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Howson Care Centre Requires improvement

We are carrying out checks at Howson Care Centre. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 February 2017

We inspected Howson Care Centre on 25 October 2016. This was an unannounced inspection. The service provides care and support for up to 83 people. When we undertook our inspection there were 79 people living at the home. This is a large premises which is split into different units to take into consideration the different types of people the provider is registered to provide services for, such as people with mental health problems, physical disabilities and those living with dementia.

People living at the home were of mixed ages. Some people required more assistance either because of physical illnesses, mental health needs or because they were experiencing difficulties coping with everyday tasks, with some having memory loss.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

We found that people’s health care needs were assessed, but care was not planned and delivered in a consistent way through the use of their care plans. People were not involved in the planning of their care. The information and guidance provided to staff in the care plans was unclear. Risks associated with people’s care needs were assessed, but plans were not put in place to minimise risk in order to keep people safe.

The care plans and risk assessments did not fully reflect the needs of people and what action staff should take to prevent a person from being at risk of harm. The clinical governance measures were not robust enough and did not reflect whether lessons had been learnt from audits to measure the quality of the service. You can see what action we told the provider to take at the back of the full version of the report.

People had been consulted about the development of the home. However, the auditing system was poor and there was no analysis of quality checks, or lessons learnt passed on to staff.

You can see what actions we told the provider to take at the back of the full version on the report regarding the review of care plans and ensuring quality checks are more robust.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection there was one person subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period. The home was divided into different units and a core staff worked in each unit, with some staff working across units depending on people’s needs.

People were treated with kindness and respect by the majority of staff. Staff in the home took time to speak with the people they were supporting. However, some staff had a poor attitude to people and did not treat them with respect. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People had a choice of meals, snacks and drinks. Meals could be taken in dining rooms, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it. However, there were no menus on display so people could not remind themselves of the choices they had made.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. On-going training was available for all staff. However, the training sessions for registered nurses was behind schedule.

Areas of the home were in need of repair. Some areas had chipped woodwork and unkempt furnishings. There was a lack of a maintenance plan.

Inspection areas

Safe

Requires improvement

Updated 11 February 2017

The service was not consistently safe.

Checks were not made to ensure the home was a safe place to live.

Sufficient staff were on duty to meet people’s needs.

Staff in the home knew how to recognise and report abuse. However, risk assessment were not always up to date and staff did not ensure people were protected from harm.

Medicines were stored and administered safely.

Effective

Good

Updated 11 February 2017

The service was effective.

Staff ensured people had enough to eat and drink to maintain their health and wellbeing. However, menus were not on display, so people could not be reminded of their choices.

Staff received suitable training and support to enable them to do their job. However, training for registered nurses was behind schedule.

Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity Act 2005 were understood by staff and people’s legal rights protected.

Caring

Requires improvement

Updated 11 February 2017

The service was not consistently caring.

People were relaxed in the company of staff and told us staff were approachable.

People’s needs and wishes were respected by staff.

The majority of staff ensured people’s dignity was maintained at all times. However, some staff showed a lack of respect for people in their attitude and language.

Staff respected people’s needs to maintain as much independence as possible.

Responsive

Requires improvement

Updated 11 February 2017

The service was not consistently responsive.

People’s care was planned, but not reviewed on a regular basis with them. The care plans did not fully explore the needs of people and how other agencies could help them.

Activities were planned into each day and people told us how staff helped them spend their time.

People knew how to make concerns known and felt assured anything raised would be investigated.

Well-led

Requires improvement

Updated 11 February 2017

The service was not consistently well-led.

An analysis of audits was not undertaken to measure the delivery of care, treatment and support given to people against current guidance.

People’s opinions were sought on the services provided and they felt those opinions were valued when asked.

The views of visitors and other health and social care professionals were sought on a regular basis.