Howson Care Centre

Updated 4 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two inspectors, a medicines inspector and a specialist advisor (SPA). The SPA had expertise in nursing care.

Service and service type:

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. However, the registered manager was absent from their post and an acting manager was overseeing the service.

Notice of inspection:

This was a comprehensive service inspection and was unannounced. We inspected the service on 30 January 2019.

What we did:

Prior to the inspection we examined information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about.

The provider had completed a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report

During the inspection we spoke with five people who lived at the service, one relative, four members of care staff, two nurses, the provider, the acting deputy manager and the acting manager. We also looked at six care records in detail and records that related to how the service was managed including staffing, training, medicines and quality assurance.

Updated 4 April 2019

About the service: Howson Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It provides accommodation for people living with a learning disability and/or with mental health conditions or dementia. The home can accommodate up to 83 people. The home is divided into six units. The units are, The Court, The Main House, The Wing, The Laurels, The Flat and The Bungalow. At the time of our inspection there were 79 people living in the home.

People’s experience of using this service:

There was a system in place to support managers to carry out quality checks. The acting manager had started to carry these out on a regular basis, however these checks had not been in place long enough to understand the impact these would have on the service.

Medicines were managed safely. Arrangements were in place to monitor and manage medicines safely.

Staff told us that there was usually sufficient staff but that some units had more difficulty than others in ensuring there was sufficient staff.

People enjoyed the meals and their dietary needs had been catered for. This information was detailed in people’s care plans.

Staff followed guidance provided to manage people's nutrition and pressure care.

The care plans had been reviewed and contained information about people and their care needs.

Staff had not consistently received training to support their role, however plans were now in place to address this.

Staff had started to receive regular supervision and plans were in place to ensure people received this on a regular basis.

People had good health care support from professionals. When people were unwell, staff had raised the concern and taken action with health professionals to address their health care needs. The provider and staff worked in partnership with health and care professionals.

Staff were aware of people's life history and preferences and they used this information to develop positive relationships and deliver person centred care. People felt well cared for by staff who treated them with respect and dignity.

There was a range of activities on offer. The acting manager was looking at how they could develop this area further.

The environment in the Court was not adapted to support people living with dementia. However, a refurbishment plan was in place to address this.

The provider had displayed the latest rating at the home and on their website. When required notifications had been completed to inform us of events and incidents.

More information is in the detailed findings below.

Rating at last inspection: Requires Improvement (Report Published 30 July 2018). At our previous inspection in May 2018 the service was rated overall requires improvement. We found continued breaches of Regulation 17 and 12 HSCA 2008 (Regulated Activities) Regulations 2010 and a breach of Regulation 18 Registration Regulations 2009, the provider had failed to inform us of accidents and incidents.

At this inspection we found the regulations were being met. There were improvements in the management of medicines and quality monitoring systems. However, these improvements had not fully taken effect because they had only recently been introduced. We have taken this into account in determining the rating.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: Arrangements are already in place for the provider to provide regular monitoring reports. We will continue to receive these and continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.