Care Home: Hovenden House Nursing Home

What the care home does well The people who live at Hovenden House receive good quality, person centred care. Feedback from the residents was very good. They said `we get well looked after, the care staff are all excellent and the food is excellent.` Another said `Its the small things that make a big difference, we get a bath whenever we want, the food is really good and the staff are very kind.` Residents have access to a variety of activities in the home which are facilitated by an activity co-ordinator and a committed group of volunteers. There is a dedicated activity room where residents can do crafts and can use computers. All residents have a person centred care plan which is agreed by the resident or their representative and which is regularly reviewed with the resident. Staff are well trained and supervised. Feedback about the staff was very good. One resident said `I have a lovely care worker who is very kind to me.` Staff said that they feel supported by the managers and receive specialist training in order to be able to meet peoples specialist needs. The service has a robust quality assurance system where the residents are able to make decisions about the running of the home and get involved in local community projects. What has improved since the last inspection? There were no requirements made at the previous inspection however since the last inspection staff have received further training and new policies and procedures have been put into practice following the investigation of two Adult safeguarding Investigations (see complaints and Protection - standard 22 & 23). What the care home could do better: No statutory requirements have been made however a couple of recommendations have been left. Some of the food, fluid and turning charts had not been fully completed by staff, this is essential when monitoring a persons health. Although the manager and two nurses have attended training on the Mental Capacity Act there has not been any reviews of care plans in accordance with this new legislation. Some of the residents expressed a wish to go out more. They said that they cannot always go out as there`s a lack of staffing, particularly bus drivers. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hovenden House Nursing Home Lowgate Fleet Spalding Lincs PE12 8LP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alison Jessop     Date: 1 9 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Hovenden House Nursing Home Lowgate Fleet Spalding Lincs PE12 8LP 01406423037 01406425243 hovendenhouse@lc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Leonard Cheshire Disability care home 32 Number of places (if applicable): Under 65 Over 65 4 physical disability Additional conditions: 28 Condition of registration The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Physical disability (PD) 28 Physical disability over the age of 65 years of age (PD(E) 4 The category PD applies to service users who are under the age of 65 years The maximum number of service users to be accommodated is 32 Date of last inspection Brief description of the care home Hovenden House is a large country house set in extensive landscaped grounds in a rural setting approximately 3 miles from the market town of Holbeach. The home is one of many run by the Leonard Cheshire Foundation. It is approached from a driveway and there are car parking spaces to the front of the home. There are 3 single storey extensions at the rear of the home where there is a garden and patio area designed for physically disabled people. The care home provides nursing and personal care and accommodation for people with a physical disability. All accommodation, which is accessible by disabled people, is on the ground floor. There is also a shaft lift Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home installed which gives access to the first floor. The Leonard Cheshire charter which is outlined in the service users guide states, we believe that each individual person, whatever his or her disability, is a uniquely valuable individual and that people with disabilities should have the personal freedom to pursue their aspirations and take their own place in the world. Transport is available to enable people living the home to access local services in the community. A copy of the Service User Giude and Statement of Purpose can be obtained from the manager. The current fees for accommodation range from £1900 to £600 per week. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted approximately six hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of three people through their records and assessing their care. We spoke to three people who use the service and saw rooms of those people Care Homes for Adults (18-65 years) Page 6 of 27 who said we could and spoke to four staff members. The manager was present throughout the visit and the general outcomes of the visit were discussed with her. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken, ensuring that so far as possible service users needs can be met. Evidence: Prospective residents needs are assessed by a trained person prior to being accepted for accommodation. Information is also gained from various external agencies such as nurses, doctors and speech and language services. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are involved in decision making and their care plan reflects the individuals needs and preferences which allows people to take responsible risks. Evidence: Each resident has a person centred care plan which they have written with the assistance from staff. The plans describe in detail the residents needs, wishes and personal preferences. There is a personal profile which also describes the residents individual choices, skills and interests and preferences on the delivery of their personal care. The care plans are very detailed and have all been agreed by the resident or their representative. Residents spoken to confirmed that they are able to make decisions about their lives and said that their independence is promoted. One resident said i have agreed my care plan and am happy with it, they try to promote our independence. Care Homes for Adults (18-65 years) Page 12 of 27 Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service have the opportunity to participate in a variety of suitable activities and are encouraged to feel part of the wider community. Evidence: The home employs an activity co-ordinator who arranges a programme of activities and outings for the residents. Each resident has a personal calender which is completed when activities are arranged. Residents said that they are given a choice and can make suggestions about what they want to do. On the day of the inspection some of the residents were going out to a pub for a sausage and mash lunch. some of the volunteers were helping the residents make Christmas cards and jewellery. In the afternoon an entertainer visited the home to sing to some of the residents. The manager said that the residents had decided that they would like to find a new entertainer as they wanted some variety, this demonstrated that residents are Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: involved in decision making in the home. One resident said we do lots of activities here. We do ten pin bowling, card making and crafts, tapestry, bingo and sports. Residents are able to participate in the local community and go out to social events on day trips, recently residents have been to Skegness, shopping trips, a trip to the ice show and out to visit the hairdresser. Holy communion is also held in the home on a Thursday. Comments about the food were very positive. One person said the food is excellent, another said the food is really good and we get a good choice. We get to cook meals and do baking in the residents kitchen. Another said we get a cooked breakfast once a month but we would like it more often. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and health care support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home receive good quality care in a way that offers sensitivity and dignity. Evidence: The residents spoken to said they are well cared for. One resident said we get well looked after. Another said the staff are kind and treat us in a dignified way. We get a bath whenever we want. All the residents looked well cared for and were nicely dressed. Care practice observed was carried out in a gentle and sensitive way. Some of the women were dressed up for the outing that day and wore lovely jewellery and nice clothes which reflected their choice of style. Care plans were very detailed and records such as pressure sore prevention and treatment, risk assessments and body maps were completed by staff. Some of the food and fluid charts had gaps where entires had not been made. The visits from GPs nurses, and other specialist services were documented. Where people have specialist issues such as swallowing difficulties, full care plans and risk assessments were in place. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Medication procedures are adequately maintained. One resident self medicates and has a secure storage area in their bedroom. A nurse said we make sure we offer pain relief to a resident who has a pressure sore before we change their dressings to try to prevent them from experiencing any pain. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints and allegations are taken seriously by the management team and action taken to ensure that the residents are safeguarded. Evidence: The manager stated that there has been one complaint received in July 2008. This was responded to within the timescale stated on the complaints procedure. There has been three adult safeguarding investigations. One which is currently being investigated by the police. The details of this cannot currently be disclosed as the investigation has not been concluded. Two other safeguarding alerts were investigated, one which was unsubstantiated and another which was some practice issues that have since been resolved. The manager has taken action and put in place new procedures following all investigations. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, comfortable and clean environment for people to live. Evidence: The home is very spacious with lots of large communal areas for the residents to use. Each residents bedroom has been decorated to personal taste and filled with personal items and furniture. Some of the areas of the decor in the home looks tired however as the service will be relocated in the future it would not be cost effective to spend money on the building at this stage. The residents all said they are happy with the environment and some have lived there for many years. There is a large garden which residents like to use and one resident has a memorial for her deceased husband outside her bedroom window which she can look at and visit. She said staff said that they will move this for me when we move to the new building, which Im very happy about. The activity room provides a dedicated area for residents to do crafts and use the computers. There is also a dedicated smoking room. The home was very clean and staff observe good infection control procedures. No Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: malodours were detected. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained to understand the specialist needs of the residents. Although staffing levels are adequate, more resources would benefit residents to enable them to access the wider community more often. Evidence: When new staff begin employment they receive a skills for care induction and mandatory training such as Moving and Handling, Health and Safety, Infection Control and Safeguarding Adults. Some of the staff have attended specialist training course such as Huntingtons Disease, Understanding Brain Injury, Safer Eating and Effective Communication. The managers have attended a course on Adult Safeguarding for managers and the Mental Capacity Act. The manager stated that there is almost a full staffing team and recruitment is being carried out. The home uses bank staff and occasionally use agency staff. There is a manager, care supervisor, named nurses allocated to specific residents and support workers who have a key working role. One resident said we need more staff in the morning and the afternoons. Another said I would like to go out more but the staff dont have the time, we would like to go Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: out more on the bus. Another said It would be better if we could get more staff, I would like to go out shopping more, we used to go out every week, but now theres no drivers. No evidence could be found that residents personal care and health care needs are not being met by the staffing levels. Two staff recruitment files were inspected. All had been subject to Enhanced Criminal Record Disclosures and employment references prior to working in the home. Staff have signed a declaration that they read and understood the policies and procedures in the staff handbook and all staff have received a copy of the General Social Care Council Code of Conduct. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a robust quality assurance system that ensures the residents views are listened to and acted upon. Evidence: We talked to the manager about the safeguarding issues and she said that she is committed to making sure that the residents are safe. New policies and procedures are in place to prevent further issues. The manager has her Registered Managers Award and attends training courses in order to keep her knowledge up to date. The home has a quality assurance system. Annual surveys are given to residents who are also able to feedback their views through the committee meetings. The meetings are chaired by the residents and minutes are taken by the volunteers. This means that staff are not involved and then the outcome is fed back to the manager. The next meeting is to discuss the menus with the chef. The residents participate in an accessibility project and campaign which looks at the accessibility of public areas. They also wrote to the local council to request for access to a local sports centre. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The home uses external health and safety advisors and an internal audit is carried out by staff. The requirements of the last fire safety inspection have been met with agreements on timescales for the replacement of the sliding bedroom doors. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 19 19 Staff should ensure that they complete health monitoring records such as food and fluid intake charts at all times. Staff need to show evidence and record that the residents mental capacity has been assessed when reviewing their care. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!