Inspection on 04/07/05 for Howson Care Centre

This inspection was carried out on 4th July 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

Howson Care Centre 20/11/08

Howson Care Centre 22/11/07

Howson Care Centre 07/11/06

Howson Care Centre 01/02/06

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 Lincs DN21 3JZ Lead Inspector Wilma Crawford Unannounced 04 July 2005 09:30 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 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 C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Howson Care Centre Address Willingham By Stow Gainsborough Lincs DN21 3JZ 01427 788283 01427 787567 Telephone number Fax number Email 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 Carol Anne Horne Care home with nursing 65 Category(ies) of MD Mental Disorder (22) registration, with number LD Learning disability (9) of places OP Old age (25) DE(E) Dementia - over 65 (9) Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 22 February 2005 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 to service users who have a Learning Disability, who are working towards supported living placements. “The Main House”, provides services to people with Mental Health problems. “The Wing” provides accommodation to people with a Learning Disability. “The Court” provides both nursing and residential services to older people. Each unit is selfcontained with its own kitchen, bathroom and lounge/ dining facilities.The kitchen in the main house area provides all meals and drinks and snacks can be prepared in the 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. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out by two inspectors between 09.30 am and 2 pm. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff the manager and observations of care practice. Discussions with the manager, two care staff and two residents took place. A partial tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: To ensure the home is safe and the people living there are protected, staff must be recruited correctly and records must be available to demonstrate this. Any new employees must not work in the home until two satisfactory references, criminal records bureau or Povafirst check have been obtained. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 7 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 Standards 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 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 8 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. 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. Prospective service users have an opportunity to “test drive” the home. 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 to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, The home has a satisfactory assessment process in place to ensure that it can meet the needs of the people admitted to the home. EVIDENCE: Records contained detailed needs assessments, these had been completed prior to the resident being admitted to the home. Staff and residents confirmed that assessments had taken place prior to planned admissions. Files seen showed that one resident had been written to confirming that the home could meet their individual needs Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,8 Care plans identified all areas of need and provided detailed care instructions for staff. Input from outside agencies was fully documented in care plans. EVIDENCE: Each service user has an individual plan, which contains information relating to their care needs. Information provided included completed nutritional assessment and pressure risk assessments and where individuals were at risk Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 10 of developing pressure damage. Individual residents medical conditions and personal likes and dislikes were also documented. Care plans had been evaluated monthly with additional evaluations if the resident’s needs or prescribed care had changed. Residents’ health needs were being met. Visits by doctors and other health professional visits were recorded in residents files. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 There are excellent educational and leisure opportunities for residents with learning disabilities and mental health difficulties, which ensure that independent living skills are developed. EVIDENCE: The home employs an activities co-ordinator, whose role is to explore educational opportunities that may be available locally and to provide a range of home and community based activities for residents. A number of residents have educational placements. Residents gave numerous examples of community activities that they take part in and said that they are able to choose how to spend their time, and who with. They also gave examples of safeguards that are in place to ensure that they are safe whilst out in the community, and comprehensive risk assessments are in place. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 12 Two residents seen during this inspection commented that their visitors are always made welcome in the home and refreshments are made available. The homes signing in book was seen and showed that visitors attend this home in numbers at various times of the day. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 13 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’ legal rights are protected. Service users are protected from abuse. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Robust procedures for handling allegations of adult abuse contribute to the protection of service users, and staff were clear on the action to take in the event of this occurring. EVIDENCE: The home’s adult protection policy was in line with current local guidelines. Staff spoken with had a good knowledge of the types of abuse that could occur and the actions that they must take if they had any concerns. Staff said that adult protection training had taken place and completion of this had been recorded in training files. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 14 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 have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23,24,26 The standard of the environment had greatly improved during the last year. Residents living at the home live in a clean, comfortable and homely environment. EVIDENCE: A major refurbishment and redecoration programme has been completed during the last year. This has included the building of a new conservatory, installation of air conditioning units, fitting of radiator covers, installation of new doors to provide locks to bedrooms in “The Main house”,(locks are fitted to bedroom doors in all other areas), redecoration of bedrooms and bathrooms, fitting of new flooring and carpets, purchase of new bedding and furnishings. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 15 A decked area is being created off “the Court” and a Peacock garden for residents use. A training /meeting room has also been created for staff use. People who were spoken with said that they were very happy with the refurbishment of the home. Residents said that they liked their rooms and felt that they had everything they wanted. The home was clean and tidy with no offensive odours. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Adequate staffing levels are provided. The procedures for recruitment of staff are not robust and need to be reviewed to ensure that residents are protected. Additional training is required to ensure staff can meet all the needs of the residents EVIDENCE: Four staff files were examined and found to be incomplete, one did have a Pova first check record and two of the others had only one reference. To ensure the home is safe and the people living there are protected, staff must be recruited correctly and records must be available to demonstrate this. Staff duty rotas demonstrated that the home was providing adequate staffing levels. Two nurses and 9 carers are on duty during the day and at night one nurse with 5 care staff care for the 65 residents currently living at the home. A handover period to ensure that all relevant information is passed on, is in place. Staff said that they felt that there were enough staff to care for residents. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 17 Documented induction training had been provided to new starters, and staff comments confirmed that training had been provided, this included; adult protection, manual handling and fire safety. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 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 and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 The manager and regular visits by the owner, ensure there is sufficient leadership, guidance and direction to staff to ensure residents receive consistent quality care. EVIDENCE: The manager is registered with the Commission. Mrs Horne is a qualified nurse with experience in care home management. She is currently working towards her registered manger award. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 19 Residents and staff said that they found Mr Howson and Mrs Horne approachable and available to discuss any issues. Mr Howson visits the home regularly and provides support to Mrs Horne. At a previous inspection Mr Howson was required to complete a monthly report detailing his findings at the home, these reports are now being completed. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 N/A 2 N/A 3 3 4 N/A 5 N/A 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score N/A N/A N/A N/A 3 3 N/A 3 Score Standard No 7 8 9 10 11 Score 3 3 N/A N/A N/A Standard No 27 28 29 30 3 N/A 3 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 N/A 15 N/A COMPLAINTS AND PROTECTION Standard No 16 17 18 Score N/A N/A 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 N/A 34 N/A 35 N/A 36 N/A 37 N/A 38 N/A Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 21 No 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 OP29 YA34 Regulation 18 Requirement The registered manager must not employ staff to work in the care home unless she has obtained all regulatory information including CRB, Pova first checks and two written references. Timescale for action July 4th 2005 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 YA8 OP11 Good Practice Recommendations Residents be given the opportunity to meet regularly with the chef to provide suggestions towards planning menus. Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Unity House, The Point Weaver Road off Whisby Road Lincoln, LN6 3QN 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 Howson Care Centre C53-C04 S2539 HowsonCareCentre V235826 040705 Stage 4.doc Version 1.20 Page 23 - 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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