Archived: Houndswood House Care Home

Updated 25 February 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2014 and to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 January 2016 and was carried out by two inspectors. The inspection was unannounced and had been brought forward in response to concerns received at the CQC. Before our inspection we reviewed information we held about the service including statutory notifications relating to the service. Statutory notifications include information about important events which the provider is required to send us.

During the inspection we spoke with four people who lived at the service, four relatives, a visiting health care professional, four members of staff, the deputy manager and registered manager. We received feedback from health and social care professionals who visited the home. We viewed six people’s support plans and looked at safeguarding records, monitoring records and audits, cleaning schedules and accident/incident records. We observed staff interactions with people and saw how care was provided to people.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us due to complex health needs.

Updated 25 February 2016

This inspection was carried out on the 7 January 2016 and was unannounced. It was a focussed inspection in response to concerns we had received about the standards of care at the home. The concerns related to poor care and a lack of appropriate response to people’s health needs. We considered the information and concerns and concluded that we should focus on two of the key questions: Is the service safe? Is the service well-led?

Houndswood House provides accommodation for up to 50 people who require nursing and personal care, including people living with dementia. There are two separate units in the home, Magnolia Lodge for people living with dementia and Primrose House for people who require nursing care. At the time of our inspection there were 43 people living at the home.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

CQC had received information relating to five recent safeguarding concerns at the home. However these had not been reported to us by the provider and therefore we had not been informed in a timely way and this had delayed our involvement and response to the concerns.

Most people looked groomed and it was evident that they had been assisted with personal care. Some of the people who lived at Houndswood house were sitting around in various lounges and other people were being assisted to get ready for the day or had chosen to stay in their bedrooms.

We observed staff to be caring in their approach to people. Feedback from four relatives was extremely positive and complimentary and relatives raised no concerns about the standards of care. Relatives in particular were complimentary about the staff. One relative told us “I have always been happy with the care my ‘Relative’ has received. Another told us “My ‘relative’ likes it here and if they are happy, so am I” They went on to say “The staff are wonderful”.

We noted that records and paperwork was not always consistent and not always kept up to date. For example records relating to fluid intake, weight monitoring and ‘must’ scores were not always maintained accurately and the registered manager was arranging a staff meeting to address this imminently.

The home was due to be refurbished at the end of 2015; however the registered manager told us the refurbishment had been put on hold for approximately 9 months. This was a decision taken by senior managers and the registered manager did not know why the refurbishment had been put on hold.

We noted storage of equipment was an area of concern, and this was referred to the manager to address, as we observed this to be a hazard.

We saw that people’s daily care file records were located in the doorways or on window sills in the corridors, therefore not protecting or maintaining people’s privacy/confidentiality.

The manager told us they were short staffed and this meant that they and the deputy manager had to cover some of the nurse shifts. This impacted on their ability to concentrate on the ‘management type issues’ and they told us they were often behind with completing paperwork and other tasks.

The ‘call bell system’ was not working correctly apart from to alert staff that people needed help The time and date settings were found to be incorrect and no records or historic data were available. So they could not be monitored effectively.

Medicines were found to be administered safely by staff who had been trained. Staff competency was checked and medicines were only administered by the nurses.

Staff were able to demonstrate they understood fully the safeguarding procedure, what constituted a concern, how to report concerns and how to escalate these if required.

The registered manager had systems in place to monitor the quality of the service. However these were not always effective in identifying issues or concerns or in putting timely remedial actions in place.