Howards Residential Home

Updated 31 July 2018

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, 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 31 May and 2 June 2018 and was unannounced. It was a comprehensive inspection.

The inspection team consisted of a lead inspector, an inspection manager and an expert-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. This expert had experience of dementia care.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We reviewed information from notifications of significant events such as serious injury of safeguarding referrals. They contain important information which the provider is required to give us by law.

Over the two days of the inspection, we spoke to 11 people, three relatives, a district nurse, the registered manager and her deputy, two carers, one staff member in the kitchen and the activities coordinator. We looked at four care plans. We reviewed quality audits, staff training and supervision records, recruitment records, medicines records, complaints records, accidents and incidents, activity plans and menus. We observed staff interaction with people in communal areas including the lunchtime meals.

Updated 31 July 2018

Howards Residential Home is a residential care home that provides accommodation and personal care for up to 20 people some living with dementia. The inspection was carried out over two days, the 31 May and the 12 June. Both were unannounced. The service had 19 people using the service on the first day of the inspection and 17 on the second day.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

Staff knew how to keep people safe and there was a sufficient number to meet people’s needs. People’s risks were assessed and measures were put into place to protect people from harm while respecting their freedom of choice. The home was clean. Policies and procedures meant that medicines were managed safely apart from the lack of PRN protocols which has since been addressed.

Staff considered people’s individual needs. Staff were trained to deliver the care needed. Staff had sound knowledge of legislation and guidance relating to consent and decision-making requirements. The home’s design and decoration met the needs of the people living there. People were supported to maintain a balanced diet and have plenty to drink. People had access to healthcare and staff liaised with healthcare professionals.

Staff were caring and respectful of people and their needs. Staff genuinely appeared to enjoy working for the service. People were cared for in a homely environment. Staff knew people well and interacted with everyone in a friendly caring manner. There was good communication with families who were made to feel welcome and contributed to care planning where people did not have the capacity to do so for themselves.

Staff took time to find out about people as individuals. Activities considered people’s interests and hobbies and helped to reduce social isolation. Relatives and people could freely express concerns knowing that they would be listened to and action would be taken. There was great sensitivity around end of life care and people were enabled to express their wishes about how they would like to be cared for at the end of their life.

The registered manager nurtured an open culture in the service, while they provided a good level of support to staff. Good communication was facilitated by meetings and by the registered manager’s availability and approachability. The registered manager continually looked for ways to improve the service and sought the advice of other professionals when needed. The registered manager understood her managerial responsibilities and the legal requirements were met.

Further information is in the detailed findings below