DS0000062516.V297849.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!