Inspection on 07/07/05 for Honey Lane Care Home

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Honey Lane Care Home 28/01/09

Honey Lane Care Home 01/08/07

Honey Lane Care Home 24/08/06

Honey Lane Care Home 08/02/06

Honey Lane Care Home 14/12/04

Honey Lane Care Home 13/07/04

Honey Lane Care Home 07/01/04

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Claremont House

Oak Ridge

Sun Court Nursing Home

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Honey Lane Care Home Honey Lane Waltham Abbey Essex EN9 3BA Lead Inspector Lysette Butler Unannounced Thursday 7th July2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Honey Lane Care Home Address Honey Lane Waltham Abbey Essex EN9 3BA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01992 718558 01992 653463 Towertrend Limited Mrs Jennifer Jane Fuller Care Home 41 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (41), Old age, not falling within any other of places category (8) Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 8 persons) 2 Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 41 persons) 3 One person, under the age of 65 years, who requires care by reason of dementia, whose name was made known to the Commission in October 2003 4 The total number of service users accommodated must not exceed 41 persons Date of last inspection 14 December 2004 Brief Description of the Service: Honey Lane Care Home is a 2-storey purpose built home providing care for persons, of both sexes, over the age of 65. The service users’ rooms and communal areas are entirely situated on the ground floor with offices on the 1st floor. The home is divided in to four separate ‘wings’. There are 41 beds: 32 beds for service users who have dementia; one service user with dementia who is under 65 years of age; 8 for service users who need residential care only. (There had been no further decrease in the number of residential care beds since the last inspection.) This home does not offer nursing care. The home is located about 2 miles from the centre and main shopping area of Waltham Abbey, which is an Essex market town. It is on a main bus route and there is good access by road as the home is in close proximity to the M25. The home is part of a larger care group called Carebase. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took six hours on one day in July 2005. Twenty-six of the thirty-eight National Minimum Standards were inspected during this visit. It was found that many of the standards had been met or partially met. The overall care and well being of the residents was very good; staff and residents were welcoming and happy to speak to the inspector. A new manager and administrator had started at the home since the last inspection following the promotion of the previous manager. During this visit the inspector spoke to three residents; three relatives/ visitors; nine staff members including the administrator; one of the housekeeping staff; the cook; one of the activities coordinators; and five care assistants. The inspector also spent time with the new acting manager and the area manager for Carebase. Residents and their relatives expressed satisfaction with the care they received and with the quality of the food offered. What the service does well: What has improved since the last inspection? What they could do better: Residents’ care files need to contain details of the residents/relatives wishes regarding terminal care/ funeral arrangements. Daily progress note sheets need to be redesigned to enable care assistants to expand the care evaluations. Activity evaluations still need further improvement. Individual resident documentation often still remains unsigned, named or dated and needs to be improved. Improved filing for documentation required for regulatory requirements is needed. Please contact the provider for advice of actions taken in response to this Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 & 6. The information supplied to prospective residents and their families to enable them to make the right choice of home was good. EVIDENCE: Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 9 The Statement of Purpose and Service User Guide had last been reviewed in June 2005; the name of the new manager and administrator had been added. The Statement of Purpose, Service Users Guide and the latest inspection report was kept in the reception area of the home. There was also a copy of the National Minimum Standards and Care Standards Regulations available in the reception area of this home. The contract remained as last year and contained all the elements required in the national minimum standards. All the residents, or their representatives, had a copy of the contract. There was a copy of the contract in the service user files and social services had a copy if they were funding the resident. The new acting manager continued to use three different needs assessment forms when visiting prospective residents, so that she was enabled to gain a holistic view of them. She was also using the social services COM 5; information acquired by speaking to staff where the resident was admitted and the relatives of the prospective resident. The manager was taking one of the senior care assistants on assessment visits. The new manager demonstrated an understanding of her responsibilities in relation to needs assessment and the current resident group. Staff training was linked to the needs of the residents and all staff were regularly updated on dementia care. There was a low turnover of staff so updating was easy to follow up. Individual life histories ‘scrapbooks’ were continuing to be compiled for the residents. Short-term trial visits were not generally offered, as this often increases the prospective residents disorientation. Families are welcome to view the home if they wish to. A prospective resident very occasionally goes to the home for lunch with their relatives, explained as lunch out for them and the family. All residents are however admitted on a one-month trial basis. The home has a constant waiting list and therefore does not accept emergency or respite admissions. Intermediate care was not offered in this home. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 All indicators examined during this inspection suggested that the service users health and personal care needs were very well catered for. EVIDENCE: Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 11 Care planning had generally improved since the last inspection. Four care plans were reviewed during this inspection. They had been reviewed regularly and there was evidence of changes being made as appropriate on the plan itself. One had been completely rewritten as their needs had changed considerably. The resident or their representative had signed the four plans checked. Daily progress notes were brief, generally because of the design of the documentation used. The inspector and manager discussed changing the layout to allow for more detail to be included. Not all care plans reviewed contained information regarding end of life and funeral instructions. Residents were given access to all medical professionals needed, or requested. Due to the dementia of the majority of the residents at this home, many of the health care services were supplied within the home. The home continued to have a weekly consultant ‘surgery’ in the home and emergency admissions to hospital remained low. However on the inspectors’ arrival at the home a resident had just had a fall due to generalised weakness following a short period of illness. The staff handled the situation very well and the resident went to hospital by ambulance within a short period of time. The falls coordinator continued to visit the home on a regular basis. Since the last inspection there had been no change in any of their pressure sore prevention procedures. There were no individuals with pressure sores at the time of this inspection. At the time of this inspection all the residents looked healthy and well cared for. Since the last inspection the home had experienced an outbreak of influenza that affected both the residents and the staff; the management and staff handled the outbreak very well. The medication policies & procedures were detailed and clear. No service users were self-administering their medications at the time of this inspection. Each resident file contained a completed risk assessment form regarding medications. All medication administration records were checked and were correct. The local dispensing pharmacist carried out regular pharmacy audits. All senior care assistants were all undertaking an advanced medications course through a local college. The consultant reviews the residents’ medication and signs the medication administration records when he sees the original residents. There were no controlled drugs in the home at the time of this inspection. All observed interactions between staff and service users, demonstrated a commitment to protect the privacy and dignity of the service users. Service users and relatives stated that staff were friendly, approachable and helpful. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 Activities were varied and well planned for the needs of the residents in this home. EVIDENCE: The regular coordinator was on annual leave at the time of this inspection but a bank coordinator was in and interacted well with the residents and staff. One of the care assistants also does ten hours a week activities, which she is very enthusiastic about. She concentrated her activities time on completing the life histories of the residents, which are very good to help concentrate the time staff spent with residents on them as individuals. A weekly plan of activities was on all the notice boards throughout the home. Activities documentation was slightly improved but needs to be advanced further. Evaluations tend to be very brief. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents in this home were protected from abuse. EVIDENCE: The protection and rights of the residents’ was observed to be inherent in the way the staff acted. There had been no Protection of Vulnerable Adults incidents in this home since the last inspection. Protection procedures were good throughout the home. The inspector discussed the managers’ role and responsibilities regarding Protection of Vulnerable Adults procedures with the new manager. The home had is’ own copy of the Department of Health document ‘No Secrets’. All staff had received a copy of the Essex Protection of Vulnerable Adults booklet. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 & 26. The overall environment was homely, clean and comfortable. EVIDENCE: Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 15 There have not been any changes made to the fabric of the building since the last inspection. The overall décor was good and there was evidence of ongoing decoration/maintenance taking place. There is a full time maintenance person in post who undertakes all the work within the home and grounds. All garden areas were now secure. At the time of this inspection the home was clean, light and airy. There were moderate malodours throughout the home on arrival of the inspector, (08.30 AM) however this had been rectified by the end of this visit. There was gel hand cleaner in the entrance that all visitors were asked to use. An occupational therapy assessment of the home had been undertaken in October 2004. All recommendations had been instigated. Communal areas were accessible by all residents and each unit was entered via a keypad-coded door. CCTV was in use on the outside of the building only. All en-suite’s had non-slip flooring and shared rooms all had floor length opaque privacy screening. The laundry was clean and tidy. The working systems were in line with infection control polices. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Recruitment procedures undertaken ensured that service users were protected from abuse. EVIDENCE: Staffing levels were adequate at this home with an even balance of care and ancillary staff. Agency staff numbers were very low with permanent staff covering the majority of additional shifts. Four personnel files were reviewed during this visit. There had been a general improvement in the layout and content of all the files reviewed. Supervision notes were kept in a separate file. Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 37 & 38. The management and administration procedures in the home protected the resident s rights and ensured good care. EVIDENCE: Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 18 The new manager had only been in post for nine weeks at the time of this inspection and had not yet applied for registration with the Commission for Social Care Inspection. The general ethos in the home was good. Staff told the inspector that they found the new manager approachable and easy to talk to. They respected her and her open management style. They were happy working at the home and felt supported. The new manager has met with the residents, staff and visitors, either individually or in groups. Supervision was up-to-date and staff felt that the sessions were useful especially if there had a particularly difficult problem within the home. Appraisals were carried out yearly and copies were present in some of the files checked. The manager carried out supervision for the senior care assistants; they in turn carried out the care assistants’ supervision. The filing and management documentation in the home was in disarray since the last administrator had left. The current administrator and manager were working together to improve the situation. Filing was an issue at the time of this inspection. All insurances, servicing and certificates checked were valid. Overall the care and atmosphere in the home was good Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 3 x x x 3 2 3 Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 12(2) Requirement All esidents care plans must contain information regarding end of life and funeral instructions. (New form supplied with action plan.) Timescale for action 31st August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 12 Good Practice Recommendations Daily progress sheets should be redesigned to allow for as much comment as needed. (Newly designed form supplied with action plan.) The registered manager should ensure that all activities offered to the service users are properly evaluated and documented. (This is a repeat recommendation. Newly designed form supplied with action plan, to improve documentation.) All documentation should be named, signed and dated. All records required by regulation must be filed approriately and easy to follow. 3. 4. 37 37 Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester, Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Honey Lane Care Home I56-I05 S37535 Honey Lane V235851 070705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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