Inspection on 05/11/07 for Howard Court Nursing Home

This inspection was carried out on 5th November 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 Nursing Home 26/03/09

Howard Court Nursing Home 18/12/06

Howard Court Nursing Home 05/10/05

Howard Court Nursing Home 28/07/05

Howard Court Nursing Home 20/01/05

Howard Court Nursing Home 15/07/04

Howard Court Nursing Home 11/02/04

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

CARE HOMES FOR OLDER PEOPLE Howard Court Nursing Home 9 Burlington Road Ipswich Suffolk IP1 2EU Lead Inspector Jan Sheppard Key Unannounced Inspection 5th November 2007 9.30 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 Nursing Home DS0000024421.V354402.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 Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howard Court Nursing Home Address 9 Burlington Road Ipswich Suffolk IP1 2EU 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) 01473 210787 01473 233619 sayersa@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Mrs Audrey Sayers Care Home 40 Category(ies) of Dementia (40) registration, with number of places Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th December 2006 Brief Description of the Service: Howard Court is a forty-bedded nursing home for older people suffering from severe mental infirmity and is located with a residential area of Ipswich, close to the town centre and all its facilities and resources. Originally owned by the local authority, the home now forms part of the BUPA care group and was registered under the name of this organisation in December 1994. The home has twenty-six single bedrooms and a further seven shared rooms. The current fees range from £506 to £764 per week. Information regarding the service can be obtained from the Statement of Purpose and Service User Guide. These and a copy of the most recent CSCI inspection report can be obtained from the manager. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over eight and a quarter hours during a weekday. This was a key inspection, which focused on the core standards relating to older people. During this inspection the inspector made a tour of the building, had in depth discussions with the homes manager, met all the residents and where possible spoke or communicated with them, spoke also with staff on duty and carried out spot checks on a number of the homes records. During the inspection day a number of visiting relatives were also spoken with and after the inspection others were contacted by phone. The comments in this report reflect the findings made by the inspector during that visit on 5th November and also take account of information gathered over past months from the homes manager and by way of the pre-inspection survey questionnaires completed by relatives and carers. This was a positive inspection when it was found that the requirements and recommendations made at the last inspection had been met. One requirement and one better practice recommendation are made following this inspection. On the day of this inspection the home had a calm and homely atmosphere where the residents and staff were seen to be interacting positively together. The needs and wishes of the residents were being interpreted sensitively by the staff who were seen to be delivering care to meet individual assessed needs. They were seen to be doing this in a manner, which ensured the residents safety whilst enabling them to retain their dignity and promoting their remaining abilities to determine actions for themselves. What the service does well: The dedicated and well-trained staff team give good priority to meeting the complex and at times challenging care needs of the residents in a relaxed and homely manner. The home offers a very unrestricted environment where residents are free to access all areas of the building. Comments from relatives were generally complimentary about the care offered one said, “They are very professional in every respect. The impression of a very caring and homely environment is evident”. Howard Court Nursing Home DS0000024421.V354402.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. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 7 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 Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable to this home, which does not offer intermediate care. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents or their can expect to receive good information to enable them to make an informed choice about using this service. The needs of prospective service users are fully assessed prior to admission so that both the home and the prospective resident can be assured that the service is appropriate and can meet their needs. EVIDENCE: The manager visits every prospective new resident to make an assessment of their care needs to gain a view as to whether they would be compatible with the other residents in the home and that the home would be able to meet their Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 10 needs. Relevant medical nursing and social care reports and assessments are always sought. As the majority of the referred residents are unable to judge for themselves the views and wishes of their families are fully considered. Families along with the prospective new resident are always invited to visit the home prior to any decision about admission being made. One relative who spoke with the inspector said that they were very grateful for this opportunity and the kindly manner in which the staff explained things to them and then supported them through the difficult process of seeing their loved one ‘ going into care’. Another relative commenting on the scarcity of dementia care places in this area said that they were pleased having visited Howard Court to find it such a welcoming and homely environment where their relative was now happily settled. The home provides prospective residents and their representatives with good documentation about the services offered by the home including a comprehensive statement of purpose and service users guide. This information includes details of the facilities offered in the home, a sample menu of meals and plan of daily activities. A brochure on the financing of residential and nursing care and other information concerning the provision of specialist care for residents suffering from dementia is also included. A copy of the Service Users Guide is provided in each resident’s bedroom. All residents are issued with a contract and written details as to the terms and conditions of placement and the assurance that their individual and changing needs will be continually reassessed. The admission records for two recently admitted residents examined found that the home was correctly following its admission policy and procedures. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect that good care plans are maintained so that staff are fully aware of the needs and any guidelines for each resident. Residents and their families can be assured that prompt access to medical services is sought to maintain well-being. Although the medication storage and administration system is generally robust better attention needs to be given to the accuracy of some of the administration records to ensure protection to the residents and an accurate audit trail is available. EVIDENCE: Four care plans were examined, two for recently admitted and two for more long standing residents. These were all well maintained with good details of assessed care needs and clear guidelines as to how this care should be Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 12 delivered. The manner of intervention and the levels of support required were stated along with suggestions as to how best to encourage or enable the resident to retain as much ability and independence for themselves as was safely possible. All areas of care were included, including eating and drinking, continence care, personal care, health and safety and medication. In each case there was evidence that individual care plans and risk assessments had been regularly reviewed. The manager explained that since the last inspection a revised format for care plans had been introduced and that all the plans had been reviewed prior to adapting them into this new system. With one exception relatives spoken with confirmed that they feel involved with this care planning process are able to take part in reviews if they wish and are encouraged to make comments and suggestions to the staff concerning the care of their loved one who is unable to speak for themselves. Close working relationships have been developed with allied medical services including local GPs, chiropody, dental and optical services. The manager said that a doctor from the nearest GP practice situated in the same road would make an immediate visit if required. Referrals and visits from specialist mental health Consultants are also promptly made and responded to thereby ensuring that the health needs of the residents are fully met. The local Tissue Viability Nurse was visiting the home on the day of this inspection and she discussed with the inspector the improved now be used for keeping written and photographic records of pressure wound care. She explained that she assists the home with regular skin inspections and that all new residents have a skin assessment within 6 hours of admission to the home. She also assists the home with regular staff training concerning this aspect of care. The home was able to evidence good awareness of infection control with reminding notices and hand washing products seen to be freely visible for visitors and products being carried and being used by individual members of staff. The care for the two known MRSA suffers was seen to be being properly monitored and recorded. The manager commented that unfortunately this infection appeared to have arrived in the home via the local hospital and was now in decline. Staff from the local Hospice has recently delivered training for the homes staff concerning the care of the dying and also concerning support for their relatives. A further follow up training session has been planned for December. The inspector examined the systems for the safe storage and administration of resident’s medication and found these to be generally well maintained apart from one or two omissions in the recording. The manager explained that the recently adopted Nomad Concise system had proved to be a considerable improvement and the new equipment, three medication storage trolleys, had also proved to be beneficial enabling staff to administer medication close to the Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 13 recipient. Controlled medication was appropriately stored and a check of the administration records for these found them to be accurately recorded. Throughout this inspection the inspector noted that staff were treating the residents in a kindly manner endeavouring to interpret their requests and wishes and giving them time to respond. Residents who spent much of their time pacing along corridors and into rooms were monitored for their safety and were not restricted from this activity although efforts were made to direct them to other less energetic pursuits in a caring and courteous manner. In an effort to protect the privacy and dignity of residents staff were seen to knock on the doors of residents rooms and to ask them about various activity options. The inspector discussed with the homes manager the prevalence of residents who wore nothing on their feet or who constantly carried their shoes and or other clothing. The merits of various methods used to encourage the more consistent wearing of shoes and indeed some other items of clothing were discussed, this to ensure the safety and well being of the residents at all times. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The diverse social and activity needs of the residents are very well supported and meet their needs. A wholesome diet is provided in a manner, which meets the special nutritional requirements of individual residents. EVIDENCE: The home was able to evidence that it offers residents a range of different activities planned to meet their individual needs and interests. Since the last inspection an increase of activity co-ordinator hours has been introduced into the home and a recently appointed new organiser has just completed an Activities Training Workshop. A monthly programme is arranged and this was advertised around the home. The December programme was noted to include a number of seasonal events including a Christmas party a Carol service and a musical entertainer. The residents also benefit from visits by children from Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 15 local schools that offer various entertainments. Staff explained that despite their physical and mental infirmity many of the residents still enjoy ‘an outing’ and these are arranged for short durations only in the near vicinity of the home to the local park and on some Sundays to a nearby church. Other residents are assisted to take walks in the homes large and well appointed gardens where a large patio was well used during the summer months and where the aviary and collection of colourful birds are always an attraction. The home is well placed within the town with good transport links nearby and this assists the considerable number of relatives who regularly visit the home. Those who spoke with the inspector confirmed that visiting is without restriction that they were always made very welcome. One relative who visits daily explained that she does so at lunch times so that she can assist her relative to eat lunch. The comment questionnaires returned to the Commission by family members and others also confirmed that they felt welcome in the home at any time and that they were always kept informed of important matters relating to their family member. The manager explained that because so many of their residents suffer from severe mental infirmity and find it difficult or impossible to express their opinions or choices importance is placed on gaining information about individual likes and dislikes from family members and looking at the non-verbal clues and body language shown by individuals. During this inspection the menus were examined and the serving of lunch in the dining room and in the small lounge was observed. It was seen that a choice of two main dishes were offered and that residents who needed assistance were supported individually by staff in an unhurried and relaxed manner. The most comfortable way in which this individual feeding should be carried out was discussed with the homes manager. Varying sized portions served to meet individual requirements e.g. not much meat and a lot of custard, were served as identified for individuals. The chef who has worked at the home for several years told the inspector of a recent training course he had attended concerning the latest thinking on the provision of adequate nutrition for dementia sufferers. He explained that although the menus, which are displayed throughout the home, show the usual identified meals at set times in fact the times of meal taking is now far less prescribed but is arranged to meet the specific needs of the residents. The homes manager explained that some residents like to have several breakfasts spanning most of the morning and this is accommodated. The practice of having a range of finger food constantly available for residents to take in a ‘grazing manner’ instead of just at a formally set mealtime is now feely available in the home. This assists giving residents better choice and for those who are no longer able to use a knife and fork independently. The Night Bite menu which has recently been introduced for the late evening and night hours now also includes a range of light cooked meals along with sandwiches and Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 16 cake and this is said to be better meeting the nutritional needs of residents who wander and do not sleep at night. Care plans evidenced that individual nutritional risk assessments are carried out where residents had identified dietary requirement or where eating difficulties were identified. The difficulty of identifying resident’s individual food preferences was discussed with the chef who explained that he now works very closely with the new activity organiser who is often able to identify resident’s likes and dislikes during activity sessions. The possibility of using picture menus to assist with this process was suggested. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 17 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 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints policy is clear and is freely available for residents and their families. The open culture of the home allows the residents to express their wishes and dislikes freely in a safe and understanding environment. The staff have a good understanding of the policies and procedures concerning Adult Protection and Whistle Blowing and how these give protection to the residents. EVIDENCE: There have been no incidents concerning adult protection reported since the last inspection. Staff evidenced a good awareness of this subject mentioning its particular importance for these residents who because of their dementia are often unable to speak or to judge for themselves. “We have to learn to watch for signs and interpret residents behaviour” one staff member said. The training records evidenced that all staff regularly undertake protection of vulnerable adults training. A good record of all complaints and incidents is maintained. An examination and discussion with the homes manager of the five incidents recorded since Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 18 January 2007 evidenced that these had been dealt with promptly following the homes policy and procedures and that they had been resolved to the satisfaction of the complainants. During this inspection the inspector had the opportunity to speak with two relatives who had reported an incident earlier in the year. They expressed their surprise that this had been recorded so formally explaining that they would often discuss minor problems with the manager not really expecting them to be formal complaints. As their relative was unable to express anything for themselves they said that they felt an extra responsibility on their behalf to monitor what was going on and added that any matter had always been attended to satisfactorily and very promptly by the management. Details as to how any resident or their representative can raise any concerns or make a complaint is contained in the homes Statement of Purpose and Service users Guide. A printed copy of this is displayed within the home where it is accessible to all visitors to the building. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 19 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 and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents and their relatives can be assured that the service offers a good safe environment, is well appointed and subject to regular maintenance which meets the requirements of the people using the service and these standards. EVIDENCE: The residents live in a home that is maintained to a satisfactory standard of repair and is of an appropriate design to meet their needs and abilities. The older design of the building lends a spacious and airy atmosphere so that at no time during this inspection despite the number of very active residents who were constantly moving around the building did it feel to be crowded. Planned over two floors, all areas are accessible by lift. On the ground floor there are Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 20 two large lounges, both being attractively decorated and comfortably furnished and a large centrally sited dining room. The dining room is of sufficient size to allow easy access for wheelchairs and provides a pleasant area for residents to come together at meal times. There are also additional seating areas located around the home, which offer residents and their families a quiet and more private setting. The home has 26 single bedrooms of which 17 have en-suite facilities and a further 7 shared rooms of which 4 have en-suites. A number of assisted bathrooms and shower rooms are located strategically around the home. On the ground floor is a large centrally sited kitchen where all resident meals are prepared, this is appropriately located opposite the main dining room and forms an important facility at the heart of the home. Good sized and well appointed laundry facilities are also located on the ground floor and these have immediate access to a drying area in the garden. The home offers a very unrestricted environment for its residents who can access the homes secure gardens via several exit doors from the main building. All areas of the home were well maintained (apart from scuffed woodwork in the main ground floor corridor) and had good quality decorations. All the environmental aspects mentioned following the last inspection have been attended to with various items of new furniture purchased for individual bedrooms so that overall residents rooms appeared homely and offered comfortable personal spaces. The manager explained that it is planned for the interior of the home to be fully refurbished during 2009. This will include making all bedrooms for single occupation, new furnishings and fittings throughout and modernization of the bath and shower rooms. A recent upgrade of a bathroom into an attractive and welcoming wet-room was shown to the inspector. On the day of this unannounced inspection the home was found to be very clean and to have no mal-odours. Sluice rooms were found to be clean and secure. The kitchen too was found to be clean and well ordered and the cleaning records evidenced what cleaning tasks had been completed on a daily basis. The kitchen also benefits from a regular planned steam cleaning routine. Since the last inspection minor rearrangements have been made so that staff other than kitchen staff who need to access minor cooking facilities in the kitchen, for example to prepare the ‘nite bite’ meals as needed, only have access to a limited area of the kitchen thereby limiting and managing the risk of Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 21 contamination and the spread of infection. During this inspection all staff seen entering the kitchen were wearing appropriate protective clothing. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 22 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 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Experienced and trained staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. The recruitment procedures are robust and offer protection for the residents. EVIDENCE: Residents living in this home are supported and cared for by sufficient staff that are appropriately qualified and trained to meet their individual care needs. The staff found to be on duty on the day of this inspection matched the pre planned staff rota for the day. Two nursing staff are on duty throughout the day and during the night. The supporting care staff usually six in the morning and four in the afternoons are experienced and well qualified with more than 56 holding NVQ qualifications at levels 2 or above. Care workers commented favourably as to their training opportunities within the home. An annual training needs programme has been developed and the manager commented Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 23 that more specialist dementia care training and dementia mapping training would be advantageous. The manager explained that the home is able to retain many of its staff for considerable periods, and that it is currently fully staffed and that it does not have to use any agency staff. Staff recruitment is not usually difficult with good choices being able to be made from a number of applicants. The comments made on the relatives and visitors questionnaires and those also made directly to the inspector, spoke generally of understanding, kind staff who were very caring and who tried hard to meet the residents needs individually. One adverse comment said that some staff treated the residents like children and several others mentioned the difficulty of communication where English was not a first language. Another relative said, “ Staff are kind and caring and very supportive of myself”. The inspector examined the recruitment documentation for randomly selected staff members. These were well presented and clearly organised and evidenced that all the required documentation and checks had been obtained prior to the commencement of duties. The records also evidenced that newly appointed staff are provided with a structured induction programme and have an ongoing training needs programme designed to meet their specific needs. During the inspection staff were seen to work well together as a team all grades of staff supporting each other to ensure the smooth running of the home. Interactions observed between staff and residents were relaxed, warm and supportive, where residents were treated with respect. One relative who spoke with the inspector commented on the tireless and good-natured approach of the staff who have to do such a difficult job. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use this service can be assured that the home benefits from the calm and consistent approach of the experienced manager who ensures that the health, safety and welfare of residents is promoted. The quality assurance system enables the management to assess information to enable them to improve the care experience for the residents. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 25 EVIDENCE: The current manager has worked at the home since 1996, initially in a nursing position and was then was appointed as manager. She successfully completed the qualification of Registered Managers Award in 2005 and has also undertaken additional training in the care of older people suffering from dementia. There is a clear staffing structure, and sound policies and procedures and this enables the home to be run in the best interests of its residents. The manager sets the tone for the home provides strong leadership to the team and enjoys good relationships with the residents. There appeared to be a good understanding of equality and diversity issues and a grasp of the complexity and varying strands of these issues. BUPA has a comprehensive system for quality assurance in its homes, which include regular surveys of residents and their relatives. The company carries out regular audits of the home and monthly Regulation 26 visits are made. The manager reported that she is well supported by the wider company consultant structure mentioning in particular one specialist medical consultant who visited the home from a great distance to assist with one particularly difficult resident care management issue which was satisfactorily concluded. The manager also stated that the three BUPA homes in the Ipswich area are able to work closely together and this too assists with the quality of care that they can offer. Spot checks made of the homes records, fire testing, water temperature recording, accident reporting, staff supervision records, records concerning residents personal monies, and minutes of staff meetings found these to be well recorded thereby offering protection to the residents and assisting with the smooth running of the operational procedures of the home. Risk assessments for the environment were seen to be in place along with moving and handling assessments for all the residents. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 x x x x x X 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 x 3 x 3 x x 3 Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement The records of medication administered must be accurately recorded/maintained so that an accurate record for an audit trail is kept of medication administered to service users. Timescale for action 30/11/07 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 OP30 Good Practice Recommendations More staff should undertake the specialist dementia care training including instruction on dementia mapping so that service users needs can continue to be meet. Howard Court Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Nursing Home DS0000024421.V354402.R01.S.doc Version 5.2 Page 29 - 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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