Howson Care Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff used a range of deescalation techniques to support people when they became distressed. These interventions were detailed within people’s care records. People sometimes required physical interventions from staff as a last resort to ensure their safety during times of heightened distress. However, assessment processes were not always in place to ensure the most appropriate and least restrictive physical interventions had been identified, agreed and recorded. For example, a person required staff to physically intervene when they became distressed as they posed a risk to themselves and to others. However, their care plan did not state what safe holds should be used by staff or for how long and in what circumstance. This meant the provider could not be assured people were always supported in the least restrictive way possible. We raised this with the registered manager, and they took action to review the use of safe holds for each person.

Personalised care plans and risk assessments were in place to ensure staff had guidance on how to meet people’s daily care needs. National recognised screening tools were used to assess people’s care related needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to assess people who were at risk of malnutrition or losing weight. Most people and their relatives told us they were involved in assessing their care needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Information about people’s wishes and preferences was included in their care documents to ensure that staff understood how to deliver personalised care and support. Care records were completed to support the delivery of evidence-based care and treatment. For example, daily records recorded personal care and evidenced people’s hydration and nutrition. Most people and their relatives spoke positively about the care they received from staff. One person told us, “The staff are very nice to me. They help in every way they can and support me. I am happy here."

The provider worked well across teams and services to support people. They shared their assessment of needs when people moved between different services.

The staff at the service worked as a cohesive team. Communication between staff was effective and handover briefings supported effective service delivery. Events were well organised and community outings facilitated to promote people’s quality of life. Feedback from people and their relatives indicated staff worked together efficiently.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access the healthcare treatment they needed. This included making referrals to specific health and social care practitioners such as Speech and Language Therapists (SaLT) and supporting people to schedule and attend appointments such as medication reviews. This ensured the care and support people received remained appropriate to their needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People were supported to engage in meaningful activities and access their local communities. This promoted people to experience a good quality of life. People and their relatives mostly spoke positively about care staff describing them as “very kind”, “really lovely” and “always easy to speak to.”

Staff were mostly very engaging with people and had developed trusting relationships. We observed some lovely interactions between people and their staff. However, we also noted staff engagement fluctuated between different areas of the service. In particular, within The Main House, people were not always engaged with in a meaningful way during mealtimes. We raised this with the registered manager who said they would increase observations and staff support to ensure better parity of experience for people across all areas of the service. Despite this, people in other areas of the service mostly experienced positive mealtime experiences and friendly engagement from staff.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the need to gain consent and were able to demonstrate this through their engagement with people. People indicated they had control over daily choices that mattered to them. Where people lacked the capacity to make choices and provide consent, decision specific mental capacity assessments were in place.