Inspection on 22/11/07 for Howson Care Centre

This inspection was carried out on 22nd 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

Howson Care Centre 20/11/08

Howson Care Centre 07/11/06

Howson Care Centre 01/02/06

Howson Care Centre 04/07/05

Howson Care Centre 22/02/05

Howson Care Centre 21/06/04

Howson Care Centre 03/03/04

Howson Care Centre 24/07/03

Howson Care Centre 13/11/02

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Howson Care Centre Willingham by Stow Gainsborough Lincolnshire DN21 5JZ Lead Inspector Julie Western Unannounced Inspection 22nd November 2007 09:30 X10029.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 Howson Care Centre DS0000002539.V354324.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 and Care Homes for Adults 18 – 65*. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howson Care Centre Address Willingham by Stow Gainsborough Lincolnshire DN21 5JZ 01427 788283 01427 787567 lous@howsoncare.fsbusiness.co.uk 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) Howson Care Centre Limited Mrs Carole Anne Horne Care Home 78 Category(ies) of Dementia (9), Learning disability (22), Mental registration, with number disorder, excluding learning disability or of places dementia (22), Old age, not falling within any other category (25) Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission are within the following category: Dementia - code DE Learning disabilities - Code LD Mental Disability - Code MD. Old Age not falling within any other category - code OP. Residents in `The Laurels` must be admitted under the LD category and require personal care only. Residents admitted in the DE category must be fifty years of age or over. The maximum number of people who can be accommodated is 78. 2. 3. 4. Date of last inspection 7th November 2006 Brief Description of the Service: Howson Care Centre is situated at the edge of the village of Willingham By Stow and is set in landscaped grounds with car parking spaces to the front of the building. The home is owned by Howson Care Centre Limited and is managed by Mrs. C. Horne. The accommodation comprises of four areas; The Flat offers first floor accommodation for up to 8 service users who have a Learning Disability and who are working towards supported living placements. The Main House, provides services for up to 22 people with Mental Health problems. The Wing provides accommodation for up to 7 older people and 2 younger adults with a Learning Disability. The Court provides both nursing and residential services for up to 25 older people. The newly registered unit, known as “The Laurels”, is a separate, two-storey, purposeHowson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 5 purpose-built unit, and will be used for up to 15 people with a learning disability. It was not in use at the time of the inspection. Each unit is self-contained with a kitchen, bathroom and lounge/ dining facilities. The kitchen in the main house area provides all meals and drinks and snacks can be prepared in two smaller kitchen areas. The majority of the accommodation with the exception of The Flat area is situated on ground level comprising single and double bedrooms, some of which have en-suite facilities, 9 toilets, 4 bathrooms and 1 shower unit. The owner of the home visits weekly on a Thursday and works closely with the manager. At the time of the inspection the home confirmed that the weekly fees ranged from £348 - £431, depending on the assessed needs of the resident. Additional charges are made for services such as chiropody and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the administrator’s office. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, any preinspection questionnaires completed by the Manager and any residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection was unannounced, took place over three hours and consisted of tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Four residents and three care and ancillary staff were spoken with. The deputy manager was present throughout the inspection. What the service does well: What has improved since the last inspection? Several improvements have been made to the environment including a new carpet in the Court and new digital televisions in the Court and the Wing. The dining room in the Court has been moved and now provides a better eating atmosphere for residents. The Flat has new carpet, a refurbished bathroom and new furniture. The Court now has double-glazing; this means that all the windows at Howson Care are now double-glazed. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 7 Part of the Dignity in Care government grant has been used to buy new curtains in double rooms. There is a new stand-aid in the Court and a new swing in the garden for the use of residents. 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. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have sufficient information about whether the home in order to make an informed decision about whether the home is right for them. EVIDENCE: The deputy manager confirmed that she or the manager always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 10 Residents and visitors spoken with had received a welcome pack containing the statement of purpose and service user guide in the form of a brochure, before admission. These were clearly printed and easy to understand; the statement of purpose needed updating to reflect the new wing’s purpose and facilities. Written admission documentation was comprehensive and very clear and gave staff the information they needed to meet the residents’ needs. Terms and conditions and contracts were seen and were up to date; the administrator confirmed that residents received theses on admission to the home. A resident described how she had visited for the day before she was sure she wanted to move in permanently. Records confirmed this and showed that that staff tried to ensure that everyone involved was happy with the arrangements for a long-term stay. A staff member described the admission process and the importance of making new residents and their families welcomed. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service’s records give a clear picture of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 12 The care plans for the three residents selected were clear and easy to understand. There was evidence of residents’ participation, with residents signing care plans where possible, but where this was not possible, no reason was given as to why there was no signature. Reviews took place on a monthly basis and the deputy manager said they were updated more often if there was a need. Records confirmed this. Care plans showed that residents’ health care needs were being met. Visits by doctors and other healthcare professionals were recorded as well as any changes to medication or care needs. The local GP visits every Thursday. There was a clear medication policy and the pharmacist, who last visited on 6/11/07, had no major issues of concern. The deputy manager said that the 2 minor issues had already been addressed. Senior staff members spoken with had received training in safe handling of medication and the deputy manager said there was regular up-date training. Training records confirmed this. Staff members were observed communicating with residents sensitively and with regard for their dignity, allowing them freedom of choice wherever possible; a resident said ‘they’re good, I’ve no complaints at all about them’ and another said ‘they’re very kind’. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of stimulating activities is made available to residents. They have a choice of meals from a balanced and varied menu. EVIDENCE: The home employs an activities co-ordinator and an assistant, who work from Monday to Friday. Regular activities were displayed on the residents’ notice Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 14 board. These included entertainers [one of the entertainers being an ‘Elvis’ and who several residents said they enjoyed]. The programme of activities showed that there was involvement with the community; this included visits from the Salvation Army and the Boy Scouts. Several residents went to the village Friendship Club, which had one of its annual meetings in the home. Several residents spoken with described visits and outings to local pubs, garden centres and coffee shops in the minibus, that has wheelchair access, or an 8-seater car. Future activities included a visit to the Christmas Fair in Gainsborough, a meal at the Newark showground and a pie and pea supper. Regular activities included weekly bingo, exercise class and visits from outside entertainers. Television and books were available and the home had a trolley for residents to make various purchases from, as there was no shop in the village. There is a Snoezelen [light and relaxation room] for the use of residents, which is regularly visited by an aromatherapist. One resident said she regularly went home at weekends and another had regular caravan holidays. The deputy manager said that residents’ meetings had proved to be unsuccessful but that residents were asked informally for their views on a regular basis. It was recommended that where informal meetings were held, they were formally recorded later. Residents spoken with said that they were always consulted about matters concerning the running of the home. Following the last report, one of the dining areas had been changed and the deputy manager said that residents no longer had to wait so long for meals. Menus were balanced and varied, with a daily choice, including a vegetarian choice, and a use of fresh fruit and vegetables. Residents were seen eating and enjoying the mid-day meal. All residents spoken with praised the food; one resident said ‘it’s lovely and if I want more I just have to ask.’ This resident was having an alternative to the main meal. The cook was knowledgeable about the dietary needs of older people and kitchen staff had achieved national qualifications in catering. Staff members were seen assisting residents who needed help with eating; this was done sensitively. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected and safeguarded from harm by robust complaints procedures and by staff training. EVIDENCE: Residents spoken with said they had no wish to complain but would go to their key worker or the manager if they did. One resident said ‘What would I complain about?’ One staff member had a good knowledge of the types of abuse that could occur and the actions she would take if she had any concerns. The complaints records showed that there had been three complaints since the last inspection. One was an objection to the planning consent for the new wing, known as The Laurels, which was granted by the local council. Another relating to the lack of supervision of one resident was not substantiated and a third also regarding lack of supervision is ongoing. Both of these have been referred to Social Services. Procedures for safeguarding adults were comprehensive and had been updated and revised. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 16 Staff members spoken with said they had received training in safeguarding adults, which training records confirmed. The deputy manager said that all staff members had received or were receiving in house training on POVA [protection of vulnerable adults]. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While residents in the Flat, the Wing and the Court live in a largely pleasant and safe environment, the Main House offers accommodation that is basic and lacks a domestic atmosphere. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 18 EVIDENCE: The standard of decoration outside the building was good, with well-tended grounds and areas for residents to sit out or play various outdoor games. Some of the patio and courtyard areas around the main house lacked interest. Internally, the decoration and furnishing standards in The Flat, The Wing and The Court were generally good. Residents said how much they liked their rooms. Rooms seen were well personalised and clean. Some rooms have ensuite facilities and there are four bathrooms and one shower unit. Risk assessments were seen for residents who were at risk of falls or who required aids and adaptations to help their mobility. The Main House was in need of redecoration in several areas and the furniture, and in particular, the dining room tables and chairs, was basic. The flooring, which in most communal areas was linoleum, gave an institutional atmosphere to the area, which was added to by staff constantly having to use keys to open doors. The two bathrooms and the shower room were basic and lacked touches to make them domestic in nature. One lavatory did not have a wash-hand-basin. A shared bedroom in the Main House had no screening to allow dignity or privacy for its occupants. This room lacked any signs of personalisation, such as pictures, photographs or belongings. Furniture was basic and the veneer on a chest of drawers had come off. Because the room was small, a chair was partially blocking the way to the wash-hand-basin. The deputy manager said that the owner was aware of these issues and planned to upgrade the Main House in the near future. The Laurels, which was newly registered in October 2007 had no residents as yet and was therefore not inspected. Gloves and aprons were provided and the home has clear infection control policies. The home was clean and pleasant-smelling throughout. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantities for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: The staff rotas showed that there were usually 9-10 staff members during the day; one in the Flat, three in the Main House, two in the Wing and three to four in the Court. Staff members said they thought they had enough time to complete their tasks and residents confirmed this. As yet, the Laurels was not staffed as there were no residents. In addition to the care staff, the home employed 5 cleaners, a cook and a kitchen assistant, a laundry assistant and a breakfast assistant for the Court. A handyman and two gardeners were employed as and when needed. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 20 Staff mentioned that there were no cleaners at weekends and no laundry assistant. This meant that Mondays were very busy and staff did not have as much time to give residents on these days. Residents spoken with were full of praise for the staff team; one said ‘they’re good - very helpful’ and another visitor said ‘they help us if we need it’. Two staff files were examined; they contained photographs, recruitment procedures, including criminal records and vulnerable adults checks. The deputy manager described how new members of staff were interviewed, gave references, had CRB [Criminal Records Bureau] checks and underwent an induction procedures before starting and a staff member confirmed this. Staff members confirmed that they received regular supervision and appraisals. Training records showed that staff members had received training in protection of vulnerable adults, first aid and infection control. Training in moving and handling, health and safety and fire and safety was planned. Staff members said the training had enabled them to improve the care and support for the residents. Records showed that 15 care staff had achieved the National Vocational Qualification, a nationally recognised qualification, at level 2 and 3 had achieved NVQ at level 3. Five cleaners had achieved NVQ level 2 in housekeeping and two catering staff had NVQ 2 in catering, with one care staff member working towards level 3. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An open style of management helps the home run smoothly; the health, safety and welfare of the residents are promoted. There is no evidence to show that residents are involved in decisions affecting them. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager is a qualified nurse with experience in care home management. She has the registered manager’s award, a professional qualification. The deputy manager, who was present at the inspection, is a registered Mental Nurse, of nine years’ experience, eight of them at this home. The deputy manager said that as yet the home’s quality assurance system was still not in place and questionnaires were still to be sent out. Regular audits, including taking the views of residents and visitors, have not yet been taken. Although residents said that their opinions were asked for on many issues around the running of the home, there was no evidence to support this. Residents and staff members said that the manager was approachable and accessible. Residents’ monies were checked and two residents’ personal monies were found to balance. A visit from Social Services contracting officers two years ago confirmed that the keeping of residents’ monies was acceptable. A random check of maintenance checks showed that boilers were tested last month and hoists two weeks ago. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 23 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 X 2 2 3 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 2 34 X 35 3 36 X 37 X 38 3 Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 24 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 OP19 Regulation 23[2](b) Requirement The registered person must ensure that the Main House is kept in a good state of repair internally. The registered provider must ensure that furnishings in the Main House are domestic of character and of good quality. Where screens are not provided in shared bedrooms, the dignity and privacy of service users must be protected. The registered person must provide hand-washing facilities in lavatories to prevent the spread of infection. The registered person must develop an effective quality assurance and monitoring system based on seeking the views of service users. Timescale for action 16/01/08 2. OP20 16[2](c) 16/01/08 3. OP24 16[2](c) 16/01/08 4. OP26 13[3] 16[2](j) 16/01/08 5. OP33 24 16/01/08 Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 25 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 YA1 Good Practice Recommendations The statement of purpose should be updated to include the information on the facilities and purpose of the new wing, ‘The Laurels’. Where signatures on residents’ care plans cannot be obtained, a reason should be given to demonstrate that all attempts have been made to involve the residents in care planning. Bathrooms should have decorations such as plants, pictures for example, to provide a homely and domestic atmosphere. 2 OP7 3 OP21 Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Howson Care Centre DS0000002539.V354324.R01.S.doc Version 5.2 Page 27 - 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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