Inspection on 07/11/06 for Howson Care Centre

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Howson Care Centre 20/11/08

Howson Care Centre 22/11/07

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 Lincs DN21 3JZ Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 7th November 2006 09:00 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.V318296.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.V318296.R01.S.doc Version 5.2 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 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 65 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (9), Learning disability (9), Mental disorder, of places excluding learning disability or dementia (22), Old age, not falling within any other category (25) Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Dementia (over the age of 65) DE(E) (9) Dementia (DE) (1) Learning Disabilities (LD) (9) Mental Disorder (excluding Learning Disability or Dementia) (MD) (22) Old Age, not falling into any other category (OP) (25) The one DE bed is used for the service user named in the notice of proposal dated 19 July 2005 The maximum number of service users to be accommodated is 65. 2. 3. Date of last inspection 1st February 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 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. The current scale of charges at this home is from £335.00 to £392.00. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by Commission for Social Care Inspection (commission) including the homes previous inspection reports, their service history and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of three resident’s records and assessing their care. The inspector spoke with two of the residents who was being case tracked and joined two other residents for lunch. The inspector also spent time with the manager, the homes administrator and one member of staff. This site visit included a thematic enquiry. This consisted of asking a number of standardised questions to a sample of the residents. This was part of a national pilot scheme. We informed the registered person and sought the agreement of residents in advance of asking the questions about the care they receive. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The manager stated that medication checks are now undertaken on the residents who self administer and signatures are also made of medication given at the correct times. Risk assessments have also been placed in those residents files relating to the possible risk to residents who self medicate. The manager also commented that new dining room chairs had been purchased which allows residents to be transferred from their wheelchairs at meal times. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 6 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.V318296.R01.S.doc Version 5.2 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 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.V318296.R01.S.doc Version 5.2 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. (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): 1, 2, 3 & 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a comprehensive care needs admission assessment, which helps to ensure that a residents needs would be met. This home does not provide intermediate care. Residents are not aware of having a contract or receiving a copy of the provider’s service users guide. EVIDENCE: A review of all information available prior to this inspection, including a previous inspection report dated July 05 and evidence seen at this inspection in Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 9 residents files and care plans, showed that the home does not admit residents without a care needs assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. The commission (Commission for Social Care Inspection) sent resident’s questionnaire forms ‘Have Your Say…’to the home prior to this inspection and twenty-three were returned. Relatives or care staff completed the majority of questionnaires on behalf of residents. Not all questionnaires were fully completed so numbers will not necessarily correspond. Seven residents stated that they had received a contract and twelve stated that they had not received a contact. Twelve questionnaires confirmed that residents had information about the home prior to admission and nine said that they did not have information about the home prior to admission. Resident’s files did not contain service users guides. The manager stated that service users guides are either given to residents or to their relatives. Three resident’s files seen did contain contracts and statement of terms and conditions two of which two were signed and dated by the resident or their representative. Two of the three residents who were being case tracked commented that, they either did not know or did not receive a copy of the homes service users guide. They were also did not know as to whether they had a contract or statement of terms and conditions. Both residents were unaware if their contract had changed whilst living in this home. One of the residents commented that no one came to talk to her prior to admission with another residents confirming that some one did visit her prior to admission. All files had a care needs assessment for those people being case tracked. The manager commented that some of the care needs assessments had been updated and replaced by the homes new format. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 10 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are not involved in their care plans. There is good care planning in this home, which helps ensure that the general health and welfare of residents is addressed. Nursing staff are proficient in administering medication. Residents have not signed their medication risk assessments. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 11 EVIDENCE: An inspection carried out in February 06 found that residents care plans reflected the need to maintain residents independence in their daily lives and to respect the privacy and dignity of residents. Care plans had been evaluated monthly with additional evaluations if the resident’s needs or prescribed care had changed. However, care plans were found not to have empowered residents in respect to ensuring that they signed their care plans or care needs reviews. This needs to be undertaken to ensure that any changes to residents care is jointly agreed between the provider, residents or their representative. One resident stated that ‘care staff are quite good although I could put a bomb under some’. Another resident commented that ‘you would be surprised how good the men are here, they look after you properly and are well mannered’. Those questionnaires completed by residents showed that twenty stated that staff listen and act on what I say and one commented that staff usually listen and act on what I say, with two stating staff do not listen and act on what we say. The local authority made a contract-monitoring visit on the 22/06/06 and found that ‘service users files were examined and on the whole found to be in good order’. Those files seen of residents who were being case tracked showed that their health needs were being met. Visits by doctors and other healthcare professional were recorded as well as any changes to their medication or care needs. The questionnaires returned by residents showed that nine felt that they always receive the medical support that they need and eleven felt that they usually received the medical support that they need, with four feeling that they sometimes receive the medical support that they need. Information received from the provider prior to this inspection showed that the pharmacist inspected the home on the 11/09/06 and recorded that no signatures had been missed on medication sheets. This inspection found that all medication sheets were in order and that risk assessments were in place relating to those who self medicate. However, risk assessments had not been signed by residents to confirm that they agreed with the terms of the risk assessment. Spot checks were also undertaken on all those residents who self medicate. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 12 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 adequate. This judgement has been made using available evidence including a visit to this service. A range of stimulating activities is made available to residents. Resident’s experience of the home matches their expectations and preferences. Meals times are not well managed. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 13 EVIDENCE: Previous inspection found that care plans identified those areas in which residents needed prompts in order to maintain their independence. Risk assessments also identified the risks and level of supervision required for individual residents. One resident commented that she is very independent and that ‘I keep myself to myself’. 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 in-house and community based activities for all residents. Resident’s questionnaire showed that sixteen residents felt that activities are always available and two stated that activities are usually available, four residents commented that they are sometime or never available to them. The local authorities contract-monitoring visit noted that ‘there is a varied activities programme and links are being made within the community to integrate residents where possible’. Two residents stated that they do not do activities with one commenting that that they are available but I am not interested. A resident confirm that she visits her son or daughter on alternate weekends and spends a day with them usually a Sunday. Another resident stated that she goes on at least eight caravans holidays a year and will be going on holiday again to Mablethorpe in eight days time. She also showed the regulator her bedroom and bathroom and stated that ‘I come and go as I please to my room, I have my own television and that’s it’. Residents confirmed that they receive visitors who are made welcome. No visitors were seen during this visit. The inspector joined two residents for lunch and found the meal provided to be hot and well presented. However, residents were seated for twenty-five minutes before the meal was delivered. The manager and care staff on duty were advised of this fact and that this process was institutionalised practice. Comments received from residents during this visit was that ‘some days its alright (meals) and others its right off’, another residents said ‘the food is rubbish’. Resident’s questionnaires showed that thirteen always liked the meals and six usually liked the meals and two sometimes did and one never liked the meals provided. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment in which residents are protected from abuse. The home has a robust complaints procedure, which empowers residents. Not all staff have received safeguarding vulnerable adults training. EVIDENCE: The home’s adult protection policy was in line with current local guidelines. One carer spoken with had a good knowledge of the types of abuse that could occur and the actions that she would take if she had any concerns. The carer confirmed that she had worked for the provider for two years and that she has not undertaken a safeguarding vulnerable adults training course. The Local Authorities Social Services Department has recently undertaken a safeguarding adult protection investigation at this home. The commission has been informed by the Social Services Department that the allegation was not substantiated. All residents spoken to stated that they felt safe, one said ‘ no Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 15 reason not to’ and another commented that ‘I lock myself in, I have a key to my door’. The provider has received three complaints since the last inspection. One complaint was viewed and it was found that a thorough investigation was undertaken with the resident kept informed of progress made. The complaints form evidenced that the resident had signed and dated it confirming her satisfaction with the outcome. Resident’s questionnaires showed that sixteen always know how to make a complaint and seven replied no, this has been taken as they didn’t know how to make a compliant. Thirteen knew who to speak to if they were unhappy, with six usually knowing who to speak to if they were unhappy and four sometimes knew who to speak to if they were unhappy. . Two residents stated that they have not received any written information, which tells them how to make a complaint. Both residents felt that they have all the information they need to raise any concerns about their care. One resident said ‘I would just tell Carol (manager) if anything was wrong’. Another resident said that ‘I would make my own complaint’. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 16 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. One area of the home had an unpleasant smell and the carpet also needs to be replaced. The proprietor has made improvements to the home. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 17 EVIDENCE: Risk assessments were seen relating to those residents who were at risk of falls or who required aids and adaptations thus putting them at risk. Residents stated that they have keys to their doors, which ensures their privacy. One resident commented that ‘they keep this home very clean’. The home employs separate staff for domestic and laundry services. Gloves and aprons are available and the home and were seen to be in use by all staff. The home has an infection control policy. A tour of the home found that the dining room/lounge in the Court had an unpleasant pungent smell, which should be addressed by the homes cleaning procedures. The carpet also needs to be replaced as it is badly stained. The local authority made a contract-monitoring visit and noted that ‘new furniture had been purchased for the older peoples unit and redecoration has taken place to some communal areas’. The residents Questionnaires identified that ten residents felt that the home is fresh and clean, nine residents considered the home is usually fresh and clean with two residents commenting that it is sometimes fresh and clean. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 18 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. Appropriate recruitment practices are in place. Staffing level meets the needs of residents. Staff are trained to carryout their care tasks. EVIDENCE: An inspection carried out in February 06 found that care workers personnel files contained CRB checks (Criminal Record Bureau), references and application forms. All care workers had seen The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. This inspection found that recruitment procedures remain robust. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 19 The last inspection of this home also showed that the rota usually had ten staff on duty during the day with two trained nurses. Information received prior to this inspection showed that staffing ratios were examined at a staff meeting on the 30/09/06. It was felt at this meeting that due to the home having several empty beds that staffing would be eight carers rather than ten. One carer stated that she felt that there were enough staff to see to the needs of residents. Resident’s questionnaires showed that nine felt that they received the support that they need and eleven stated that they usually receive the support that they need. Two residents felt that they sometimes or they never get the support that they need. This information was given to the manager at the time of the inspection. The providers training profile relating to those cares who have undertaken NVQ training evidenced that seventeen staff have either level 2 or level 3. The home exceeds the ratio of 50 of care staff trained to level 2. The manager confirmed that training records are not currently up to date with regard to courses undertaken. The home has ancillary workers, which include; a handy man, two cooks, two kitchen assistance, two part time laundry workers and a hostess who ensures that residents get liquid refreshment throughout the day. The staff rota also showed that there is one trained nurse and five carers on duty during the night. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 20 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. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 21 The registered manager is experienced and trained to manage this establishment. The home is not pro-active in fully involving residents in quality monitoring audits. Resident’s monies are kept safe by the homes financial procedures. Records seen show that resident’s health and general welfare and safety is promoted. 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 managers award. The manager commented that residents meetings are only carried out with those residents who live in the flat. Other residents in other parts of the home are not afforded the opportunity of having residents meetings with relatives possibly taking part. Records were also seen that staff meetings are also carried out in the home. Evidence was seen that the provider has produced a ‘stakeholder survey form’, which has yet to be sent to residents or relatives. The manager confirmed that as yet home has not undertaken audits, which should include the views of residents or visitors. The inspection carried out in February 06 found that the home only deals with personal allowances of residents, which are kept at the home. The administrator was seen and stated that all monies relating to funding are paid into the companies’ bank account on a standing order, direct debit or by check by relatives or the County Council. Some relatives keep residents personal allowances and the home invoices them when further monies are required. Some seventeen residents are able to sign for the personal allowances and lockable facilities are available in their rooms. Residents monies are kept in one lump sum and therefore impossible to check against individual residents accounts. The administrator commented that the home is audited by accountants. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm and fire drills are carried out. The emergency alarm system has not had regular checks although the system was serviced in May 2006, the manager should liaise with the fire service to find out when checks should be made. Staff also receive fire training as part of the homes initial training. Certificates were available showing that gas safety inspections have been carried out, legionella checks, electrical wiring checks, portable electrical equipment checks and that hoists had been service in the last six months. Howson Care Centre DS0000002539.V318296.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 2 2 3 3 4 x 5 x 6 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 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 ENVIRONMENT Standard No Score 19 2 20 x 21 x 22 x 23 x 24 x 25 2 26 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 x 33 2 34 x 35 x 36 x 37 x 38 2 Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 23 yes 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 OP1 Regulation 5. Requirement All residents or their representatives must be given by the provider an up to date service users guide. The provider must ensure that residents or their representatives are given a copy of their contract and the terms and conditions of their stay. The provider must ensure that consultation with residents and relatives is undertaken and that care plans are signed to confirmed agreement on the personal care to be delivered. (The timescale of the 25/03/06 has not been met and a new timescale has been given). Those risk assessments seen of residents who self medicate must be signed by residents to confirm that they agreed with the terms of the risk assessment. The provider must ensure that meals are taken in a congenial setting in which residents are not seated waiting for their food for long periods of time. DS0000002539.V318296.R01.S.doc Timescale for action 25/02/07 2. OP2 5 25/02/07 3. OP7 15 25/02/07 4. OP9 13(2) 23/12/06 5. OP15 16(i) 23/12/06 Howson Care Centre Version 5.2 Page 24 6. OP18 13(6) 7. 8. 12. OP19 OP26 OP33 23(d) 16(k) 12(3) The home must ensure that all workers employed at this home undertake adult protection training. The provider must ensure that carpets, which are stained are cleaned or replaced. The provider must ensure that the home is kept free of offensive odours. The home must carryout quality monitoring audits based on the views of residents and visitors. (The timescale of the 25/03/06 has not been met and a new timescale has been given). 25/03/07 25/02/07 25/12/06 25/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP30 OP38 Good Practice Recommendations The homes training profile needs to be kept up to date listing all training undertaken by care staff. Advice should be sought from the Fire and Safety Service regarding the frequency required for the testing of the homes emergency lighting system. Howson Care Centre DS0000002539.V318296.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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.V318296.R01.S.doc Version 5.2 Page 26 - 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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