Inspection on 22/11/06 for Howlish Hall Care Home

This inspection was carried out on 22nd November 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

Howlish Hall Care Home 21/12/08

Howlish Hall Care Home 18/01/06

Howlish Hall Care Home 23/06/05

Howlish Hall Care Home 18/01/05

Howlish Hall Care Home 05/08/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Howlish Hall Care Home Howlish Lane Coundon Bishop Auckland Durham DL14 8ED Lead Inspector Lesley Anne Moore/Bridgit Stockton Unannounced Inspection 22nd November 2006 12:30 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 Howlish Hall Care Home DS0000000721.V317972.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. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howlish Hall Care Home Address Howlish Lane Coundon Bishop Auckland Durham DL14 8ED 01388 609226 01388 606871 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) Williams & Spenceley Limited Mrs Joyce Spenceley Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (50) of places Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Day Care: Three day care attendee over the age of 65 may be accommodated commensurate with the home’s Statement of Purpose. Physical Disability: Persons with a physical disability over the age of 55 may be accommodated commensurate with the home’s Statement of Purpose. Named Individual The home may accommodate a named individual as set out in a letter to the registered person dated 24 May 2006, which establishes the basis on which the individual’s needs will be met by the home. Where necessary the home’s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 18th January 2006 Date of last inspection Brief Description of the Service: Howlish Hall is a Grade 2 listed building, which dates back to the early 17th Century and is set in 2.75 acres of landscaped wooded gardens near to Coundon in County Durham. A frequent bus service is available which provides links to the local towns of Coundon and Bishop Auckland. The home provides 24hr personal care with nursing for older people. Accommodation at the home is provided over two floors, with a mixture of single and double room, some being en-suite. There are a sufficient number of bathrooms and toilets to meet the needs of residents who live there. In addition there is a choice of lounge and one main dining room. Howlish Hall has recently been extended to provide a two-storey extension which allows for a further 17 bedrooms all of which are en-suite. There has also been an increase in the number of toilets, bathrooms and communal areas for use by residents. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of 5 hours on 24 November 2006. The staff did not know that the inspection was going to take place. The plan for the inspection was to check whether the home had implemented any recommendations made at the previous inspection; to talk with the residents about their experience of living in the home; to meet with the care staff and the Registered Manager; and to look at the homes records. What the service does well: What has improved since the last inspection? Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 6 The brochure and statement of purpose have been updated to reflect recent changes in the building and an up to date fee schedule. Another member of staff has taken over the role of Training Officer further to the long-term sick leave of the previous appointee. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Howlish Hall Care Home DS0000000721.V317972.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 Howlish Hall Care Home DS0000000721.V317972.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence to include a visit to this service. Admissions to the home only take place if the service is confident that the staff has the skills, ability and qualifications to meet the assessed needs of the prospective new service user. EVIDENCE: New service users are admitted on the basis of a full assessment, to include a visit to the home prior to admission where possible, undertaken by a member of staff trained to carry out this role. The service user and their representative are involved in this process allowing them to make an informed decision about where they wish to live confident that the staff in the home are able to meet Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 9 their individual needs. In a recent survey carried out by the home (Client questionnaire No. 1) 13 out of the 16 service users questioned said that they had visited the home prior to admission. Further, in the same survey 12 out of 16 service users reported that they were involved in the planning of their care. Howlish Hall Care Home DS0000000721.V317972.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of all service users are met through a robust care planning system that is reviewed on a regular basis and encourages involvement of both the service user and their representative. EVIDENCE: A key worker system is in operation that provides each service user with a lead named nurse who is responsible for planning and evaluating that individual’s care. Care plans are used as a working tool to provide staff with detailed information to fully meet the health, personal and social care needs of each service user. A comprehensive risk assessment is included with the care plan, updated on a monthly basis, which considers the care needs of service users balanced against their desire for independence and personal choice. The Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 11 records of 3 service users were examined and clearly demonstrate an effective system in which care is delivered according to assessed need and reviewed on a regular basis with the service user and/or their representative. There is documented evidence of specialist health care staff that periodically visit service users at the home. There is an efficient medication policy in place supported by documented policies and procedures allowing for the safe handling and administration of medicines. Service users spoken to feel that the staff respects their privacy and dignity. In the homes client survey reported on in June 2006, 15 out of the 15 service users returning completed questionnaires said that the staff treated them with respect and that their visitors were also welcomed and treated with respect. The same service users said that privacy was provided for visiting. Service users were observed to have a comfortable easy rapport with the staff on duty at the time. Howlish Hall Care Home DS0000000721.V317972.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet service users expectations. Service users are encouraged to take control of their lives and to give feedback wherever possible so that improvements can be made. Service users receive a balanced diet that meets their cultural and dietary needs. EVIDENCE: There is an activities co-ordinator in post supported by an assistant who runs a comprehensive activities programme tailored to the individual needs of service users. At the time of the inspection service users were actively involved in making gifts for the forth-coming Christmas fair. The service users also spoke enthusiastically about their recent holiday to Blackpool; evidence of this was seen in a photograph album on display in the home. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 13 Discussions with service users, their relatives and staff confirm that an open door policy is in operation as regards visiting the home. The new extension to the home provides additional communal areas where service users can spend time with their relatives/friends in addition to the comfort of their own rooms. The new lounge area also provides a degree of privacy at the current time if a service user requires it. A client questionnaire system in operation allows service users to give feedback on their experience of living in the home, and to exercise a degree of choice over how they conduct their lives, e.g. ‘Do you wish to be more involved in decision making within the home?’, ‘Are you happy with the services you have received so far?’ and ‘Are you involved with planning and reviewing your care?’ On the whole there has been a positive response recorded in the area of daily life and social activities from those service users who have been involved in the recent quality surveys. During the inspection one service user was finishing off a late lunch having made the choice to eat at a time that suited her. The home was able to respond to this service users individual request. Howlish Hall Care Home DS0000000721.V317972.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that is accessible, clearly written and easy to understand allowing anyone associated with the service to complain or to make suggestions for improvement. There is evidence to suggest that staff listen to and act upon any suggestion/complaint received. Training of staff in relation to the protection of vulnerable adults is regularly arranged and reviewed by the home. EVIDENCE: Inspection of the complaints log shows that staff are recording and acting upon complaints that have been received. The Registered Manager reports that 2 complaints have been received in the previous 12 months both of which have been dealt with as per the prescribed company policy. However, the documentation of one particular complaint looked at did not include a written acknowledgment of the original complaint being sent out to the complainant within 2 days. There was however written evidence available detailing the outcome of the home’s investigation into the complaint and a written response to the complainant. Although the home’s policy does not specify that this Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 15 acknowledgment should be made in writing, it was suggested to the Registered Manager that this would be good practice and would safe guard both service users and staff in addition to keeping a documented record of all action taken/discussions with service users and their representatives. The staff demonstrate a good working knowledge of the policies and procedures in relation to protecting and safeguarding the rights of service users. The staff are clear when incidents need external input and who to refer the incident to. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 16 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, 20, 24, and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment providing a pleasant, safe place to live in which service users are supported to achieve their maximum independence. EVIDENCE: The standard of accommodation at the home is of a high standard that is enhanced by the recent completion of a new 17-bedded extension. The staff encourage service users to view the home as their own, one service user commenting ‘it’s like home from home’. Service users have been given the choice to move into a room in the new extension. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 17 Many of the rooms are personalised with small items of furniture and personal possessions being brought from home. The shared areas provide a choice of communal space and allow opportunity to meet friends or relatives in privacy or in the service users own room. There is a good selection of general aids such as hoists and variable height beds to promote the independence of individual service users. However, it was noted at the time of the inspection that a number of large pieces of lifting equipment were stored in the main corridor which could pose a potential risk to service users. Service records are up to date and the home has an in-house maintenance arrangement. However, it was noted that the water temperature in the basin of the bathroom outside Room 38 was set at an unacceptably high temperature, which could put service users at risk. This was brought to the manager’s attention at the time of the inspection and rectified. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to meet the needs of the individual service users. EVIDENCE: Of the service users completing the CSCI comment cards 9 reported that they always receive the care and support they need and 1 that they usually receive the care and support they need. Examination of the staff duty rotas show good planning to ensure that the home is staffed efficiently, particular attention being paid to busy times of the day and to the changing needs of the service users. On average 7 staff members are on duty during an early shift, 5 staff members during a late shift and 3/4 staff members during a night shift with at least 1 trained nurse on duty at all times. There is documented evidence to show that all the staff receive relevant training that is focussed on improving outcomes for service users. In addition Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 19 78 of the care staff have achieved NVQ level 2 or above which demonstrates a commitment to staff training and development. The recruitment procedure is clearly defined and examination of staff personnel files show that this is being adhered to in ensuring the delivery of a good quality service. A robust induction programme supports this for all new members of staff. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has the required qualifications and experience, is competent to manage the home and to meet its stated aims and objectives. EVIDENCE: On entering the home there is a very relaxed and orderly atmosphere, which is a reflection of the management style of the manager. Staff and service users speak positively of the culture and ethos within the home in which everyone is respected and their comments listened to. Staff describe a manager who is Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 21 part of the work force but at the same time provides leadership and support to her staff team. The home has sound policies and procedures in place that are reviewed on a regular basis in line with current developments in health and social care. Staff shows a firm commitment to translating this policy into practice in the interests of the service users. Service users are encouraged to take responsibility for managing their own money where possible. The home provides an efficient facility in which to achieve this supported by adequate documentation. Health and safety records are up to date to ensure the safety and well being of service users, staff and visitors to the home at all times. Staff receive fire training at appropriate intervals. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 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 Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 23 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 OP16 Good Practice Recommendations Good practice would be that the compancy policy and proceedure for dealing with complaints is adhered to. Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Howlish Hall Care Home DS0000000721.V317972.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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