Howe Dell Manor

Updated 28 October 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector.

Service and service type

Howe Dell Manor is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Howe Dell Manor is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 11 October 2023 and ended on 20 October 2023. We visited the service on 11 October 2023 and 17 October 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 4 people and also spoke with 7 staff including the registered manager, deputy manager, quality assurance manager and managing director. We received feedback from health and social care professionals. We reviewed a range of records. This included 5 people’s care records and medication records. A variety of records relating to the management of the service were also reviewed. These included training records, incident records and quality assurance processes.

We 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.

Updated 28 October 2023

About the service

Howe Dell Manor is a converted manor house in Hatfield, Hertfordshire that accommodates up to 19 people living with mental health conditions. At the time of this inspection there were 17 people living at the service.

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

There had been improvements since the last inspection. Care plans were now in place to minimise risks and governance systems were widely used more robustly. Some further detail was required in the care records, but this did not detract from the care people received. Overall, we found whilst risk management was more effective, there were still some areas of staff practice that needed to be embedded. The provider had plans in place to address these.

People told us they were happy with the care provided and felt safe living at the service. Risks to people health and welfare were identified and assessed. People’s support needs were met by sufficient numbers of staff who were recruited safely. Infection control was promoted, and medicines were managed well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us staff had the necessary skills to support them. Staff said they felt supported by the management team, enjoyed the training provided and were supported to develop. The provider had recently reviewed their training. A revised and improved training plan was due to be delivered.

People were supported to eat and drink and were able to choose how they spent their time. The provider continually assessed the premises and had an ongoing refurbishment plan in place.

People had access to ample communal areas and extensive grounds which were in use on the day of our visit.

Staff worked with a vast number of health professionals to support people.

People said staff were caring, treated them as an individual and listened to their views and opinions. People’s end of life wishes and preferences were discussed, and staff were trained to support people if this need arose. Complaints were investigated promptly and people told us they could speak up.

The management team were well thought of among staff and people. The provider monitored the quality of care in the service and continued to develop their governance systems to embed this practise. There were meetings and frequent contact with people, relatives and staff to get their views. Feedback was collated and shared and used to improve the service.

Rating at last inspection

The last rating for the service was requires improvement published on 27 July 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.