Howard Lodge Care Centre

Updated 21 February 2020

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors, and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Howard Lodge Home 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.

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.

Notice of inspection

This inspection was unannounced and was carried out on 28 October 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who worked with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with ten people who used the service and ten relatives about their experience of the care provided. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, deputy manager, activities staff, one volunteer plus seven care staff. We reviewed a range of records. This included four people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training records and policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted four health and social care professionals who regularly worked with the service for their feedback.

Updated 21 February 2020

About the service

Howard Lodge provides accommodation with personal and nursing care for older people, some of whom may be living with dementia. Howard Lodge accommodates 72 people across four separate units, known as hamlets, each of which has separate adapted facilities. At the time of the inspection 71 people were using the service.

People’s experience of using this service and what we found

Feedback from people and relatives about their experience of using the service was universally positive. This was summed up by one relative who told us, “I have nothing but praise for this home. The quality of leadership and togetherness of staff, their genuine caring nature, all of this stands out.” This sentiment was echoed by everyone we spoke with.

The provider and registered manager demonstrated exceptional leadership and lead by example, promoting a highly caring and person-centred ethos where people’s needs and wishes were placed at the heart of the service. Consequently, the culture within the service was extremely positive. Staff felt listened to and valued, and worked very well together as a cohesive and supportive team.

The level of engagement with people, their relatives and the staff team was excellent. The service listened to people and actively sought feedback to ensure people, relatives and staff were fully included in how the service was run

Staff morale was high and staff told us they loved their jobs. This benefitted people who were supported by a happy, stable workforce who knew them very well. The positive impact of this was summed up by a relative who told us, “Carers walk around with smiles on their faces. That’s a great lift for everyone.”

We were provided with numerous examples of the kind and caring nature of staff and how the service went the extra mile to meet people’s needs and aspirations. Family members told us there was a positive atmosphere at the service and people were encouraged and supported to take part in a range of stimulating and meaningful activities.

The service demonstrated a commitment to providing opportunities for people to continue to do things they had previously enjoyed or try new things. Best practice guidance was consistently applied to support people with dementia to have opportunities for meaningful engagement.

The provider had invested in time and resources to ensure the building and gardens were attractive and well maintained and met the individual needs of the people who lived there. Careful consideration had been given to ensuring the environment was ‘dementia-friendly’, providing lots of opportunities for stimulation, exploration and reminiscence.

The service had been recognised and won awards for its level of community engagement. Strong links with the community had been forged which provided people with opportunities to feel like valued members of their community and promote their social inclusion.

The provider demonstrated a strong commitment to providing excellent end of life care which considered the support needs of people, their relatives and staff. When people died, care and attention was given to remembering and celebrating their lives with their relatives and staff.

The training staff received was of a very good quality and staff were encouraged to continuously develop their skills and knowledge. People were supported to have as much choice and control over their lives and were supported in the least restrictive way possible. Policies and systems in the service support this practice.

The safety and quality of the service was monitored and assessed consistently. Regular audits on all aspects of the service were completed and improvements were made when needed. The service was creative and innovative looking at different ways they could continuously improve the service and ensure positive outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection. The last rating for this service was Good (April 2017)

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

We were made aware of a notification of a specific incident. Following which a person using the service died. This incident is currently subject to investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the unsafe management of medicines. This inspection examined those risks. We found no evidence during this inspection that people were at risk of harm from this concern, and this had been an isolated incident.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.