Inspection on 08/12/05 for Howards

This inspection was carried out on 8th December 2005.

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

Howards 24/09/08

Howards 27/09/07

Howards 05/03/07

Howards 16/08/05

Howards 20/12/04

Howards 13/08/04

Similar services:

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Howards Howards 24 Rowtown Addlestone Surrey KT15 1EY Lead Inspector Mary Williamson Unannounced Inspection 8th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Howards DS0000013683.V272366.R01.S.doc Version 5.0 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. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Howards Address Howards 24 Rowtown Addlestone Surrey KT15 1EY 01932 856665 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) Greydales Limited Mrs Julia Susan Ghassemi Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Sensory impairment (1) of places Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be: Over 65 years of age. One (1) named service user of age 59 years may be accommodated. Date of last inspection 16th August 2005 Brief Description of the Service: Howards is a care home situated in a quiet residential area on the outskirts of Addlestone. It provides care for twenty-one service users who are old. Accommodation is arranged on two floors, with nineteen single bedrooms and one double bedroom. There are two lounge areas and a conservatory, which is also the dining room. This overlooks a well- maintained garden with two fishponds and ample garden furniture. There is a shaft lift in place providing access to the first floor. There is off the road parking at the front of the premises. The home hires a mini bus from a local charity to provide outings for the service users. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and the second in The Commission for Social Care Inspection programme year 2005/2006. Mary Williamson who is the Lead Inspector for the home undertook the inspection. Mrs Margaret Davies the Deputy Manager was present for the duration of the inspection. Mr. Graham Samuel The Provider was also present for part of the inspection. The Registered Home Manager was not on duty as she was attending a training course with the cook on nutrition. All the service users were spoken to. They were sitting in both lounges and some were in their bedrooms. They were able to provide feedback on all the Christmas activities taking place. Some enjoyed a Salvation Army Carol Concert the previous day, and some were preparing for a party in the local school the following day. Sherry was served prior to lunch and one service user stated that was a daily occurrence. There was good interaction between care staff and service users. The atmosphere was relaxed and homely. There is a well -established core staff team in this home who have a good understanding of the needs of the service users in their care. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. The inspector would like to thank all the service users and staff team for their positive input to the inspection. What the service does well: Howards provides good quality care to service users in a comfortable and homely environment. Individual and communal accommodation is satisfactory with the garden being an attractive feature and enjoyed by all the service users. There is a well- established team of staff in post who relate well to service users and have a god understanding of the service users needs. Howards DS0000013683.V272366.R01.S.doc Version 5.0 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. Howards DS0000013683.V272366.R01.S.doc Version 5.0 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 Howards DS0000013683.V272366.R01.S.doc Version 5.0 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): These standards remain unchanged. Please see the previous inspection report dated 16th August 2005. EVIDENCE: Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 9 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, and 10. Care plans demonstrate the individual care undertaken, and outlines the systems in place to meet health care needs. There is no risk assessment in place for the self- administration of medication. EVIDENCE: Individual car plans are in place and these are maintained at the same satisfactory standard since the last inspection. Four care plans were sampled during the visit and these were informative, detailed, and well maintained. These are reviewed on a regular basis. However one service user did not have a care plan in place and she also required a risk assessment regarding the use of her reclining chair for sleeping. A moving and handling risk assessment was also required for this service user. All service users are registered with a local GP. Service users are also supported by the district nurse who visits the home to monitor tissue viability, undertake dressings, carry out blood tests, and recently administered the flu vaccine. Visits to or by the optician, dentist, and chiropodist are also arranged. Specialist input can be arranged on referral by the GP. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 10 There is a medication policy in place. The home uses the blister pack system. All staff who administer medication have been trained in this procedure. The medication recording charts were seen and are well maintained. The list of staff signatures that administer medication must be updated. A risk assessment needs to be in place for the service user who administers his own insulin. Privacy and dignity of service users is respected. Staff were observed to knock on service users doors prior to entering. All the bedroom doors are fitted with locks and some service users manager their own keys. They can also see relatives and friends in the privacy of their own rooms. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 11 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, and 15. The assessed recreational needs of service users are supported and activities are made available inside and outside the home. The catering arrangements are satisfactory and meet the nutritional needs of the service users. EVIDENCE: The leisure activities programme meets the individual and collective needs of the service users. Several service users enjoy a daily newspaper and others enjoy television and radio. Several service users stated that they had enjoyed a Salvation Army Carol Concert the previous day. They were also planning a trip to see the London Christmas Lights the week following the inspection. The deputy manager was organising transport for a Christmas party the following day in the local school. Other activities include board games, card games, and occasional outside entertainers. Service users have sherry and coffee mornings. Sherry was being served prior to lunch. Relatives and friends are welcome in the home at any reasonable time. Relatives are invited to participate in the care planning process. The local clergy visit service users on request and support them with their spiritual needs. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 12 The kitchen was visited and found clean and orderly. The cook was attending a training course and a member of care staff was preparing lunch. Lunch included grilled sausages, onion gravy, cabbage, runner beans and mashed potato. This was followed by ice cream chocolate log. All the service users spoken to stated they were very satisfied with the standard of food provided and the catering arrangements in the home. The menus were seen which, are planned by the cook on a four week rota. The variety of food offered is nutritious, wholesome, and meets the service users nutritional needs. Special diets are catered for. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 13 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, Service users are protected by the complaints procedure in place. EVIDENCE: There is a complaints procedure in place and a copy of this is included in the service users guide. There are no recorded complaints since the last inspection. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 14 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, 21, 24, and 26. The service users live in a clean, and well-maintained home. The home meets both individual and collective needs of the service users. EVIDENCE: Some areas of the home have been redecorated to a good standard since the last inspection. The home is well maintained and provides a comfortable and homely environment for service users to live in. Both lounges have a Television and service user choose where they wish to sit. The conservatory also acts as the dining room and overlooks a well -maintained garden. Nineteen service users bedrooms are single en-suite rooms. There is one shared bedroom provided. All the bedrooms are comfortably furnished and have been personalised to reflect individual personalities. Some service users manage a key for their own bedroom door. There are sufficient number of toilets and bathrooms provided throughout the home. Both assisted bathrooms are situated on the ground floor. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 15 The standard of cleanliness throughout the home is good. There was no malodour present. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 16 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, and 30. A competent team of staff meets the assessed needs of the service users. EVIDENCE: The staff duty rota was seen and the number of staff on duty was sufficient to meet the current service users assessed needs. The cook and manager were attending a training course and arrangements were in place to provide adequate cover in their absence. The Christmas duty staff cover was also seen and the number and skill mix of staff to cover this period was also satisfactory. The staff spoken to confirmed that they all had undertaken induction training followed by foundation training. Regular mandatory updating takes place in manual handling, first aid, health and safety, and food hygiene. It was positive to note that all staff have recently undertaken fire safety training, which was a requirement from the last inspection. The recruitment policy in the home safeguards the service users living there. The turnover of staff in the home is low and no new staff have been employed since the last inspection. All staff have a CRB disclosure in place. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 17 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, 37, and 38. The home was functioning well. The health and welfare of the service users is observed and promoted. EVIDENCE: The registered home manager was attending a training course and the Deputy Manager Margaret Davies was in charge. The home was functioning well. Arrangements had been made to provide extra staff in the absence of the cook and the manager. The staff team were aware of the needs of the service users and of their own duties and responsibilities. Service users were keen to comment on the efficiency of the staff team. There is a wide range of policies and procedures relating to health and safety in place and these were sampled during the inspection. On talking to staff it was evident that they receive regular health and safety update training. They were also aware of the COSHH procedures in place. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 18 Risk assessments are in place for identified risks. It was noted that one service user required a moving and handling risk assessment and another required one for self-medication. The accident records were seen and are well maintained. Fire safety records were seen. Fire alarms are tested weekly and this is recorded. There is a contract in place for the maintenance of fire fighting equipment, and emergency lighting. It was good to note that all staff have recently had fire safety training, which was a requirement from the last inspection. Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 19 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X 2 3 Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 7 Regulation 15(1) Requirement The registered person must ensure that all service users have a current and up to date care plan in place, which must also include all risk assessments associated with the individual service user. The registered person shall ensure that a risk assessment is in place for the selfadministration of medication, and a current list of staff signatures who administer medication also in place. Timescale for action 08/12/05 2 9 and 37 13(4)(b) 15/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Howards DS0000013683.V272366.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Howards DS0000013683.V272366.R01.S.doc Version 5.0 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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